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Current Percentage of Adult Smokers within

the WHO European Region

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Female to Male (Adult)ratio

Africa 3:20 Americas 11:25

Southeast Asia 8:41 Europe 22:40

Mediterranean 5:34

Western Pacific 14:43

Austria, Denmark, Ireland, Sweden,

Norway, Netherlands and United Kingdom

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Youth Prevalence of Tobacco

• The WHO European Region has the highest prevalence of youth tobacco smoking among all the WHO Regions

• The prevalence of female youth is considerably higher in the WHO European Region than all other WHO Regions

Tobacco use is the leading cause of preventable death worldwide

Tobacco Kills nearly 5.4 million people globally each year... approximately every 6.5 seconds a person dies due to smoking related diseases

By 2030 tobacco will kill more than 8 million people worldwide each year

Tobacco is the only product that kills 50% of its users when used exactly as intended. It is estimated that if no serious action is taken, up to 1 billion people could die from tobacco use in the 21st century

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Mortality from Tobacco Compared to the rest of the world, the WHO European Region has one of the highest proportions of deaths attributable to tobacco

16% of all deaths in adults over 30 in the WHO European Region were due to tobacco

This is in contrast to the African or the Eastern Mediterranean Regions, with 3% and 7% proportion of tobacco-attributable deaths, respectively

Global average is 12%

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Voluntary global target for 2025

30% relative reduction inprevalence of current tobacco smoking

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176 countries plus the European Commission so far (almost 90% of the world’s population) have already agreed to implement this

international legally binding treaty

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How Europe is doing in tobacco control?

Compared to other Regions, WHO European Region is doing relatively well. Between 2008 and 2010……

• Region has the highest average cigarette prices and the highest average tax rates - strong progress since 2008

• Region has the second highest share of Parties that have introduced a comprehensive ban on tobacco advertising, promotion and sponsorship BUT progress is weak since 2008

• Region has the highest level of full protection from tobacco smoke in indoor workplaces, good progress since 2008

• Majority of Parties with well-established programs in the treatment of tobacco dependence and cessation come from the Region, no major progress since 2008

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BUT

• Region has the highest adult and youth smoking prevalence

• Region has the lowest rates for implementation of large warnings (more than 50% of main surface of packages) and also has the lowest share of pictorial warnings

• National tobacco control programmes – elaboration and implementation is at low level

• Mass media campaigns are rare

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Protecting People from Tobacco Smoke (WHO FCTC Article 8)

• 8 countries, Albania, Hungary, Ireland, Malta, Spain, Turkey, Turkmenistan, United Kingdom, and now also Ukraine, are smoke-free however level of enforcement varies greatly

• Educational and healthcare facilities are the public places most likely to be legislated as smoke-free

• 89% of member countries have national laws requiring fines for violations of smoke-free laws

• 11 countries had national laws dedicating funds for enforcement

• 24 of the 53 countries in the region (45%) had a complaint driven system requiring an investigation after a citizen complaint

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Percentages of Smoke Free Public Places

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What do we know?

• Research clearly shows that there is no safe level of exposure to second-hand smoke

• Comprehensive smoke free laws are the only effective means of eliminating the risks associated with smoking

• Ventilation and smoking rooms are not effective

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What is the regional evidence on comprehensive smoke-free policies?

• Strong support from general public

• Strong public support leads to high enforcement and compliance

• Protect employees by reducing the exposure to second-hand tobacco smoke in workplaces and public places

• Protect employees by reducing the content of second-hand smoke in the air in workplaces and public places

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What is the evidence? (cont.)

