Smoking in Austria is prevalent and dangerous. One of the authors (DC) has recently worked as a visiting Professor of Cardiology at the University of Vienna, and noted with alarm the high smoking rates in Austria, compared to his native Australia. In Vienna and in Sydney, we treat the (avoidable) complications of smoking for the heart, on a near daily basis. As a visitor to Austria, several aspects of the smoking epidemic here are immediately obvious. Smoking rates are particularly high in young adults and remarkably, smoking is permitted indoors in bars and outdoors in restaurants, resulting in considerable “passive smoking” exposure (with significant health dangers to non-smokers). Importantly, cigarettes are extremely cheap; approximately € 4.50 per packet here verses € 7.50 in Switzerland and € 20 in Australia. The price of cigarettes is a key determinant of community smoking rates [
1]; cheap cigarettes mean many (often heavy) smokers. Smoking prevalence in Austria was 43% of adults in 2008 versus 24% in Australia. In Austria, in 2014, approximately 1980 cigarettes were smoked per adult per year (16th highest in the world!) versus approximately 950 in Australia. The health consequences of this are potentially devastating. For example, lung cancer was the most common cause of death for men in 2013 [
2] and caused nearly 400 deaths in Austria in 2014, the third most common cause of death in the country [
3]. The vast majority of lung cancer is, of course, caused by smoking [
4]. Equally, smoking is clearly both atherogenic and thrombogenic and this is a key modifiable risk factor for myocardial infarction and stroke [
5]. Less well known but now with a good evidence base, it is clear that passive smoking also accelerates heart [
6] and lung diseases [
7]. …
