Dr Katrín Fjeldsted is the President of the Standing Committee of European Doctors (CPME).
Smoking is harmful to health – unconditionally. The morbidity and mortality caused by tobacco consumption and exposure to its emissions undeniably poses an immense social and economic burden on Europe. In particular, because this harm could be prevented.
Tobacco control laws are intended to counteract some of this harm. The extent of tobacco’s damaging effects merits the very strictest of legal frameworks in which its production and sale is permitted.
All too often though, commercial interests override health, resulting in laws which fall short of implementing the evidence-base for effective tobacco controls and adhering to international obligations, such as the Framework Convention for Tobacco Control put in place by the World Health Organization (WHO).
While international obligations exist, Europe has so far been lagging behind in creating a new legal framework to strengthen the controls on tobacco manufacture, presentation and sale of tobacco and related products; despite the fact that a high level of protection of human health is enshrined in Article 114 III of the Treaty on the functioning of the European Union.
In the work towards a new Tobacco Products Directive, replacing Directive 2001/37/EC, the protection of health must be the guiding principle. In focus in particular are young people and children which need to be stopped from taking up smoking. Established smokers must be given easy access to and information on smoking cessation tools.
Three issues merit special attention:
- Labelling and packaging: In order to make cigarettes less attractive, advertisement and design features of its packaging need to be restricted strongly. Life style messages and design themes should be replaced by information highlighting the harmful characteristics of tobacco and show opportunities for smoking cessation. Scientific evidence recommends a combination of health warnings composed of both text and pictures. Since studies have shown a linear relationship between the size of health warning and their deterrent effect, the 75% unit package surface coverage proposed by the Commission must be the aim.
- Additives: Many additives, such as menthol or fruit aromas, are introduced to tobacco products mask the flavour of tobacco itself. The result is that the consumption of such products is easier and thus more accessible, particularly for new smokers. It is therefore necessary to prohibit tobacco products with a characterising flavour. Likewise additives which imply vitality or energy and health benefits or colour smoke, as well as additives which increase the toxicity or adictiveness of a tobacco product upon consumption must be banned from use. This ban must include forms in which they are added to tobacco products after the manufacturing process, for instance by the consumer.
- ‘Slim’ cigarettes: These products are in packaging and marketing overwhelmingly designed to appeal to young women, with brand names making direct references to this target group and lifestyle features relevant to them. It is a further method used to imply a diminished strength of tobacco and thus a lesser degree of harm. The consumption of cigarettes of which the diameter is less than 7.5 mm is in no way less harmful than other products, therefore they must be prohibited.
With the adoption of a new Tobacco Products Directive there is the opportunity to introduce policy changes which are achievable and which are proven to benefit the protection of health against tobacco-related harm. From the medical point of view there is no ambiguity. European institutions must fulfil their obligation towards their citizens and legislate better tobacco control laws for better health. The evidence is on their side.