• Can cause a decrease in smoking prevalence and smoking related behaviors

• Can reduce mortality and morbidity from exposure to second-hand tobacco smoke

• Have a positive impact on economic gains in the health system

• Do not result in any economic loss and tobacco tax revenues can be maintained or even increased

• Have either a neutral or positive economic impact on businesses

• Do not drive away tourism

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Important to keep in mind• All countries are at different starting

points and need to consider the best timing for implementing comprehensive smoke free policies

• There still exists great variation in the smoke free legislation within the Region, starting from the definitions of indoor workplaces, indoor public places and public transport

• There is also great variance in dealing with compliance, such as the amount of penalties and whether it is merely symbolic payment or a substantial amount of money and a strong deterrent

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Raise Taxes on Tobacco (WHO FCTC Article 6)

• 42% of countries within the region report that >75% of the retail price of the most popular brand of cigarettes is tax

• Prices of the most sold brand of cigarettes (20-pack) in international dollars range from $1.03 (Kazakhstan) to $9.51 (Ireland)

• Large disparities in price between some neighbouring countries - an example, cheapest brand in Romania is 4.44 international dollars, while in neighbouring Moldova, it is 24 cents

• The average % of retail price of the most sold brand of cigarettes that is tax in high-income countries is 75%, compared to only 51% in low- to middle-income countries

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Tax Percentage of Most Popular Cigarette Brands

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Warning about the Dangers of Tobacco (WHO FCTC Articles 11 and 12)

• No countries within the region fall in the highest implementation category for cigarette warning label legislation

• 25% of countries in the region have pictorial warnings for cigarettes - an improvement from the 13% in 2008

• 9% of countries in the region have pictorial warnings for smokeless tobacco

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Percentages of Health Warnings

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Enforce Bans on Tobacco Advertising, Promotion and Sponsorship

(WHO FCTC Article 13)• 57% of the countries in the region have legislated bans on

tobacco sponsored events

• 25% of the countries in the region have legislated bans on promotional display at the point of sale - we fall behind most other WHO Regions in ban on point of sale

• 19% of the countries in the region have legislated bans on tobacco products in TV/films

• 55% of the countries in the region have legislated bans on tobacco brands in TV/films

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Percentages of Bans on Advertisement

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Offering Help to Quit Tobacco Use (WHO FCTC Article 14)

• 66% of the countries in the region offer nicotine replacement therapies (NRT) and/or some cessation services, at least one of which is cost covered

• 62% of the countries in the region offer a quit line/help line with a live person available to discuss cessation with callers

• 8 % of the countries in the region (or 4 countries) offer at least one of NRT, Bupropion, or Varenicline, with full cost coverage

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Percentages of Cessation Service

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Monitoring(WHO FCTC Article 21)

• 62% of countries collect recent, representative and periodic tobacco control data for adults and youth

• 5 countries carried out GATS and Kazakhstan in 2013

• 29 of 53 countries implemented Global Youth Tobacco Survey

• Only 25% of countries in the Region collect data on smokeless tobacco use (Denmark, Finland, Georgia, Iceland, Kyrgyzstan, Latvia, Norway, Poland, Russian Federation, Sweden, Switzerland, Ukraine and Uzbekistan).

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The Power of Data to Fight Tobacco

WHO European Parties to WHO FCTC reported major constraints: 1) lack of

financial aid and/or human resources, 2) industry interference, 3) lack of

political will and 4) need for strengthened inter-sectoral collaboration

Data can…..

Optimize lack of resources…by identifying priority areas for action

Increase political will by…highlighting the problem Increase political will by…showing public support for

introducing new measure(s)

Tackle industry lobbying by…presenting data to refute their claims

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• Exaggerating the economic importance of the industry

• Manipulating public opinion to gain the appearance of respectability

• Conspiring to influence political and legislative decisions

• Faking support through front groups

• Discrediting proven science

• Intimidating governments with litigation or the threat of litigation

What Does theTobacco Industry Do?

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A total of 176 countries plus the European Commission(almost 90% of the world’s population) have already agreed to implement an international treaty, the WHO FCTC and its Article 5.3 and guidelines

Principle 1: There is a fundamental and irreconcilable conflict between the tobacco industry’s interests and public health policy interests.

Principle 2: Parties, when dealing with the tobacco industry or those working to further its interests, should be accountable and transparent.

Principle 3: Parties should require the tobacco industry and those working to further its interests to operate and act in a manner that is accountable and transparent.

Principle 4: Because their products are lethal, the tobacco industry should not be granted incentives to establish or run their businesses.

“We know that tobacco use is not a choice. It is a powerful addiction. The true choice is between tobacco and health”

Director General of WHO at World Conference in Singapore.