Head of the Board of Directors Rene Medema in AD | ‘Smoking takes more lives than corona’

René Medema, director of the Netherlands Cancer Society in Amsterdam, made a controversial statement: he compares the Dutch anti-smoking policy to the corona restrictions. “Ten thousands of people have died of COVID-19, that is terrible. But a stricter anti-smoking policy would make more sense than a stricter COVID-19 policy.”

“If the entire country were to quit smoking, we would instantly see a 30% decrease in cancer rates. 30 percent! 30 percent of all cancer deaths are related to tobacco. To compare: doctors and researchers are working hard every day to improve cancer treatment. We gain a 1.5% improvement in health every year, and we are happy with that. To attain an improvement of 30% we would have to work for twenty years. We would leap twenty years ahead ahead if all tobacco were banned!”

If it all seems so simple, why don't we just do it?

“It’s all about the money. The tobacco industry lobbies hard and generates a state profit of 2.4 billion in taxes, compared to 500 million in medical costs as a result of the tobacco. That is a simple equation. The economic benefits are more important than our health.”

Whose fault is that?

“We are all responsible here. We tend to believe that smoking is a personal responsibility, and that you should suffer the consequences. But 80 percent of smokers start before they are even 18 years old. About 100 children in the Netherlands pick up smoking every week.They always seem to know one 90 year old grandma who smokes, so it’s hardly strange that children make this mistake. But consider Australia, where one pack of cigarettes costs 24 euros and only 14% of the population smokes, instead of the 20% we see in the Netherlands.”

Amsterdam

At first glance, the Netherlands Cancer Institute may seem like a regular hospital, but the message board reveals the severity of its patients’ experiences. “I hope you get well soon mommy,” the childish handwriting on a colorful post-it proclaims. The primary hospital specialized in cancer is often a last resort for people, once they are out of options at their local hospitals. René Medema, head of the Board of Directors, conducts fundamental cancer research as a professor of medical oncology. His statement: “Smoking is a greater threat to public health than COVID-19. We need to make our move, now.”

Why do you compare our anti smoking policy with the COVID-19 policy?

“I want to shed a light on the absurdity of our government’s anti smoking policy. We have taken all sorts of drastic measures against COVID-19 - we have closed the clubs, and allow less people into the stores. The coronavirus has to be conquered, no matter what. But no one seems to realize that there are more people who die of cancer. Not that I want to downplay the victims of COVID-19. An estimated ten thousand people have died of COVID-19, that’s terrible. I don’t want to downplay that. It’s just as severe, even for health care workers. But when you compare the corona restrictions with the anti-smoking policy, stronger anti-smoking restrictions would make more sense.”

Why would you like to see stricter anti-smoking restrictions?

“Smoking has more victims than COVID-19. 14,000 people were diagnosed with lung cancer last year, and ten thousand people pass away as a result of the illness. Smoking is to blame for at least 80% of these cases. And smoking also causes head and neck tumors, esophageal cancer, thyroid cancer, colorectal cancer, bladder cancer, breast cancer, COPD, and cardiovascular problems. Smoking kills an estimated 19,300 people every year. 9300 more than we have lost to COVID-19 right now. It’s absurd to me that we cannot ban cigarettes from our supermarkets.”

Isn’t that comparing apples and oranges? An addiction and a pandemic.

 

“We’re not trying to say: just let COVID-19 do its thing, focus on cancer instead. The government makes drastic choices regarding COVID-19 and we approve of them. Both are threats to public health. But consider how easy it would be to control death as a result of tobacco, but that we don’t, it’s bizarre to see how strict the restrictions are to avoid death as a result of the coronavirus. The Dutch economy can survive without tobacco.”

Should all cigarettes be banned?

“Yes, it is very simple: cigarettes are a huge problem. We have to take control. Jumbo and Albert Heijn go on about sustainability, but if they continue to sell cigarettes, what’s the point? If they really care about their patients’ health, they’ll remove them immediately. If you pretend to care about health and sustainability you can’t offer cigarettes together with your ecological products. We immediately remove fipronil eggs because of a small dose of harmful pesticide. But the health risks are much smaller than for tobacco. Consumers might think:  if it’s in the supermarket, it must be ok. That’s why it’s so great that the Lidl doesn’t sell cigarettes anymore.”

Which patients have stayed with you?

„Anne Marie, for example. A woman with small children. That’s incredibly unsavory. She was really angry with herself. She spent the last two years of her life telling people about how the industry ruined her life. Cigarettes with clean air filters appeared healthier in tests than they turned out to be. I myself know someone with lung cancer. He is younger than me. That cuts deep.

If it were up to you, one pack of cigarettes would cost 24 euros?

“Yes, it seems to be a good reason not to pick up smoking in Australia. If even 14% of people smoke when the packs cost 24 euros each, the sky's the limit. Raise the price, and help people beat their addiction. Tobacco lobbyists will probably bring up a black market, but that’s nonsense. Does that mean we should sell cocaine in the supermarket, just because there’s a black market? That’s also not good for your health, so it shouldn’t be freely available either. We have decided not to listen to the lobby, but we still do. It’s hard for us to raise the price of a pack of cigarettes to 10 euros. And see the prevention agreement aimed at healthier lifestyles. The plan has been stripped bare by the tobacco lobby, that’s sad!”

What exactly bothers you?

“The closer we came to signing the agreement, the more important aspects were removed. The price of cigarettes was raised with only one euro, and a next increase will need to be evaluated. This means that it’ll take years before we can get anywhere. And what exactly are we evaluating? The size of the black market? It’s disgusting that the government earns 2.4 billion euros in sales taxes. Who is really paying for this? Our society.”

Economic gain takes priority over public health: the state makes 2.4 billion a year from tobacco sales tax. Last year 10,000 people died as a result of lung cancer, which was caused by smoking in 80% of these people. 30% of all deaths due to cancer can be attributed to tobacco, according to Medema.

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