GRAPHICAL ABSTRACT

BACKGROUND

Cigarette butts are the leading cause of fire incidents in Korea. While this fire hazard is often overlooked, it represents only 1 dimension of the broader threat posed by tobacco. Beyond fire-related risks, tobacco remains the most preventable cause of death worldwide.

Despite sustained tobacco control efforts, smoking prevalence in Korea increased from 17.7% in 2022 to 19.6% in 2023 [1], reversing a 30-year downward trend. Although further investigation is needed to understand this rebound, aggressive tobacco industry promotions [2] may be a contributing factor, as the industry has long functioned as a vector for tobacco use [3]. To counter this influence, it is crucial to strengthen existing advocacy networks and engage new allies who can both contribute to and benefit from tobacco control efforts.

We propose that firefighters represent a potential alliance group. Tobacco control aligns with their interests for multiple reasons: cigarettes are a major fire hazard, tobacco control protects both public health and firefighter safety, and tobacco tax revenue supports fire services. We elaborate on these points below.

TOBACCO PRODUCTS AS A MAJOR FIRE HAZARD

Cigarette butts have been the leading single cause of fire incidents since 2007, when national fire statistics first became available [4]. They account for 5235 to 7222 fires annually (Figure 1), representing 12.6%–16.5% of all fire incidents each year (based on full-year data through 2024). In 2024 alone, fires caused by cigarette butts resulted in 22.1 billion Korean won (KRW) of property damage and 122 fatalities and injuries [4]. Unlike other major fire causes, such as cooking and electrical overload, which stem from essential daily activities, tobacco use is entirely avoidable and represents a preventable risk. To reduce fire risks associated with cigarette butts, the National Fire Agency has conducted campaigns urging people to smoke only in designated areas and to fully extinguish cigarette butts before disposal. However, a more effective and sustainable strategy would be to reduce the number of cigarette butts at the source by decreasing tobacco use.

Also, fire risks are not limited to combustible products. Non-combustible products such as e-cigarettes and heated tobacco products contain lithium-ion batteries that can overheat, explode, or ignite. Although such incidents are less common, they still pose a meaningful fire risk [5].

TOBACCO CONTROL TO PROMOTE THE HEALTH AND SAFETY OF THE PUBLIC, AS WELL AS FIREFIGHTERS

Tobacco use and exposure to secondhand smoke kill 8 million people each year. Among the many diseases caused by smoking, cancer and respiratory illnesses such as lung cancer and chronic obstructive pulmonary disease are especially important. These conditions are also ones for which firefighters face elevated risk due to occupational exposures. Firefighters are regularly exposed to smoke and hazardous chemicals, including benzene and formaldehyde, both of which are also present in tobacco products. A recent meta-analysis reported a higher lung cancer prevalence among firefighters than in the general population [6]. In 2023, the International Agency for Research on Cancer classified occupational exposure as a firefighter as a Group 1 carcinogen, underscoring the substantial baseline risks they face. Tobacco use further exacerbates these risks by increasing firefighters’ cumulative exposure burden.

Despite these elevated risks, tobacco use remains prevalent among firefighters. To date, only a few studies have examined tobacco use in this population. The Report on the Human Rights Conditions of Firefighters [7], which surveyed 8525 of approximately 40 000 firefighters, found a smoking prevalence of 30.3%. This was higher than the national average of 22.6% in 2015 [1]. While this difference likely reflects the predominance of males in the sample (94% were male [7], and smoking prevalence among male in 2015 was 39.4% [1]), the fact that nearly 1 in 3 firefighters smokes is still concerning. Moreover, a 2016 study in Daegu that verified smoking status through both self-report and urine cotinine found substantial underreporting: 22.5% self-reported smoking, but 51.2% tested positive for urine cotinine [8]. Future studies are needed to assess firefighters’ tobacco use with validated measures. In parallel, targeted cessation support is required to address the specific risks faced by firefighters who use tobacco products.

