Consumers often claim to understand the warning labels on tobacco products. However, they struggle to correctly assess their actual risk. This was highlighted in a study presented at the AddictCZSK international conference in Bratislava by Michael Fanta, Ph.D., Chief Analyst at the Center for Economic and Market Analysis and academic researcher at Anglo-American University in Prague. Together with experts Dr. Ladislav Kážmér, Ph.D. from the National Institute of Mental Health and Dr. Kamila Zvolská, Ph.D., from the Center for Tobacco Dependence at the First Faculty of Medicine, Charles University, they discussed the perception of risks associated with legal drugs, their regulation, and their impact on public health.
Consumers Do Not Understand the True Harmfulness of Products
At the conference, Michael Fanta presented research analyzing how students perceive the risks of various tobacco products. They were asked to rank products—traditional cigarettes, heated tobacco, electronic cigarettes, and nicotine pouches—by their level of harm. First, they ranked them without seeing the products, then after viewing their packaging.
“Using special glasses, we tracked what aspects of the packaging attracted the most attention. With electronic cigarettes, students focused primarily on flavor descriptions, while warning labels were largely ignored. For heated tobacco, attention was mostly drawn to the brand logo rather than the health warnings. The strongest impact was seen with traditional cigarette packaging, where graphic health warnings, such as images of diseased organs, captured the most attention,” Fanta explained.
The results showed that students struggled to accurately assess the risks of individual products. Before seeing the packaging, 64 out of 105 respondents identified traditional cigarettes as the most harmful. After viewing the packaging, this number only slightly increased to 66. “Although they believe they understand warning labels, they are unable to correctly rank products by risk. This suggests that communication regarding the relative risks of tobacco products needs improvement,” Fanta emphasized.
Traditional Cigarettes Still Dominate the Market
Despite growing discussions about less harmful smoking alternatives, traditional cigarettes continue to dominate the market. Dr. Kamila Zvolská, Ph.D. pointed out that the Czech Republic remains one of the countries with a high proportion of smokers—approximately one-third of the population smokes.
“Some countries have implemented systematic measures to reduce smoking rates below five percent. In the Czech Republic, the situation remains alarming—cardiovascular mortality associated with smoking is twice as high as in countries with lower smoking rates,” Zvolská noted.
According to her, smoking is the leading preventable risk factor for cardiovascular disease in young and middle-aged people. Three-quarters of patients under 35 who are admitted to hospitals with heart attacks are smokers. “On average, smokers suffer their first heart attack 10 years earlier than non-smokers and die approximately 10 years sooner. Passive smoking poses nearly the same risks as active smoking,” she added.
Centre for Tobacco Dependence, III Internal Clinic – Department of Endocrinology and Metabolism, 1st Medical Faculty, Charles University in Prague, Michael Fanta, Ph.D., Chief Analyst, Center for Economic and Market Analysis
When it comes to alternatives, all still contain nicotine or tobacco. “Products containing tobacco are more harmful than nicotine-only alternatives because they contain higher levels of toxic substances,” she warned. Zvolská also mentioned Swedish snus, a type of nicotine pouch, which some data suggest helps smokers quit.
“Marketing often creates the impression that electronic cigarettes and heated tobacco are similar reduced-risk alternatives to traditional cigarettes. However, there is a significant difference—electronic cigarettes do not contain tobacco; they only heat liquid to produce aerosol. In contrast, heated tobacco carries risks nearly comparable to conventional cigarettes,” she explained.
Alcohol and Socioeconomic Factors of Mortality
Dr. Ladislav Kážmér, Ph.D. focused on the health consequences of alcohol consumption. He pointed out that Europe has the highest alcohol consumption rate globally, with the Czech Republic and Slovakia ranking among the EU’s top alcohol-consuming countries.
“In the Czech Republic, 6% of all deaths are attributed to alcohol—9% among men and 3% among women. Major causes include liver diseases and other health complications related to excessive drinking,” Kážmér stated.
According to him, there is a clear link between alcohol consumption and social factors such as unemployment and education level. “Regions with high unemployment rates, such as the Moravian-Silesian Region, have significantly higher alcohol-related mortality rates compared to other areas,” he warned.
Long-term statistics show that people hospitalized due to alcohol-related issues live 20 to 25 years less than the general population. “If a 20-year-old man is hospitalized for alcohol dependence, his life expectancy is 25 to 27 years shorter than that of the average citizen,” Kážmér added.