This contribution sets out to answer the question to what extent fundamental rights may act as a constraint for states to employ lifestyle differentiation, particularly between smokers and non-smokers, regarding the access to their healthcare systems. In human rights treaties a tension is palpable between the obligations of states, which represent the general interest, and the rights of smokers, who attempt to hold on to their individual freedom. On the one hand, states have to guarantee the health of their citizens. On the other hand, they are unable to mandatorily enforce health standards as smokers do not have to tolerate unbridled state interference in their private lives. However, this right to self-determination is not absolute. If the smoker persists in using tobacco products, states are granted a broader margin of appreciation in their socio-economic obligations, which in itself is already wide, out of respect for that individual choice beyond their control. As a result it is possible that a state differentiates between lifestyles and imposes mandatory conditions for the right to healthcare, which require smokers to alter their behaviour, even though the right to healthcare should be guaranteed to all without discrimination. For example the Belgian state explicitly settles the tension between the individual and the general interest by viewing the solidarity of the social security system as a double-edged sword. Every individual, including smokers, has to contribute to the realisation of equitable rights for all. With rights, come responsibilities. As always, however, state interference has to be proportional to the desired, legitimate goal.

中文翻译：

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当医疗保健陷入烟草烟雾时：（欧洲）人权角度的选择性医疗保健系统

这项贡献旨在回答以下问题：基本权利在多大程度上可以限制各州，特别是在吸烟者和非吸烟者之间，在获得其医疗保健系统方面，实行生活方式差异。在人权条约中，在代表普遍利益的国家义务与试图保持其个人自由的吸烟者权利之间可明显看出紧张关系。一方面，国家必须保证其公民的健康。另一方面，由于吸烟者不必容忍国家对自己私人生活的肆意干预，他们无法强制执行健康标准。但是，这种自决权不是绝对的。如果吸烟者坚持使用烟草制品，出于对超出其控制范围的个人选择的尊重，国家在社会经济义务方面获得了更大的升值幅度，而社会经济义务本身已经很广泛。结果，一个州可能会在生活方式之间进行区分，并对医疗保健权施加强制性条件，这要求吸烟者改变其行为，即使应保障所有人的医疗保健权不受歧视。例如，比利时政府通过将社会保障体系的团结视为一把双刃剑，明确地解决了个人利益与普遍利益之间的紧张关系。每个人，包括吸烟者，都必须为实现所有人的平等权利作出贡献。有了权利，就要有责任。与往常一样，