PROPORTION OF TOBACCO TAX USED FOR THE FIRE SERVICE BUDGET

The tobacco tax in Korea is earmarked. Following the 2015 increase, which raised the tax per pack from 1550 KRW to 3318 KRW, the government introduced the Fire Safety Shared Tax. Under this scheme, 20% of the tobacco excise tax (118.8 KRW per pack out of the 594 KRW excise tax) is earmarked specifically for fire safety. Since 2020, the proportion of tax allocated to this purpose has increased to 45% (267 KRW). The Fire Safety Shared Tax is distributed across 3 primary areas: firefighting personnel expenses (55.6%), fire safety project costs (33.5%), and safety-related initiatives for local governments (10.9%). As of 2024, the Fire Safety Shared Tax amounted to approximately 320 billion KRW [9]. Tobacco taxation is among the most cost-effective policies for reducing tobacco use and its associated disease burden. Under the current tax structure, further tax increases could simultaneously reduce smoking and strengthen funding for fire services. As tobacco use itself contributes to fire risks, allocating revenue to fire services represents a preventive reinvestment rather than a fiscal justification. Collaboration between health and fire authorities is therefore essential, whether through tobacco tax revenues or other mechanisms.

A potential concern is that substantial tobacco tax increases could eventually decrease the revenue earmarked for fire safety as a consequence of reduced smoking prevalence [10]. However, the fiscal gains from reduced prevalence are likely to exceed potential revenue losses. These gains could be redirected to fire service budgets, as the socioeconomic costs of tobacco use far exceed tax revenues. Furthermore, a decline in smoking would likely reduce the number of fire incidents, partially offsetting any reduction in dedicated budget allocations. Nonetheless, further research (e.g., economic modeling) is needed to assess these long-term fiscal and operational implications. Examining changes in government revenues as tobacco use declines offers additional value as an integral component of tobacco endgame strategies. In both firefighting and public health, prevention yields greater long-term benefits than reactive approaches. Reducing tobacco use addresses the underlying cause, generates substantial socioeconomic returns, and enables reinvestment in preventive services, including fire safety and health systems. This feedback loop supports sustainable financing and accelerates progress toward tobacco endgame goals.

CONCLUSION

Reducing smoking can lower fire-related risks and improve health outcomes for both the general public and firefighters. Additionally, increasing tobacco tax is a key tobacco control strategy that not only reduces smoking prevalence but also generates funding for fire services. Achieving these dual benefits requires stronger intergovernmental collaboration between public health and fire service agencies.

Specific joint efforts include health promotion programs that assess tobacco use and provide cessation support for firefighters; mass media campaigns that shift focus from safe disposal of cigarette butts to reducing tobacco use; and coordinated advocacy for higher tobacco taxes to simultaneously advance public health and strengthen firefighting capacity. Such a partnership provides an opportunity to create mutually reinforcing gains.

Discussions about partnerships to advance tobacco control are not limited to Korea or to firefighters. Other sectors affected by tobacco-related harms, including those working to protect the environment, can also be valuable partners. Moreover, Article 6 of the Framework Convention on Tobacco Control recommends earmarking tobacco tax revenues, suggesting that sectors supported by these funds in other countries may also play an important role in advancing tobacco control.

Ethics Statement

This study does not involve human participants and therefore does not require ethics approval.

Notes

Conflict of Interest

The authors have no conflicts of interest associated with the material presented in this paper.

Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2021R1C1C2094375).

Acknowledgements

ChatGPT was used to improve grammar and enhance the readability of the text drafted by the authors. The authors have reviewed the output and take full responsibility for the final content.

Author Contributions

Conceptualization: Kang H, Cho SI. Methodology: Kang H, Park S. Funding acquisition: Kang H. Visualization: Kang H. Writing – original draft: Kang H. Writing – review & editing: Kang H, Park S, Cho SI.

Figure. 1.

Trends in cigarette butt-related fires as a proportion of total fire incidents (2007–2025). 12025 data is up to 19 June.

REFERENCES

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