Annals of Health Law
STRATEGY AGAINST SMOKING
eliminate the expenditures caused by tobacco-related health problems.
Since there is no indication that the current tobacco control strategies will
significantly reduce the present number of smokers in the United States, not
to mention the rising numbers in low- and middle-income countries,
tobacco-related health expenditures would remain at a high level for
decades to come. Therefore, it is justified to assume that providing a
considerable amount153 of money to pay people to refrain from smoking is a
desirable, efficient investment from an economical perspective – again
under the above-mentioned presumption and provided that the incentivizing
strategy is successful. Additionally, non-smokers would profit in the long
run from such a development because the part of the health care budget
currently reserved for smoking-related diseases, which they contribute to by
paying taxes, could be spent in other areas more beneficial for them.
III. A NOVEL REGULATORY MODEL
Based upon the foregoing findings this section will develop a regulatory
approach to significantly reduce tobacco use, particularly among people of
low socioeconomic status, by providing economic incentives for non-
initiation and cessation. Subdivided into measures against smoking
initiation and for smoking cessation, the following will outline the
regulatory model and for each subdivision explain the underlying
considerations from a behavioral economics standpoint and develop a
concept for review and verification of smoking status. Finally, the paper
will point out possible funding options and discuss the model’s potential
applicability to low- and middle-income countries.
Both tangibility and easy accessibility are of crucial importance for a
successful implementation. In addition, the concept relies on the present
tobacco control strategies in place. The availability of professional advice
and nicotine addiction treatment is an especially necessary supplement to
the suggested model.
A. Incentives Against Smoking Initiation
The core of the suggested new model against smoking initiation is a
weekly lottery. Everyone between the ages of ten and twenty-five years,
who has not smoked in the previous four weeks shall be eligible. However,
people older than twenty-two years will not be eligible for entering the
program for the first time as the model seeks to reward a long-time
abstinence from smoking until the age of twenty-five. The time between ten
153. Evidentially, it is particularly difficult to determine the precise sum that would
constitute the most efficient allocation of resources as this has to be based on estimates,
predicted outcomes and developments and shall therefore not be attempted within this paper.