Tobacco control in the WHO European Region

1

REGIONAL CONTEXT

2

WPRO

SEAROEMRO

EURO

HQ

AMRO

Temp. located in Harare

AFRO

Tobacco Kills nearly 6 million people globally each year

1,6 million people die in the European Region

3

Current Mortality Attributable to Tobacco in Europe

No room for complacency WHO Region

Deaths attributed to tobacco

EUR 16%

AMR 16%

WPR 13%

SEAR 10%

EMR 7%

AFR 3%

Global 12%

4

Current Tobacco Use in EuropeNo room for complacency

 WHO RegionMale

prevalenceFemale

prevalenceBoth sexes

EUR 38% 19% 28%

WPR 47% 3% 25%

EMR 38% 4% 22%

AMR 26% 16% 20%

SEAR 34% 4% 19%

AFR 22% 7% 15%

Global 36% 8% 22%

5

4

Youth Prevalence of Tobacco

• WHO European Region has high prevalence of youth tobacco smoking

• Prevalence of female youth considerably higher in European Region than in other Regions

Youth and smoking• Smoking behavior is typically

established during adolescence

• Most smokers had their first cigarette, or were already addicted, by the time they turned 18

• Duration and number of cigarettes required to establish nicotine addiction are lower for adolescents than adults, so addiction is established more quickly

7

Youth and smoking (cont)

• Tobacco use is related to other risk behaviors and negative health outcomes in young people, including unhealthy diet, high levels of alcohol consumption, bullying, poor self-rated health and low life satisfaction

• Should be considered as part of a broader group of unhealthy behaviors that cluster in adolescence

8

GLOBAL SOLUTION

9

10

10 Years since the WHO FCTC

11

Tobacco Policy in EuropeMoving in the right direction

2007 2008 2012

Ratification 42 45 50

Taxes 0 15 25

Smoke free places

4 4 9

Cessation 4 7 7

Ban on advertising

1 1 3

Large pictorial warnings

0 0 2

12

Ashgabat DeclarationMinisters of Health

commit

- Fully implement the WHO FCTC

- Share ambition of working towards a tobacco-free European Region

- Work together to make the global target on NCDs related to tobacco use a reality

13

14

14

Cost effective best buys

→ protect people from tobacco smoke

→ warn about dangers of tobacco

→ enforce ban on tobacco advertising

→ raise taxes on tobacco products

Intersectoral action is essential

• Multiple factors inside – and beyond – the health sector are driving the rise in smoking

• Health sector has a key role to play, but so too do other sectors

• Relying just on the health sector to reduce the tobacco epidemic is not enough

15

GLOBAL CHALLENGES

16

UN General Assembly September 2011

2011 UN High-Level meeting on NCDsPOLITICAL DECLARATION ON NCDs

Heads of State and Government

and representatives of States and Governments, recognized

the fundamental conflict of interest

between the tobacco industry and public health

17

Article 5.3 of the WHO FCTC• Principle 1: Fundamental and irreconcilable conflict

between the tobacco industry’s and public health policy interests

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

• Principle 3: Countries should require the tobacco industry and those working to further its interests to operate and act in an accountable and transparent manner

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

18

Practical examples available

• Vast majorities of Parties have yet to fully implement Article 5.3 and its Guidelines

• Progress made on some aspects, but often not across all governmental sectors

• Hungary: National Institute for Health Development's website provides information on tobacco industry strategies, Finland: interaction with industry is limited to open requests for comment, Norway: Government Pension Fund divested of tobacco

19

Electronic cigarettes

• E-cigarettes are big and evolving business

• Experimentation among youth has doubled from 2008-2012

• Huge variation of country regulations as consumer, therapeutic or tobacco products, or no regulation

20

WHO recommends

• Impede e-cigarette promotion to non-smokers and young people

• Minimize potential health risks to e-cigarette users and nonusers

• Prohibit unproven health claims about e-cigarettes

• Protect existing tobacco control efforts from commercial interests of the tobacco industry

21

Are e-cigarettes helpful or harmful?

• Hazardous to youth, pregnant women and non-nicotine users

• For adult smokers, well-regulated e-cigarettes are likely to be less toxic than cigarettes IF well-regulated and IF adult smokers use them as a complete substitution for cigarettes

22

Recent developments - CoP

• Adoption of the decision on electronic nicotine (and non-nicotine) delivery systems, known as electronic cigarettes

• Decision acknowledges the need for regulations along the lines of policies concerning other tobacco products, including banning or restricting promotion, advertising and sponsorship of ENDS

23

What next?

Endgame of tobacco is a profound social change process

where changes in people’s habits, intentions and attitudes go hand in hand with respective

regulatory and legislative changes!

25

• The reduction in smoking in many countries has gone so far that many countries are considering the endgame of tobacco

• Finland, New Zealand, Norway, Australia, Ireland

• Ashgabat Declaration 2013 (53 European health ministers committment)

• European Child and adolescence health strategy for Europe, September 2014

• Roadmap of actions for FCTC implementation 2015–2020 in the European Region

27

27

"If all the harms caused by tobacco were known earlier on, tobacco products would never

have been approved as safe for human consumption, could never have been marketed and sold like

any other consumer product“

Director General of WHO, 2013

Thank You

Ačiū

Kristina Mauer-StenderProgram Manager

WHO Regional Office for Europe

Ingrida ZurlytėWHO Country Office, Lithuania