Smoking, drinking, bad nutritional habits and lack of physical activity are life-style related health determinants linked to a number of major health problems, such as cancer, cardio-vascular disease and obesity.
According to WHO estimates, up to 80% of cases of coronary heart disease, 90% of type 2 diabetes cases, and one-third of cancers can be avoided by increases physical activity, healthier diet and stopping smoking.
In December 2003, the European Council invited the Commission and the member states to develop a plan including several initiatives to promote healthy lifestyles to citizens, and, since 2003, the EU's Public Health Action Programme (2003-2008) is tackling the key health risk factors and in particular lifestyle-related determinants of health.
This lifestyle-based approach is the first of its kind in the EU health policy and recognises that effective prevention, in fact, presents a solution to EU's health systems' economic problems. The annual direct and indirect economic cost in the EU of cardio-vascular disease, for example, is estimated at 70-135 billion euro, which is more than the total annual EU budget.
Smoking is the leading cause of death in the EU and tackling smoking therefore requires integrated action both at national and EU level. The EU anti-smoking campaign called HELP - For a life without tobacco was launched in March 2005 and aims to help those who want to quit to abandon this habit and dissuade others from ever lighting their first cigarette. The campaign's TV advertising makes particular use of humour to highlight how ridiculous and abnormal smoking really is and aims to inform of the various channels through which citizens can seek help for quitting.
In January 2007, the Commission adopted a Green paper Towards a Europe free from tobacco smoke: policy options at EU level. The paper launched a wide public debate on the best way to tackle passive smoking in the EU.
The EU Tobacco Advertising Directive, adopted in May 2003, was due to be implemented in national legislation by 31 July 2005. The directive bans tobacco advertising in the print media, on radio and over the internet and forbids tobacco sponsorships of cross-border events and activities.
Nutrition is one of the major health determinants and is one of the main determinants for cardiovascular disease and cancer whereas obesity is often related to ill health and premature death. Commission's recent (December 2005) Green Paper on obesity entitled Promoting healthy diets and physical activity: a European dimension for the prevention of overweight, obesity and chronic diseases, speaks for the growing importance given to this issue at EU level.
Nutritional lifestyle factors, eating habits and levels of physical exercise are often adopted very early in life and tend to persist throughout the life. Therefore, the recent increase, in many countries, of childhood obesity is particularly worrying.
Currently, an EU stakeholder Platform for action on diet, physical activity and health is discussing the ways forward with the aim of committing themselves for concrete actions to reverse current trends. Platform's initial recommendations for solutions to the problem include improving adult consumer behaviour and motivating young people towards healthy lifestyles. A number of European projects is funded to support the adoption of healthy nutritional habits.
Europeans drink the most in the world (the highest alcohol per capita consumption) and alcohol causes nearly 1 in 10 of all ill health and premature death in Europe. Drinking also pulls productivity down, as each hangover day means a significant drop in productivity (27%, according to a UK study).
The Commission adopted, in October 2006, a communication on reducing alcohol related harm in Europe. The policy objective of this strategy will be to reduce the health and social harm due to alcohol consumption. It priorities are: protection of young people and children; reduction of alcohol-related road accidents; reduction of the negative impact on the economy; raising awareness of health impacts of alcohol abuse. A number of European projects is currently being funded to support responsible drinking.
The European alcohol and health forum was established in June 2007 to bring together businesses and NGOs to take action on harmful use of alcohol. It is set to focus in particular on concrete actions to protect children and young people and to prevent irresponsible commercial alcohol communication and sales.
Promoting healthy lifestyles
The Council has invited the Commission and the member states to promote healthy lifestyles to the citizens by targeted health actions and communication, by strengthened monitoring of the impact of health determinants, by mobilising the existing stakeholder groups and networks and by encouraging manufacturers and commercial enterprises to promote healthy lifestyles through production, marketing and related activities.
Naturally, high extra taxation, up to member states, of alcoholic beverages and of tobacco, can be an efficient instrument in the efforts to decrease the prevalence of drinking and smoking.
The WHO Framework Convention on Tobacco Control (WHO FCTC), which entered into force on 27 February 2006, is the first global health treaty addressing both demand reduction strategies as well as supply reduction issues. The EU has ratified this convention.
Philip Morris: "We fully support laws that are designed to reduce children's exposure to tobacco advertising, yet allow us to keep talking to adult smokers."
The European Smoking Tobacco Association (ESTA) "supports provisions for both smokers and non-smokers, minimising possible nuisance through environmental tobacco smoke in public and workplaces through segregated non-smoking areas, adequate ventilation and air filtration." According to ESTA, this can be best achieved through local or national regulations or voluntary agreements, for example between employers and employees or between industry and the legislator.
The Standing Committee of European Doctors (CPME) and the Pharmaceutical Group of the European Union (PGEU) think that "the European Commission and member-state governments have a moral obligation to complement smoke-free legislation with an effective policy designed to help smokers give up." According to these two organisations, the policy put forward should include sustained price and taxation increases and education and health promotion particularly directed at the young.
