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Brussels, 27 May 2011

Q&A: The Fight Against Tobacco in the EU

What is the impact that tobacco has on EU citizens' health?

It is estimated that approximately 650 000 EU citizens die prematurely every year because of tobacco consumption.

This includes non-smokers too. According to conservative estimates, approximately 80 000 adults, including almost 20 000 non-smokers, died in the EU-15 in 2002, because of diseases caused by exposure to tobacco smoke at home and in the workplace.

Close to 13 million people in the 27 countries of the EU suffer from one or more of the six main disease categories that are associated with smoking1. These are:

1. Bronchitis and other lower respiratory infections

2. Chronic obstructive pulmonary diseases

3. Stroke, heart attacks, arterial obstructions (especially in the legs) and other cardiovascular diseases

4. Asthma

5. Lung cancers

6. Other cancers, such as pancreas, esophagus, and stomach

Who does what in tobacco control in the EU?

The EU and Member States authorities work together on tobacco control.

A central pillar of tobacco control is EU legislation on tobacco products and on tobacco advertising. These laws are meant to conciliate internal market objectives with the need to ensure a high level of public health protection across the EU. The European Commission is in charge of overseeing the implementation of these laws and of proposing necessary revisions.

The Directive on Tobacco Products (2001) requires that all tobacco products sold in the EU display two text warnings: the first compulsory warning is either "tobacco kills" or "tobacco can seriously harm you and others around you". The second warning, selected from a list of 14, includes "smoking causes fatal lung cancer". The Directive also bans misleading terms such as ‘light’, ‘mild’, or ‘low tar’, and obliges manufacturers to report to Member States on the ingredients they use. It further bans oral tobacco and sets maximum limits for tar, nicotine and carbon monoxide in cigarettes.

The Directive on Tobacco Advertising (2003) bans cross-border advertising of tobacco products in printed media, radio, and online services. It also bans sponsorship of cross border events. In addition, tobacco advertising and sponsorship on television has already been prohibited since 1989.

For other areas of tobacco control such as prevention, cessation and smoke-free environments, responsibility for providing the appropriate rules and structures lies with the individual Member States. In these areas, the EU's role is to support, complement and coordinate national efforts. The EU has made the following recommendations to Member States:

Council Recommendation on Smoking Prevention (2003), which encourages Member States to control all forms of tobacco promotion and sales to minors, as well as to improve awareness and health education.

Council Recommendation on Smoke-Free Environments (2009), which calls on Member States to adopt and implement laws to protect citizens from exposure to tobacco smoke in enclosed public places, workplaces, and public transport. It also calls for the enhancement of smoke-free laws with supporting measures to protect children, encourage efforts to quit smoking and display pictorial warnings on cigarette packages.

What national smoke-free laws are already in place?

So far, 15 Member States have laws that protect citizens from exposure to tobacco smoke in a comprehensive manner.

Total bans on smoking in all enclosed public places and workplaces, including bars and restaurants are in place in Ireland, the UK, Greece, Spain and Hungary. Italy, Sweden, Malta, Latvia, Finland, Slovenia, France, the Netherlands, Cyprus and Poland, have introduced smoke-free legislation, however, allowing for special enclosed smoking rooms.

In the remaining Member States, smoke-free laws give exemptions for certain public places such as bars and restaurants.

Current legislation to protect citizens from tobacco smoke, per Member State, can be seen here:

To protect citizens' health, these laws need to be effectively enforced. If not properly enforced by national authorities, even stringent smoke-free provisions do not provide protection from exposure to tobacco smoke in indoor workplaces and public spaces.

Several countries have stepped up their efforts to provide their citizens with smoke-free environments since last year's World No Tobacco Day. Hungary, for example, adopted a comprehensive smoke-free legislation in April 2011. Smoking will be banned in all enclosed public places and workplaces, including hospitality venues and public transport as from January 2012. Some outdoor venues such as bus stops and playgrounds will also be covered with a five meter radius. Another example is Spain, where a new law entered into force in January 2011 extending the smoking ban to all public places, including bars, restaurants, discotheques, entertainment venues and public transport terminals. Smoking is also banned in playgrounds and outdoor areas of healthcare and educational establishments, except for those dedicated exclusively to adult education. In Bavaria, following a successful referendum in July 2010, a complete ban on smoking entered into force in all bars and restaurants.

