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Tobacco Control in Europe. Excerpt from the Tobacco Atlas Germany 2020 Tobacco Control in Europe Excerpt from the Tobacco Atlas Germany 2020 Tobacco Control in Europe Excerpt from the Tobacco Atlas Germany 2020 Authors Dr. Katrin Schaller | Dipl.-Biol. Sarah Kahnert | Laura Graen, M. A. | Prof. Dr. Ute Mons | Dr. Nobila Ouédraogo This publication was funded by the Imprint Tobacco Control in Europe. Excerpt from the Tobacco Atlas Germany 2020 © 2020 German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) Responsible for the Content German Cancer Research Center Unit Cancer Prevention and WHO Collaborating Centre for Tobacco Control Dr. Katrin Schaller (head, comm.) Im Neuenheimer Feld 280 69120 Heidelberg Germany www.dkfz.de www.tabakkontrolle.de [email protected] Layout, Illustration, Typesetting Dipl.-Biol. Sarah Kahnert Cover Photo: © Alexander Marushin/Adobe Stock Suggested Citation German Cancer Research Center (ed.) (2020) Tobacco Control in Europe. Excerpt from the Tobacco Atlas Germany 2020. Heidelberg, Germany This publication is an English translation of chapter 8 of the “Tobacco Atlas Germany 2020” (Tabakatlas Deutschland 2020. Pabst Science Publishers, Lengerich, Germany, ISBN: 978-3-95853-638-8). To download the full publication (only available in German) go to https://www.dkfz.de/de/tabakkontrolle/Buecher_und_Berichte.html. Contents 1 The Tobacco Control Scale in Europe ...................................................................................................................................................................................................................................................... 2 2 Smoking Prevalence and Tobacco Control Measures in Europe .................................................................................................................................................................. 4 3 Smoking Prevalence in Children and Adolescents in Europe .......................................................................................................................................................................... 6 4 Taxation in Europe ............................................................................................................................................................................................................................................................................................................... 8 5 Smoke-Free Legislation in Europe ..........................................................................................................................................................................................................................................................10 6 Health Warnings and Plain Packaging in Europe ...........................................................................................................................................................................................................12 7 Tobacco and E-Cigarette Advertising in Europe ................................................................................................................................................................................................................14 8 Smoking Cessation in Europe ........................................................................................................................................................................................................................................................................ 16 9 Use and Regulation of E-Cigarettes in Europe ....................................................................................................................................................................................................................18 10 Use and Regulation of Heated Tobacco Products in Europe .........................................................................................................................................................................20 References and List of Figures ................................................................................................................................................................................................................................................................................. 