From my time living in Los Angeles, California, I grew very optimistic about the future of smoking. It was rare to see anyone– let alone teenagers– smoking cigarettes, and there was a very strong negative stigma around doing so.
Now that I live in Copenhagen, Denmark, my optimism is severely lowered.
Smoking is extremely common in my city, and unlike the United States, the practice is still considered “cool” among younger generations. This struck me as being very odd, as Danish culture strongly emphasizes having a healthy lifestyle: physical activity is heavily encouraged, (even required in all schools), and good diets are the norm. So, why do so many Danes participate in a routine that is so detrimental to health?
Ruby, 16, from South Africa
Petrina, 15, from Indonesia
Sebastian, 15, from Denmark/the United States
The Dangers of Smoking and its Prevalence in Denmark
While most are aware of how dangerous and unhealthy cigarettes are, here are some reminders:
In 2015, there were 5.8 billion cigarettes sold in Denmark(1). Because the population is only 5.6 million, that means that over one thousand cigarettes were purchased per head. According to surveys by the Statens Institut for Folkesundhed (National Institute for Public Health), 46 percent of all gymnasium– secondary school for ages 16 and 19– students smoke daily or occasionally(2).
These rates are reflected in the prevalence of cancer: according to the World Cancer Research Fund, Denmark has the world’s highest cancer rates, there were an estimated 124.9 deaths from cancer per 100,000 adults in 2012, and an estimated 15,669 deaths in total, according to Cancer Research UK.
When compared to the other Nordic countries, Norway, Sweden, Finland, and Iceland, Denmark comes last in almost every measure of cancer rates and survival. (Shown in graph below.) About one out of three Danes will experience some type of cancer, and only around 60 percent will survive for more than five years after diagnosis, the worst compared to the countries above. The survival rates in the other Nordic countries are all over 64 percent, led by Sweden, where 69 percent of men and 68 percent of women can expect to live at least five years after being diagnosed with cancer.(11)
According to Hans Storm, Vice-Director of the Danish Cancer Society, (Kræftens Bekæmpelse), “[Translated]: We know from research that we could prevent 40-45 percent of all cancer illnesses. Tobacco alone is the cause of a fifth of all cancer cases and a third of deaths.”(11)
Cigarette Laws: Denmark vs. United States
The Danish authorities have been somewhat complacent in terms of enacting harsher policies to limit smoking. While they have supported and funded increased education on the dangers of smoking, there is opposition to enacting economic policies, both to prevent smoking and encourage quitting. The price of cigarettes is fairly low in Denmark at about 44 kroner per pack, or 6 USD, compared to its Norwegian counterparts, whose price for cigarettes is almost twice that amount. They have been hesitant to enact higher taxes on cigarettes, even though increasing the price helped lead to a decrease in smoking in countries such as the United States. (3)
The Danish Cancer Society and TrygFonden presented a strategy to incentivize smokers to quit, similar to the one adopted in the United States, where participants have to deposit a certain amount in order to enter the program, and would get their money back with an additional bonus if they were successful at quitting smoking.
In response to this proposal, Danish Health Minister Sophie Løhde said, “It’s not cheap to smoke so it is already a cash bonus in itself to stop smoking. And I think it is a slippery slope if we start paying residents to live healthier lives.” (4) However, the Danish government provides many similar incentives, such as the education subsidy, where citizens get paid to be in school, (including university/higher education!). Minister Løhde has been hesitant to other anti-smoking measures, in response to one piece of proposed legislation to both increase fines for breaking smoking laws and increase support for those trying to quit, she stated, “the current smoking laws are perfectly adequate and that there are far more important things to debate. … Citizens can think for themselves and don’t need detailed manuals from the government.”(5)
Most recently, the Danish government proposed a package of laws in August to supposedly create ““the first smoke-free generation by 2030”.(12) However, the authorities ignored many of the recommendations from the Danish Health Authority, such as increased tobacco levies, plain-label packaging for cigarettes and forcing stores to place tobacco products out of plain view. (13)
While the United States falls behind the rest of the world on many health-related measures, the government’s steps to prevent smoking have been successful. Higher prices of cigarettes, increasingly limited areas to smoke, and stricter age laws all contributed to a smaller prevalence of cigarettes. (Most recently, California increased the legal age for tobacco purchase to 21.) Further, these actions helped create a negative stigma around the practice, making it no longer desirable. The results attest to that: in 1963, 4,336 cigarettes were purchased per capita.(9) By 2014, that number had fallen to 1083.(10)
The state has mainly aimed their focus on awareness initiatives and anti-smoking campaigns, which have been somewhat successful, such as the Danish Cancer Society’s (Kræftens Bekæmpelse) “Don’t smoke, take a lollipop” campaign to market for their anti-smoking app.(6) However, these practices ignore the blatant fact that almost all people, especially younger generations, realize smoking is harmful: one cross-cultural study by the University of Dundee in Scotland and the National University of Singapore found that “in both samples, [outpatient studies in Scotland and Singapore], awareness levels for smoking-related diseases such as lung cancer, mouth and throat cancer, heart disease, and stroke were all greater than 85%”. (7) Instead of continuing to preach a rhetoric that the population has heard, time and time again, I believe that the Danish government needs to take more concrete steps to prevent smoking.
However, these practices ignore the blatant fact that almost all people, especially younger generations, realize smoking is harmful: one cross-cultural study by the University of Dundee in Scotland and the National University of Singapore found that “in both samples, [outpatient studies in Scotland and Singapore], awareness levels for smoking-related diseases such as lung cancer, mouth and throat cancer, heart disease, and stroke were all greater than 85%”. (7) Instead of continuing to preach a rhetoric that the population has heard, time and time again, I believe that the Danish government needs to take more concrete steps to prevent smoking.
What I Will Do
I have made a few posters that address some of the main points when discussing smoking in Denmark. While people realize that smoking is harmful, and will not be convinced by a poster repeating this fact, I want to bring to their attention the hypocrisy in Danish pride in their health as a nation, while still having extremely high rates smoking. Additionally, I want to encourage viewers to support restrictions on smoking.
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