Our children are substitutes for the 19,000 smokers who die each year

It is shocking to note that in the Netherlands we have not succeeded in preventing children from smoking. Every adult smoker who dies is still replaced by a young smoker. What is missing from the ban agreement is a sense of urgency to take measures to prevent young people from smoking. The generation ban on sales is a desirable addition to the measures already taken from the ban agreement.

The NPA’s ambitions for “towards a smoke-free generation” are grand: Fewer than 5 percent of adults and 0 percent of youth will still smoke in 2040. But four years after the prevention agreement began, the number of smokers is only down drops and times . One in three adults (20 to 24 years old) smokes, and in the 16- to 20-year-old group a slight increase in smoking behavior can be seen, thanks to the popularity of e-cigarettes and vaping: 8 percent of that group now smoke daily .1

40 children under the age of 18 start smoking every day

I find it alarming that 40 children under the age of 18 start smoking every day.2 Two of these three young men eventually became addicts.3 In doing so, the tobacco industry is depriving our children of 10 years of their lives, while also suffering about thirteen years less healthy.4 Smoking has a significant impact on health care. Of the total disease burden in the Netherlands, smoking causes 9.4 percent, resulting in €2.4 billion in healthcare costs annually.5 If no one smoked anymore, the number of cancer cases would decrease by 20 to 30 percent and we would save 19,000 lives every year.4 It is necessary to take far-reaching preventive measures to achieve this.

The question is why politicians feel little urgency and delay implementing essential measures. Various anti-smoking measures have been shelved. A pack of cigarettes will increase in price by 10 percent annually. But the excise tax was last increased in April 2020 and the ban on flavorings in e-cigarettes comes too late as far as I’m concerned. Because, meanwhile, a person in the Netherlands dies every half hour from the consequences of smoking addiction.

More stringent measures are required to achieve a smoke-free generation

The goal of the ban agreement – a smoke-free generation – has not been achieved fast enough. So tobacco policy must become less observant. With this letter, we asked MPs during the lifestyle ban debate on December 14 to pay more attention to the growing number of young people starting to smoke, or to harmful alternatives such as “vaping” and “snus”. As an association of doctors we require a number of measures, view them on knmg.nl

Electronic cigarette and nicotine bags

Alternative smoking products such as electronic cigarettes, flavored and nicotine sachets are promoted as healthy alternatives to tobacco. But all these variables release toxic and carcinogenic substances. In addition, the danger of vaping is that it is a stepping stone to smoking cigarettes containing nicotine. The production of electronic cigarettes and flavor packs will be banned from January 1, 2023, and aerosol and nicotine bags have already been banned for young people under 18 years of age. My suggestion is to treat “vaping” and “snus” in the same way as tobacco. This means, among other things, neutral packaging and excise duty.

We will have to remain very sharp, and the tobacco industry will undoubtedly return with new products to the market. Because the industry is constantly looking for “alternative smokers”. Children and young people must replace the 19,000 smokers who die every year in the Netherlands from the consequences of their addiction. The “Alternatives” documentary provides a picture of the delicate tobacco industry. Youth is a tool for making money. If we don’t ban alternative smoking products early, the smoke-free generation will soon be back to square one.

Generational sales ban

I am watching with great interest the generational sales ban that has been proposed in New Zealand. Such regulation could be a nice additional measure for the Netherlands to achieve a smoke-free generation more quickly. New Zealand law will ensure that young people who are now 14 years old can never buy tobacco again. If we start now with such a generational ban on the purchase of tobacco, then for every person born since 2017 we can reach the smoke-free generation in 2035. That’s five years earlier than what was agreed upon in the National Ban Agreement. This saves pain, grief, lives and money.

what you are waiting for?

Hundreds of babies a week, about 14,600 a year, start smoking or vaping, leading to a deadly addiction. Half of these children will eventually die from the consequences of their addiction. The earlier we start with the start of a smoke-free generation, the better. Every child should be given the opportunity to grow up free of smoking and smoking cessation should become the new norm. Together we can impact the future now and we can all be part of history in the making. We have to start with that today.


1. Overweight, smoking and alcohol consumption have rarely decreased since 2018 (cbs.nl)

2. Towards a smoke-free generation: “Are we there yet?” Trimpus Institute

3. Children and Smoking: A Snapshot of the Facts – Trimbos Institute

4. Smoke Numbers – Trimbos Institute

5. Home | Public health outlook

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