A narrow majority of the Dutch think that people who smoke should pay higher health insurance fees, national statistics agency CBS said on Tuesday.

The Dutch health system is based on the principle of solidarity: everyone pays the same premium regardless of age, health or risky life-style and insurance companies must accept everyone for the basic health insurance package.

Yet in total, 58% of non-smokers think smokers should pay more for healthcare. The figure drops to 52% when smokers themselves are included in the calculations, but even 20% of smokers think they should pay more, the CBS said.

Heavy drinkers are also under fire, with 45% of respondents thinking they too should pay more in health premiums. One quarter of those polled think the same should apply to people who do not exercise enough or who are overweight.

The under-25s are least likely to support the principle of solidarity in healthcare, with almost half saying leading an unhealthy lifestyle is grounds for higher health insurance premiums.

The Netherlands still has 3.1 million smokers, of whom 465,000 smoke more than 20 cigarettes a day.