Mission Possible – Tobacco Free Finland

A Vision of Tobacco-Free Finland - How to build a long-term success?

Mervi Hara, Executive director Finland’s ASH [email protected]

Acknowledgements

 Dr. Tellervo Korhonen, The University of Helsinki  Dr. Meri Paavola, The Ministry of Social Affairs and Health Facts about Finland

• 5.4 million inhabitants • Area 338 432 km • 215.8 inhabitants per km² • 188 000 lakes • Capital Helsinki • GDP per person 35 571 € (2012) • Health care costs 6.9 % of GDP • Life expectancy (2011) ♀ 83.5 ♂ 77.2

Tobacco Legislation in Finland • The Tobacco Act in 1976: incl. smokefree public places, public transportation, sales ban to under 16, total tobacco ad ban 1978 • Smokefree workplaces 1995 • ETS carcinogenic 2000 • Smokefree bars and restaurants 2009 • Licensing system 2009 • Display ban in stores 2012 Daily smoking in Finland 1950 - 2014 80.0

70.0

60.0

50.0

40.0 Men Women 30.0

17% 20.0 2014 14% 10.0

0.0 1950 1960 1970 1980 1990 2000 2010 Adolescent smoking has almost halved during the 21st century. Experiments with smoking and subsequent regular smoking have moved to an older age.

Tobacco smoking Smokeless • 17 % of men, 14 % tobacco Current of women smoke • The typical form is daily. Swedish snus. • Adolescent smoking • The daily use was Situation has almost halved 2,9 % among adult during the 21st century men in 2013. Women do not E-cigarettes typically use snus

E-cigarettes Waterpipe • 2 % of men and • Of the 18-year-old women used e- Finns, around 30 % cigarettes daily of have tried smoking occasionally in 2013. waterpipe. • 20 % of 14-16-year- • The popularity of old adolescents have waterpipe is tried them growing worldwide. at least once.

Exposure to environmental tobacco smoke in Finland 1983 – 2014

Home Workplace 34 34 32 30 30 28 28 28 27 26 26 26 26 26 26 26 26 25 25

24 24 24 24 %

19 17 15 14 14 13 12 9 9 9 8 8 8 7 6 6 6 5 4 3 2 2 2

83 86 89 91 93 95 96 97 98 99 00 01 02 03 04 05 06 7 8 11 12 13 14 year

Source: The National Institute for Health and Welfare (THL). Health Behaviour and Health among the Finnish Adult Population, Spring 2015. Report 6/2015. Tobacco Control Policy in Finland 1976 - 2009

Reduction of Health Hazards of Smoking

Health Price Policy: Legislation: Research, Education Excise Duty Act Tobacco Act monitoring The AIM of 2010

 To end the consumption of tobacco products by 2040

INSTEAD OF

 Reducing smoking and health hazards of smoking

ENDGAME Measures: 3 x P

1 §. This act applies to the measures to prevent initiation and to promote cessation of tobacco use and protect people from exposure to tobacco smoke.

The objective of this act is to end the consumption of tobacco products, which contain toxic compounds and create dependence.

Endgame

• A political process and a strategy to end the consumption of tobacco products.

Low demand for tobacco products affects the supply of tobacco.

Changes with the new course Legislative and related measures target for endgame warning signal to the tobacco industry

Wording and image tobacco control is investment and positive action Civil society deeper engagement

Social climate even more favourable

Elements of the Finnish Stragegy

 Prevent initiation of the use of tobacco products  Support quitting the use of tobacco products  Enlarge and monitor smoke-free environments  Prevent bringing novel tobacco and related products onto the market

The Finnish The actions will be monitored, studied Way does NOT support and developed, and also evaluated and harm updated every fifth year. reduction policy Follow up

• The Goal: In 2040 2030, two percent or less of the Finnish population will use tobacco products

The goal by 2030

20.0

18.0

16.0

14.0 - 12 % annually 12.0 Men 10.0 Women 8.0 Total

6.0

4.0

2.0

0.0

2016 2020 2014 2015 2017 2018 2019 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030

National Institute for Health and Welfare. 2015 Tobacco-Free Finland network

The following organisations are involved in the Tobacco-Free Finland network:

• Finnish Institute of Occupational Health • Finland’s ASH - Action on Smoking and Health • The Finnish Medical Society Duodecim • The Organisation for Respiratory Health in Finland • Filha - Finnish Lung Health Association • HYKS Pulmonology Clinic • The Finnish Respiratory Society • The Cancer Society of Finland • National Institute for Health and Welfare • SOSTE - Finnish Society for Social and Health • Doctors Against Tobacco • Finnish Heart Association • The Association of Health Promoting Hospitals in Finland • EHYT - Finnish Association for Substance Abuse Prevention • The Evangelical Lutheran Church of Finland • Allergy and Asthma Federation • Smoke-free Municipalities Tobacco-Free Finland

• Registered trademark which promotes the tobacco-free society as a positive goal. • The network gathers together all the main players in tobacco control in Finland. • The network ensures information sharing, multi- sectorial expertise and co- operation.

Ending the Tobacco Epidemic Requires

• Goals, plans and timetables • Legislation and. control, prevention of tobacco use and intensive smoking cessation services ENDGAME • Implementation does not and follow-up mean total prohibition of all tobacco products. What’s needed?

• Engage: tobacco users, quitters and people with tobacco induced disease sharing experiences and ideas: respect and empathy • Improve cessation services esp. in primary health care • Learn from the past: No compromises with tobacco industry • Follow up cost-effectiveness of steps along the road • Monitor development nationally and internationally • Strengthen international co-operation

Tobacco control is an investment into the future, like technological development, infrastructure and education. Plans for the near future

• Standardised packaging • Restrict the private import of tobacco • Regular price increases through taxation • Nationwide, continuous and tailored mass media campaigns • Ban on distance sales of tobacco products • Resources for control and monitoring • Free of charge, low-threshold services for quitting • E-cigarettes treated like cigarettes (licensing, tax, Standardised age limits, ban on additives, health warnings etc) packaging • Smoke-free housing gaining • Smoke-free private cars, when children are popularity present worldwide.

Main messages for success

• Aim to END (harm reduction) the use • Legislation + prevention + cessation • Political commitment • Can not be achieved by any one measure • Comprehensive strategy: 1 + 1 > 2 • FCTC + international collaboration

Tobacco epidemic can be stopped Health, social and economic benefits

MISSION POSSIBLE Tobacco-Free Finland

Thank you!