Annals of Health Law
STRATEGY AGAINST SMOKING
cessation to use their own funds to increase the potential rewards232 will
also contribute to the financing.
The suggested model is designed to render itself dispensable in the long
term. Ideally, the model will contribute to a substantial reduction of the
number of smokers and a further expulsion of smoking from public and
private life, making it more and more socially unacceptable. It may even
lead to a point where the complete ban of smoking is a realizable and
desirable undertaking. In any case, if the risk of becoming a smoker
decreases, the incentives for non-initiation can be reduced and if the total
number of smokers drops, the need for cessation incentives also diminishes.
Both would substantially lower the demand for funding.
D. Applicability to Low- and Middle-Income Countries
While the design of the suggested incentive structure can be readily
applied in low- and middle-income countries by customizing the different
groups in accordance with the characteristics, the review and verification
process needs to be adjusted. Of course, it is of crucial importance that the
smoking status can be reliably verified before the distribution of rewards. In
various aspects, this poses difficulties for countries with less sophisticated
and less powerful administrative and law enforcement bodies. The
deterrence by a potential criminal liability233 naturally decreases with the
probability of being caught, leading to a greater willingness to attempt
fraud. As the suggested mechanism to control cigarette sales and
purchases234 will likely not be feasible, the process’ success will almost
entirely depend on the biochemical tests235 Here, problems might arise due
to limited personal resources, wider reliance on the private sector, less
structured short notice availability of participants for testing, the higher risk
of corruption, or the relatively higher costs of cotinine tests. However, the
program should still be able to reach a considerable number of participants,
particularly children and adolescents, through schools, universities and
public institutions. One further concern is that the model’s application, at
least in relative terms, will be significantly more expensive due to the much
higher, and still raising, percentage of smoking adults in low-income
countries and middle-income countries.
See supra Part III. B.
See supra Part III. A. 2.c.
See supra Part III. A. 2.b and III. B. 2.