Tobacco epidemic weighing heavily on Europe

EU countries are not doing enough to implement tobacco control policies, says Nessa Childers.

Nessa Childers | Photo credit: European Parliament audiovisual

By Nessa Childers

30 May 2017

The backdrop to World No Tobacco Day 2017 in Europe remains a very mixed picture. This warrants a lot more effort at EU and national level, seeing as we are talking about controlling the sole legally available substance that ends up killing as many as half of its regular consumers when used as indicated by the manufacturers.

The health and mortality burden of the tobacco epidemic still weighs heaviest on the richer world, particularly Europe, where it has reached 'maturity', though its progression does pose an increasing threat to overall development worldwide. Europe has the highest rate of tobacco use among adults worldwide.

As our lead cause of premature death, it claims 700,000 lives each year. The economic cost attributable to smoking has been estimated as equivalent to around 2.5 per cent of Europe's GDP and it accounts for 6.6 per cent of total health expenditure on our continent.


If we look at the latest available results of the tobacco control scale for 2016, in which Luk Joossens and Martin Raw rank 35 European countries on the basis of tobacco control policy implementation, the majority get a negative mark. This is also the case if we look at the EU member states only, albeit by a narrower margin.

As parties to the World Health Organisation's framework convention on tobacco control, the EU and all its member states are obliged to develop a comprehensive tobacco control policy. The World Bank has identified a set of policies that need to be prioritised.

These combine price increases through taxation, bans or restrictions on smoking in the workplace and public spaces, public information, advertising bans, health warning labels and access to addiction treatment.

We have managed to establish one of the most progressive tobacco regulation regimes in the European Union.

However, in the face of scandal-prone lobby onslaughts and court challenges to tobacco advertising legislation and the tobacco products directive, policy and implementation of measures on the ground remain inadequate, as the tobacco control scale rankings indicate.

Eurobarometer surveys show a serious of lack of compliance with smoking bans in certain spaces, including second hand smoking exposure at work. This remains a major issue in 11 EU member states, not to mention other public locations.

Activities beyond the scope of EU legislation, such as banning advertising or cross-border events - the audiovisual media services directive and the tobacco advertising directive - have resulted in significant disparities between member states.

While some member states have moved forward, with a minority going as far as banning the display of tobacco products, advertising at point of sale is still the norm in a majority of countries.

Some EU jurisdictions still allow for sponsorship of national events or outdoor advertising. Five EU member states started 2017 without any measures in place to implement the pictorial health warnings mandated by the tobacco products directive. 

High prices through heavy taxation are an effective means of dissuading young people from picking up the habit in the first place, but prices still vary widely across countries in terms of purchasing power.

In general terms, inadequacies in implementation of the provisions that survived the tobacco industry's lobby onslaught, at national and European level, stem from paltry budget allocations to tobacco control policy. These jar with the overall costs and burden of this epidemic to society.

EU countries spend less than one euro per capita annually on tobacco control, with some countries even making cuts.

The UK, followed by Ireland, is currently leading tobacco control policy in the EU, earning both countries pride of place in a 'nanny state' index whose libertarian sponsors seem quite lacking in sense of irony. Both countries adopted plain packaging legislation, as has France, the next-best performing EU member state in terms of tobacco control (Ireland is yet to roll out the measure). 

These three countries, together with six other EU member states, have also banned smoking in private cars in the presence of children.

The European Parliament put pressure on the Commission not to renew the EU-Philip Morris anti-contraband and anti-counterfeit agreement, an out-of-court settlement for tobacco industry collusion in illegal trade, which expired in mid-2016. 

This was an inadequate, obscure and outdated instrument to tackle illegal trade in tobacco products on the industry's terms, with the equivalent agreements concluded with the other major tobacco conglomerates should meet the same fate.

Conversely, the Commission deserves praise for its role in securing EU ratification of the protocol to eliminate illicit trade in tobacco products.

Indeed, and in line with the tobacco products directive, the fight against smuggling and counterfeiting is a serious matter. It must remain in the hands of adequately resourced public bodies, in control of tracking and tracing,. It should not subcontract poachers for game-keeping.

We need to devote greater resources to enforcing tobacco control, expanding the use of plain packaging, steeper taxation, display bans, and proper respect for article 5.3 of the framework convention on tobacco control to shut big tobacco out of public health policymaking.


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