For more positions on tobacco, see EurActiv 30 January 2007.
The Confederation of the food and drink industries of the European Union (CIAA), believes that any EU action for the prevention of overweight, obesity and chronic diseases should be established in a way that respects: free and informed choice for all consumers in Europe, dietary diversity and cultural identity of the EU member states and regions, the need for a strong scientific basis for all policy development, the need for EU policy to give added value over and above what is developed by the member states, the principle of proportionality and the need for all policy options to be evaluated to determine whether they are meeting the health goals set out for them.
The European Consumers’ Organisation (BEUC) wants the current revision of the Television Without Frontiers Directive to restrict marketing to children of foods high in fat, sugar and salt. It also highlights the need to assure that all consumers have clear, consistent information about what is a healthy diet and have access to healthy, affordable products.
EURO COOP, the European Community of Consumer Co-operatives, believes that education about the benefits of a balanced diet coupled with physical exercise should start at a very early age.
The EU-Office of German Sports states that the role of sports, especially the role of sports early in school, is not promoted enough.The Standing Committee of European Doctors (CPME) considers children and young people to be the most important single target group to address in the struggle against obesity in Europe, as behavioural patterns established in childhood and adolescence often remain in adult life.
The read individual to the Commission's stakeholder consultation on the Green paper on obesity click here.
The Brewers of Europe highlight the need for all EU action on alcohol to be evidence-based and to target only the misuse of alcoholic beverages, instead of "compromising the pleasure enjoyed by the people who drink responsibly".
In a recent conference, organised by the Brewers of Europe, medical evidence was presented on the benefits for health of moderate beer drinking.
Nordic countries, in particular Finland, are in favour an increase in the tax on spirits. "Alcohol policy is a national competence and each member state has its way of dealing with alcohol-related harm. One of the ways is to use the alcohol tax revenue to actions aimed at combating alcohol abuse and related health and social harm," commented an official from the Finnish permanent representation.
The European Spirits Organisation (CEPS) welcomes the Commission Communication on alcohol related harm, as it acknowledges "the role the alcohol industry can play in reducing alcohol related harm, most notably in terms of promoting responsible consumption. The five priority themes proposed are entirely consistent with CEPS’ Charter on Responsible Alcohol Consumption," said Jamie Fortescue, Director General of CEPS.
For more positions on alcohol, see EurActiv 25 October 2006.
- Oct. 2006: The Commission adopted a communication on EU strategy to reduce alcohol related harm.
- Jan. 2007: The Commission adopted a Green paper presenting policy options for the best way to tackle passive smoking in the EU.
- April 2007: The 15th European Congress on Obesity (ECO)
- 30 May 2007: The Commission adopted a White Paper on nutrition and physical activity.
- 7 June 2007: European alcohol and health forum established.
- June 2007: The 3rd annual Obesity Europe conference 2007.
- 3 July 2007: Conference on diet, physical activity and health @ workplace.
- 11 July 2007: The Commission presented a White Paper on sport.
- Autumn 2007: Joint Commission-UEFA campaign on physical activity.
- 17 Oct. 2007: The first plenary meeting of the European Alcohol and Health forum.
- 18 Oct. 2007: 1st European Parliamentary Symposium on Diet and Health.
- 14 Dec. 2007: The members of the European Alcohol and Health Forum publish their first series of commitments aimed at reducing alcohol-related harm.
- 17 April 2008: 2nd European Alcohol and Health forum.
EU official documents
- Commission:Key documents on obesity
- Commission:Key documents on tobacco [Legal documents]
- Commission:Key documents on alcohol [Legal documents]
- Council:Conclusions on obesity, nutrition and physical activity(2 December 2003) [FR] [FR] [DE]
- Commission:Health determinants - Lifestyle
- Eurobarometer:Health in the European Union(September 2007) [FR]
- Eurobarometer:Health, Food and Alcohol and Safety(December 2003)
- Eurobarometer:Attitudes towards alcohol(14 March 2007)
- Eurobarometer:Physical Activity(December 2003)
- Eurobarometer:Smoking and the environment: actions and attitudes(November 2003)
- Commission:Tobacco or health in European Union: Past, present and future(October 2004) [FR] [FR] [DE]
- WHO:WHO Framework Convention on Tobacco Control (WHO FCTC)
- WHO - regional office for Europe:Smoking
- European Network for Smoking Prevention
- International Obesity Task Force (IOTF)
- European Childhood Obesity Group(ECOG)
- North American Association for the Study of Obesity (NAASO)
- WHO - regional office for Europe:Obesity
- WHO - regional office for Europe:Alcohol drinking
