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What works in tobacco control?


31 May 2011


Health & Consumers

The WHO Framework Convention on Tobacco Control (WHO FCTC) provides a framework for evidence based measures for tobacco control. World No Tobacco Day 2011 advocates for countries to ratify and fully implement the Treaty. Some measures provided within the WHO FCTC are:

•    Monitor tobacco use and prevention policies
•    Protect people from tobacco smoke
•    Offer help to quit
•    Warn about tobacco use
•    Enforce tobacco marketing bans
•    Raise taxes

In the WHO European Region, 46 countries (out of 53) and the European Community are Parties to the FCTC. Seven countries are not yet Parties: Andorra, Czech Republic, Monaco, Switzerland, Tajikistan, Turkmenistan*, Uzbekistan, but in 2011 the President of Turkmenistan signed accession to WHO FCTC.

Monitor tobacco use and prevention policies

Good monitoring provides important information about the extent of the tobacco epidemic and helps them allocate tobacco control resources where they will be the most effective. Monitoring also shows whether policies are working and how they should be tailored to the needs of different groups. Findings must be effectively disseminated so that they help develop tobacco control policies and build capacity for effective policy implementation and enforcement.

Protect people from tobacco smoke

Contrary to arguments from the industry, smoke-free legislation does not harm businesses, and any country, regardless of income level, can implement effective smoke-free legislation. Research clearly shows that there is no safe level of exposure to second-hand smoke. Only a total ban on smoking in indoor public places, including all indoor workplaces, protects people from the harms of second-hand smoke, helps smokers quit and reduces youth smoking. In countries that have adopted complete smoke-free public legislation, public support is strong, contributing to the success of the implementation.

Offer help to quit

When informed of the risks, most tobacco users want to quit, but few get support to overcome their dependence. Health-care systems have primary responsibility for treating tobacco dependence. Programmes should include tobacco cessation advice incorporated into primary health-care services, easily accessible and free telephone help lines (known as quit lines), and access to low-cost cessation medication. Findings show that nicotine replacement therapies can double quit rates. All health-care workers should become advocates for tobacco control. Governments can use some tobacco tax revenues to help generate funds for tobacco users to free themselves from addiction.
Warn about tobacco use

Health warnings on tobacco packages that combine text and pictures are one of the most cost-effective ways to increase public awareness of the serious health risks of tobacco use and to reduce consumption. Despite evidence of this, 9 out of 10 people worldwide live in countries that do not require warnings with pictures on tobacco packages.

Pictorial warnings convey a clear and immediate message, even to people who cannot read. They reduce the overall attractiveness of tobacco packages: important for a product whose new users are typically young and image and brand conscious.
Enforce tobacco marketing bans
A comprehensive ban to tobacco industry marketing techniques can decrease tobacco consumption by about 7%. Banning tobacco advertisement, promotion and sponsorship both reduces use and changes the perception of tobacco use towards not being perceived as the norm. Comprehensive bans work and operate in accordance with countries’ constitutional principles. Partial bans have little or no effect because the tobacco industry will direct more efforts to areas not covered by the ban.

Raise taxes

Increasing the price of tobacco is the most effective intervention to reduce smoking.  It encourages tobacco users to quit and prevents children from starting to smoke. Taxes on inexpensive tobacco products should be equivalent to higher-priced products, such as premium-brand cigarettes, to prevent substitution in consumption. Taxes need to be increased regularly to correct for inflation and consumer purchasing power. Tobacco taxes are generally well accepted by the public and also raise government revenues. Allocating tax revenues for tobacco control and other important health and social programmes increases their popularity. Contrary to tobacco industry`s claims, increased smuggling does not automatically follow tax increases. Other factors are more important for the occurrence of illicit trade.

The WHO FCTC measures can reverse the tobacco epidemic and prevent millions of tobacco-related deaths. The tobacco industry is strongly opposed to these bans and measures because they work. Legislation is only the first step; enforcement is vital to achieve an effect.

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