22 Contents 1 The Tobacco Control Scale in Europe Since 2004, the Tobacco Control Scale (TCS) has been used to The United Kingdom and Ireland have always been at the top compare tobacco control activities in many European countries | of the scale and Germany has always been at the bottom | Developed by international tobacco control experts, the scale Hungary has intensified its tobacco control measures since 2010, assigns a score (number of points) to each tobacco control mea- rising from 27th place in 2010 to 8th place in 2019. In contrast, sure, with a higher score for measures that are highly effective Germany has been continuously downgraded since 2007 as it (e. g. high cigarette prices) and a lower score for those that are has not implemented significant tobacco control measures since less effective. When a country implements a measure in full, it then, and came last in 2019. In a European comparison, Ger- receives the full score. When it partially implements a measure, many is one of the countries with the greatest need for action in it receives only part of the maximum score. tobacco control. Measures to restrict tobacco industry interference (2)new since 2019 Not ratifying the FCTC (-1) 2 new since 2019 3 Measures to combat illicit tobacco trade (3)new since 2019 10 ■ ratication of the FCTC Illicit Trade Protocol (1)■ track and trace system (2) Price of cigarettes (30) 30 maximum score for 10 €/pack in 2018* Smoking cessation support (10) ■ quitline (2) 10 ■ medical smoking status recording (1)■ network of support (4) total ■ brief advice in primary care (1) ■ medication reimbursement (2) maximum Smoke-free public places (22) 100 points ■ workplaces (10) Health warning labels (10) ■ bars and restaurants (8) ■ plain packaging (4) ■ size (3) ■ pictorial health warnings (3) 13 ■ public transport (4) Comprehensive bans on advertising and promotion (13) 22 ■ TV and radio (2) ■ indirect advertising (1) ■ cinema (1) 10 Spending on campaigns (10) ■ outdoor advertising (2) ■ display ban (2) ■ sponsorship (1) maximum score for ■ print media (1.5) ■ point of sale (2) ■ internet (0.5) 2 €/capita in 2018** Maximum achievable score on the Tobacco Control Scale in 2019 | *weighted average price taking into account EU Purchasing Power Standards (PPS), **based on the average EU gross domestic product per capita expressed in PPS Points 2005 2007 2010 2013 2016 2019 Price of cigarettes 20 19 17 14 13 14 Smoke-free public places 2 2 11 11 11 11 Spending on campaigns 0 0 0 0 0 0 Bans on advertising 4 5 4 4 4 4 Health warning labels 6 6 1 1 5 5 Smoking cessation support 4 5 4 2 4 4 Illicit tobacco trade – – – – – 2 Tobacco industry interference – – – – – 0 total rank/of 36 22/30 37 27/30 37 26/30 32 33/34 37 33/35 40 36/36 Points and rank of Germany in the TCS ranking in 2005, 2007, 2010, 2013, 2016 and 2019 2 Tobacco Control in Europe Norway Iceland 5 66 4 70 Finland Sweden 6 62 15 52 United Estonia Kingdom 23 49 Russian 1 80 Denmark Latvia Federation 29 47 Poland 23 49 29 47 Ireland Netherlands 23 49 Lithuania 3 73 29 47 14 53 Germany Czechia Belgium 36 40 23 49 Slovakia Ukraine 10 58 Luxembourg Austria 32 46 20 50 34 44 France 20 50 Hungary Romania 8 59 2 74 Switzerland Slovenia 12 57 35 41 8 59 Croatia Serbia Bulgaria 17 51 33 45 Spain 27 48 Portugal Italy 10 58 Turkey 20 50 15 52 Greece 17 51 13 54 Malta Cyprus 17 51 27 48 TCS ranking of the European countries in 2019 Israel rank | points: 7 61 40 45 50 55 60 65 70 75 80 93 81 80 77 73 74 74 64 59 56 55 57 53 53 52 50 47 50 46 40 37 37 36 37 35 32 36 31 32 31 2005 2007 2010 2013 2016 2019 Points for selected countries in the TCS ranking in 2005, 2007, 2010, 2013, 2016 and 2019 | United Kingdom, France, Netherlands, Austria, Germany Excerpt from the Tobacco Atlas Germany 2020 3 Smoking Prevalence and Tobacco Control Measures in Europe The proportion of smokers in the member states of the Euro- The better evidence-based tobacco control measures are imple- pean Union, including the United Kingdom, fell by an average mented in a country, the lower the proportion of smokers in the of 18.8 percent between 2006 and 2017 | However, according population and the higher the proportion of those who stop to a European-wide representative survey, there are very large smoking | In Germany, effective tobacco control measures were differences: In Sweden and the United Kingdom, the proportion implemented mainly between 2000 and 2009. No significant of smokers has more than halved, in four countries (Denmark, tobacco control measures have been taken since 2010 – apart Ireland, the Netherlands, Estonia) it has dropped by almost a from the implementation of European regulation such as the third or more and in four countries (Belgium, Hungary, Finland, Tobacco Products Directive. According to the European survey, Italy) by around a quarter. In Bulgaria and the Czech Republic, the the proportion of smokers in Germany mainly decreased proportion of smokers has not changed between 2006 and 2017 between 2008 and 2009 and there has been hardly any change and in five countries (Slovakia, Croatia, Portugal, France, Slovenia) since then. it has even increased. In 17 countries, the proportion of smokers has decreased more among men than among women, and in nine countries more among women than among men. EU 28 30 -7
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