In addition, the first national law aimed at ending the use of tobacco products altogether came into force in Finland in September 2010; with provisions banning display of tobacco products and all vending machines and extending smoking bans to outdoor facilities and hotel rooms.

Is there evidence that smoke-free policies work?

There is proof that smoking bans have a positive impact on health through reduction of consumption and exposure. While it may take 20-30 years to have the complete picture, the evidence from smoke-free countries is encouraging: indoor air quality improved dramatically after the smoking bans went into effect, with an 83% and 86% reduction in the concentrations of particulate matter in Irishi and Scottishii bars, respectively. Better air quality has led to a significant drop in heart attacks: 11% fewer in Irelandiii and Italyiv, a 17% drop in Scotlandv, and even greater reductions in some US jurisdictions.

Numerous studies have also shown significant improvement in the respiratory health of workers in the hospitality sector as a result of smoke-free lawsvi. There are also reports that Smoke-free policies have reduced tobacco consumption and encouraged smokers to quit.

What are the next steps in EU tobacco control?

The Commission is currently considering to put forward a proposal for the revision of the 2001 Tobacco Products Directive in 2012. Following a public consultation launched last year and the analysis of possible options for revision within an impact assessment, the Directive could be strengthened, adapted to international tobacco control commitments, new developments in tobacco products and advances in science. Possible measures that are currently being examined are:

  • Regulatory solutions to address novel smokeless tobacco and nicotine products.

  • Better consumer information. For example, larger and double-sided picture warnings, standardized packaging, information on harmful substances.

  • Regulation of ingredients in tobacco products, in particular those which make tobacco products more attractive and addictive and appeal especially to young people such as vanilla and fruit flavours.

  • Revising the rules on sales of tobacco products.

Does the Commission support awareness-raising on the dangers of tobacco?

Yes, the European Commission's approach includes helping European citizens understand what tobacco does to their health. This is why, since 2005, the Commission is financing EU-wide awareness raising campaigns.

The "HELP" campaign which ran from 2005 to 2010 focused on smoking prevention amongst young people.

In the coming weeks, the Commission will launch a new campaign: "Ex-smokers are Unstoppable". The aim of this campaign is to encourage young adults in the 25 to 34 age group to stop smoking. This represents around 145 million EU citizens. The new campaign will shift the focus from the dangers of smoking to the advantages of quitting smoking, using ex-smokers and their achievements as inspiring role models.

What is the EU role in tobacco control at international level?

The EU plays an active role in tobacco control on a global level. It was a driving force for the WHO Framework Convention on Tobacco Control which entered into force on 27 February 2005. This Convention is the first binding global health treaty of the World Health Organization. To date it comprises 172 Parties, including the European Union and 26 EU Member Statesvii.

The Framework Convention provides an international regulatory framework for tobacco control. It includes provisions on packaging and labelling, advertising, promotion and sponsorship, protection from exposure to tobacco smoke, tobacco content regulation, illicit trade, pricing and tax measures and support for economically viable alternatives for growers.

1 :

Source: the 'ASPECT' study:

i :

Secondhand smoke exposure and risk following the Irish smoking ban: an assessment of salivary nicotine concentrations in hotel workers and air nicotine levels in bars, M Mulcahy et al. Tob Control 2005;14:384-388 doi:10.1136/tc.2005.011635

ii :

Secondhand smoke levels in Scottish pubs: the effect of smoke-free legislation, Semple et al. Tob Control 2007;16:127-132 doi:10.1136/tc.2006.018119

iii :

iv :

Effect of the Italian Smoking Ban on Population Rates of Acute Coronary Events, G Cesaroni et al. Circulation published February 11, 2008, doi:10.1161/CIRCULATIONAHA.107.72988

v :

International review of the health and economic impact of the regulation of smoking in public places, A Ludbrook et al. (2005) Edinburgh. NHS Health Scotland

vi :

For details on the studies, see Commission Staff Working Document: Accompanying document to the proposal for a Council Recommendation on smoke-free environments. IMPACT ASSESSMENT. {COM(2009) 328 final} {SEC(2009) 894}.

vii :

All Member States except the Czech Republic

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