Ahead of the 2010 No Tobacco Day (31 May), the European Commission unveils the results of a Eurobarometer survey which shows that a strong majority of EU citizens support stronger tobacco control measures. For example, three in every four Europeans supports picture health warnings on tobacco packs and smoke free restaurants. The survey also shows, however, that nearly one in every three Europeans still smokes, despite the fact that tobacco kills half of its users. The Commission is planning to launch an open consultation shortly with a view to revising the 2001 Tobacco Products Directive and is stepping up its tobacco control efforts throughout the EU.
1. What is the impact of tobacco on health in the EU?
An estimated 14 million people in the EU27 suffer from the six (1) main disease categories that are associated with smoking, i.e.
Approximately 650 000 EU citizens die prematurely every year because of tobacco.
Smoking affects non-smokers too. According to conservative estimates, 79 000 adults, including 19 000 non-smokers, died in the EU-25 in 2002 because they were exposed to tobacco smoke at home (72 000) and at in their workplace (7 300). It can be assumed that the magnitude of the problem has not changed remarkably during the last years.
2. How widespread is exposure to tobacco smoke in the EU?
In countries with no comprehensive smoke-free regulations, tobacco smoke is present in the majority of public places, most of which are also somebody’s workplace. In the case of children and adolescents, most of the exposure to tobacco smoke comes from parents and occurs in the home.
According to the latest Eurobarometer (May 2010):
* Smoking at home is allowed by 4 in 10 EU citizens (38%). The most permissive Member States are Greece, Spain and Cyprus, where at least 1 in 4 allow smoking everywhere in the house. Finnish and Swedish respondents are the strictest about smoking in their homes, with 95% and 86% respectively not allowing smoking in the home at all.
* 16% of citizens allow smoking in the car all the time and 12% some of the time. This depends on whether they smoke themselves. About two thirds of smokers permit smoking in the car (65%) compared with 13% of non-smokers.
* Of those who visited bars and eating establishments in the past 6 months, 45% recall that people were smoking inside the bar and 30% said the same about an eating establishment.
* A quarter of citizens are exposed to tobacco smoke in the workplace. At work, about 1 in 10 are exposed to tobacco smoke for less than an hour a day, 1 in 20 for between one and five hours per day and the remaining one in 20 for more than 5 hours per day.
3. Is there evidence that smoke-free policies work?
Smoking bans have positive health effects. While the full health benefits may take up to 20-30 years to be realised, the evidence from smoke-free countries is already very encouraging. Indoor air quality improved dramatically after the smoking bans went into effect, with an 83% and an 86% reduction in the concentrations of particulate matter in Irish and Scottish bars, respectively. Better air quality has been mirrored by substantial reductions in the incidence of heart attacks, including a drop of 11% in Ireland and Italy, a 17% drop in Scotland and even greater reductions in some US jurisdictions.
Numerous studies have also shown significant improvement in the respiratory health in hospitality workers as a result of smoke-free laws, ranging from 13 to 50%. Smoke-free policies have also been reported to reduce tobacco consumption and encourage quit attempts among smokers, thus contributing to a reduction in smoking prevalence.
4. What is the EU’s legislation on Tobacco?
The Directive on Tobacco Products (2001) requires manufacturers to put warnings on tobacco products, bans terms such as ‘light’, ‘mild’ or ‘low tar’, forces producers to provide full information on all ingredients 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 on-line services. It equally bans sponsorship of cross border events. Tobacco advertising and sponsorship on television has already been prohibited since 1989.
The Council Recommendation on smoking prevention (2003) encourages Member States to control all forms of tobacco promotion and sales to minors, as well as to improve awareness and health education.
The Council Recommendation on Smoke Free Environments (2009) 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 such as protecting children, encouraging efforts to quit smoking and having pictorial warnings on cigarette packages.
5. What are national smoke-free regulations?
So far, 12 EU Member States provide for comprehensive protection from exposure to tobacco smoke.
Total bans on smoking in all enclosed public places and workplaces, including bars and restaurants, are in place in Ireland, UK and Cyprus. Italy, Malta, Sweden, Latvia, Finland, Slovenia, France, Lithuania and the Netherlands have introduced smoke-free legislation allowing for special enclosed smoking rooms.
However, in the remaining Member States, citizens and workers are still not fully protected from exposure to tobacco smoke in indoor workplaces and public places. Bars and restaurants are a particularly difficult area of regulation.
Partial smoking bans in the hospitality sector are in place in Austria, Bulgaria, Denmark, Greece, Portugal, Romania, Belgium, Luxembourg, Slovakia, Spain and most German Länder
For additional details see: table on implementation of smoke free measures in EU
6. What are the main possible changes in the Tobacco Products Directive that the Commission is analysing?
* Improving consumer information, for example by having bigger and double-sided picture warnings, standard packaging, qualitative information on harmful substances and information on cessation services.
* Introducing a control, restriction or ban, on harmful, addictive and attractive substances in tobacco products.
* Improving mechanisms for reporting and analysing tobacco products by introducing harmonised reporting systems and introducing accompanying fees.
* Examining the current rules on sales of tobacco products, in particular with regard to promotion at the point of sales, vending machines and distance sales.
* Addressing newly emerging products.
7. Will the Commission propose lifting the ban on oral tobacco/snus?
Snus is a smokeless tobacco product. It is a moist snuff which is placed under the lip for extended periods of time. The sale of snus is illegal in the European Union. Sweden is the only country in the EU that is exempt from this ban. The derogation was granted on condition that Sweden shall take all the necessary measures to ensure that snus is not placed on the market in other Member States.
The opinion of the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) of February 2008 states that snus is a harmful product. This opinion calls for a very cautious approach; there are currently no plans to lift the ban.
8. What is the EU role in tobacco control at international level?
The EU plays an active role in tobacco control at international level. It was a driving force for the WHO Framework Convention on Tobacco Control (FCTC) which entered into force on 27 February 2005.
The EU is a full Party to the Convention since June 2005, as are 26 of its Member States (all but the Czech Republic).
The implementation of the Convention is a political and legal commitment for its Parties.
The first legally binding protocol under the Convention concerns the illicit trade in tobacco products and is in the final stages of negotiation.
In addition to the Convention itself, guidelines have been developed to facilitate and guide the implementation process. Such guidelines exist for tobacco product labelling, advertising, smoke free environments and protection of public health policies from the interests of tobacco industry.
Currently guidelines are being finalised on tobacco ingredients and their disclosure, on cessation and on awareness raising and education. They are expected to be adopted by the fourth conference of the Parties in November 2010.
Further information, WHO