Tobacco Control in Ukraine The National report Ministry of Health of Ukraine ABSTRACT This report describes the status of tobacco control and tobacco control policies in Ukraine in mid–2008. It reviews progress following the adoption of national tobacco control legislation in 2005, and establishes a baseline for monitoring the implementation of the WHO Framework Convention on Tobacco Control (ratified in 2006) and the national tobacco control programme, which is being prepared by the government. The document presents an overview of the situation regarding tobacco use and related harm in Ukraine and policy responses and implementation of tobacco control measures at national and local levels. Keywords SMOKING – adverse effects – prevention and control HEALTH POLICY HEALTH PROMOTION TOBACCO – legislation TOBACCO INDUSTRY– legislation GUIDELINES UKRAINE Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (http://www.euro.who.int/pubrequest). © World Health Organization 2009 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. 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CONTENTS Page Tables and Figures.................................................................................................................................. i Acknowledgements ................................................................................................................................iii Preface ............................................................................................................................................ v Executive summary................................................................................................................................1 Introduction ..........................................................................................................................................4 1. General information on Ukraine..........................................................................................................5 Population...................................................................................................................................5 Administrative structure ...............................................................................................................7 Socioeconomic development.........................................................................................................7 Financing of health care ...............................................................................................................7 Health of the population...............................................................................................................8 2. Tobacco consumption and tobacco-related harm............................................................................... 11 Active smoking and related problems .......................................................................................... 11 Exposure to second-hand tobacco smoke..................................................................................... 20 Stopping smoking and level of nicotine dependence...................................................................... 21 Tobacco-related mortality and morbidity...................................................................................... 23 Conclusions with regard to tobacco consumption and tobacco-related harm.................................... 26 3. Tobacco-related economic data........................................................................................................ 27 Tobacco consumption ................................................................................................................ 27 Cultivation of tobacco................................................................................................................. 28 Tobacco production and employment .......................................................................................... 29 Tobacco prices .......................................................................................................................... 31 Tobacco expenditure of the population ........................................................................................ 32 Tobacco taxes and revenue ........................................................................................................ 33 Foreign trade ............................................................................................................................ 35 Smuggling................................................................................................................................. 36 Conclusions based on tobacco-related economic data ................................................................... 38 4. Tobacco control policies................................................................................................................... 38 Political priorities and responsibilities in tobacco control ................................................................ 38 Regulation of tobacco advertising................................................................................................ 43 Tobacco taxation and price policy................................................................................................ 46 Development of smoke-free policies ............................................................................................ 53 Development of policy for the packaging and labelling of tobacco products..................................... 57 Other tobacco control regulations................................................................................................ 60 5. Response to tobacco-related problems ............................................................................................. 62 Health services and health promotion.......................................................................................... 62 Aid to stop smoking ................................................................................................................... 63 Response of the education system to tobacco-related problems..................................................... 70 Information campaigns on tobacco-related harm and tobacco control measures.............................. 73 Nongovernmental participation in tobacco control......................................................................... 75 Tobacco-related studies conducted in Ukraine.............................................................................. 78 Conclusions and recommendations ....................................................................................................... 79 References .......................................................................................................................................... 82 Annex 1 Law No. 2899-IV on Measures to Prevent and Reduce the Use of Tobacco Products and Their Harmful Impact on Public Health .............................................. 86 Annex 2 Concept of the National Programme for Reduction of the Harmful Impact of Tobacco on Public Health in Ukraine for 2008–2012....................................................... 101 Annex 3 Draft of a model resolution for local authorities on the regulation of tobacco-smoking within their administrative areas ............................................................. 106 Annex 4 Published research related to tobacco control in Ukraine ...................................................... 109 Tobacco control in Ukraine page i Tables and Figures Tables Table 1. Age structure of population, Ukraine, 1990–2008................................................................6 Table 2. Basic indices of socioeconomic development, Ukraine, 2001–2006........................................7 Table 3. National health care expenditure,