- Two recent societal cost–benefit analyses have documented the costs of smoking and the cost-effectiveness of preventing smoking.
- Smoking costs the Netherlands society EUR 33 billion per year.
- The majority of this is the monetary value of health loss; these are “soft” euros that cannot be re-spent.
- There is not a great deal of difference between costs and benefits when expressed in “hard” euros, which means that there is no clear business case for anti-smoking policy.
- The greatest benefit of discouraging smoking is improved health for the individual and increased productivity for the business sector; however, the benefits cannot be easily realised, because even in the most favourable scenario the number of smokers will decrease slowly.
- Excise duties seem to offer the most promising avenue for combating smoking. The benefits of anti-smoking policy, therefore, consist mainly of tax revenues for the government.
- Stringent policy is required to transform tax revenues into health gains.
Conflict of interest and financial support for this article: L. Kok has received a grant from the Netherlands foundation Stichting Eindspel Tabak (“Endgame for Tobacco”). L. Kok is the author of the SEO report, and P.F. van Gils is a co-author of the Maastricht report. ICMJE forms provided by the authors are available online along with the full text of this article.