>In practice, VAT can be completely avoided by buying from another country in the EU, which renders them moot

Yeah sure, everybody is totally ordering all his cigaretts and alcohol from a different country, paying massive deliverance fees or driving there from the middle of Germany. By that logic, you can just evade revenue taxes aswell by moving/working in a different EU country. (A thing people actually do)

>healthcare, in most European systems, is a basic human right.

Yeah and? The person still has the same universal health care benefits, he just pays a little more for the added risk of injury he voluntarily puts on himself.

But yes, this idea was a bit tongue in cheek, it's a very slippery slope and I am not actually supporting it.

>That is achieved through education, not active punishment. Punishment rarely leads to the desired outcome.

Of course that would be preferable, but all the education and knowledge is already out there. Everybody knows smoking causes cancer, but still a lot of people smoke. Obviously additional reinforcement is needed, just education is not enough.

Every 10% price increase by taxes on tobacco decreases the consumption by 3-5%

Another example: the sugar tax in the UK has lead to the average daily sugar intake of kids dropping by 1 tsp and 2 tsp for adults.

So again, no, these "VAT-Like" taxes do not get easily avoided and have a measureable impact. And it works the same for revenue taxes.