- WHO - regional office for Europe:Alcohol policy in the WHO European Region: current status and the way forward(12 September 2005) [FR] [FR] [DE]
- French Health Ministry:Programme National Nutrition Santé (PNNS)
- UK Department of Health:Forecasting Obesity to 2010(25 August 2006)
- Germany:Health Prevention
- WHO - regional office for Europe:Tobacco control database containing data on smoking prevalence and various aspects of tobacco control policies in WHO European Member States
- WHO - regional office for Europe:Nutrition Policy Database containing data on nutrition policies, including policy documents, institutions for implementation and collaboration with stakeholders in WHO European Member States
- Denmark:National Action Plan against obesity(2003)
- Finland:Action Program for Implementing National Nutrition Recommendations(2003)
- France:National Nutrition Health Program 2001-2005(2001)
- Greece:Dietary guidelines for adults in Greece(2002)
- Ireland:Obesity: The Policy Challenges(2005)
- The Netherlands:Time to sport(2005)
- Spain:Spanish Strategy for Nutrition, Physical Activity and Prevention of Obesity (NAOS)(2005)
- Sweden:Background material to the Action Plan for healthy dietary habits and increased Physical Activity(2005)
- The United Kingdom:Choosing Health? Choosing a Better Diet(2005)
- WHO - regional office for Europe:Alcohol control database providing data to track and assess alcohol policies and their implementation within and across countries of the European region
- Finland:Alcohol policy
- France:Alcool - Stratégie de prévention
- Sweden:Sweden's alcohol policy
Business & Industry
- SAB MillerTalking alcohol.com
- Tobacco Manufacturers' Association:Choosing Health? Tobacco Issues(June 2004)
- European Smoking Tobacco Association (ESTA)
- Tobacco Manufacturers' Association
- Tobacco Reporter (pro-tobacco trade journal)
- British American Tobacco:Smoking and health
- Philip Morris:Smoking and health
- Philip Morris:Health Issues
- Kraft Foods:Comments on the Green Paper "Promoting Healthy Diets and Physical Activity":(15 March 2006)
- Kraft Foods:Europeans Slow to Move on Obesity Concerns - New Report Reveals Data on Attitudes to Controlling Obesity(February 2006)
- Confederation of the food and drink industries of the European Union (CIAA):CIAA comments on the Green Paper on obesity(31 March 2006)
- Pharmaceutical Group of the European Union (PGEU):PGEU submission to the Commission's Green Paper on obesity(17 March 2006)
- Freshfel Europe - the forum for the fresh produce industry:Freshfel response to Green Paper on obesity
- AMCHAM EU - American chamber of commerce to the EU:Position Paper on the Green Paper on Healthy Diets and Physical Activity(15 March 2006)
- European Publishers Council (EPC):EPC Response to the Commission's Green Paper on "Promoting healthy diets and physical activity(14 March 2006)
- The Brewers of Europe:A few beers a day can help keep the doctor away(4 May 2006)
- Worldwide Brewing Alliance:Drinking and driving - Report 2(March 2006)
- Worldwide Brewing Alliance:Comments on the DG SANCO informal draft discussion paper on the EU Strategy on Alcohol(September 2005)
- The Brewers of Europe:Comments on the DG SANCO informal draft discussion paper on the EU Strategy on Alcohol(September 2005)
NGOs and Think-Tanks
- European Public Health Alliance (EPHA):Report Highlights Cost Factors in Choosing Healthy Foods(31 July 2006)
- European Public Health Alliance (EPHA):Tobacco and Smoking
- GreenFacts:Scientific Facts on Tobacco - Active and Passive Smoking
- Standing Committee of European Doctors (CPME):CPME position paper on tobacco(3 September 2005) [FR]
- Action on smoking and health
- European Consumers’ Organisation (BEUC):BEUC’s Response to the Commission's Green Paper on obesity(16 March 2006)
- EURO COOP - the European Community of Consumer Co-operatives:EURO COOP response to the Commission's Green Paper on obesity(13 March 2006)
- Standing Committee of European Doctors (CPME):CPME contribution to the Commission's Green Paper on obesity(11 March 2006)
- European Men's Health Forum (EMHF):Tackling overweight and obesity in men in Europe(March 2006)
- European Association for the Study of Obesity (EASO) [members] [members] [publications]
- International Association for the Study of Obesity (IASO) [publications]
- GreenFacts:Scientific Facts on Alcohol
- European Alcohol Policy Alliance:
- EPHA Briefing:Alcohol and Young People(1 December 2004)
- Finnish National Research and Development Centre for Welfare and Health (STAKES):Consumption of Alcohol in Fourteen European Countries - A Comparative Econometric Analysis(2001)
- Centre for Social Research on Alcohol and Drugs (SoRAD) (Sweden)
- European alcohol policy alliance (Eurocare):Drinking and Driving in Europe(2003)
- European alcohol policy alliance (Eurocare):The beverage alcohol industry’s social aspects organizations: A public health warning(2002)
- European alcohol policy alliance (Eurocare):Counterbalancing the Drinks Industry(1995)
Surveys and data
- Review on Alcoholism: Clinical and Experimental Research:Binge Drinking in Madrid, Spain(October 2007)
- Annals of Epidemiology Volume 17, Issue 5, Supplement :Moderate drinking and health(May 2007)
- TNS Opinion:Young Europeans drink less often though more heavily per sitting(23 April 2007)
- International Center for Alcohol Policies (ICAP)