No smoke without fire

DISCLAIMER: All opinions in this column reflect the views of the author(s), not of EURACTIV Media network.

This article is part of our special report Reviewing Europe’s alcohol harm strategy.

There is no surprise that EU Health officials are not listening to tobacco retailers and the tobacco industry, smoking costs the EU the equivalent of its budget each year, according to three public health campaigners.

Monika Kosinska is the secretary-general of the European Public Health Alliance, Cornel Radu-Loghin is director of policy and strategy at the European Network for Smoking and Tobacco Prevention, and Florence Berteletti Kemp is the director of the Smoke Free Partnership.

"In your article of 10 November (‘Tobacco lobby threatens EU over plain packaging’) you state that the Federation of Tobacco Retailers (CEDT) has complained that health officials in the European Commission are not listening to their arguments surrounding the revision of the tobacco products directive.

We – European Public Health Alliance, Smoke Free Partnership,  European Network on Smoking Prevention and the Framework Convention Alliance – welcome that the Health Commissioner is willing to put public health first while respecting the value of the Framework Convention on Tobacco Control (FCTC) –  international Treaty signed by the European Union.

We would remind tobacco retailers that it should not come as a surprise that health officials are not listening to them. Tobacco use kills half of all consumers and the tobacco industry's business interests directly conflict with the goals of public health – it would therefore be inappropriate to give those who promote its use a seat at the negotiating table.

As Commissioner Dalli said in the same article, ‘tobacco is the largest avoidable health risk in Europe’. The recent Aspect Report very conservatively estimated the cost to the EU of tobacco-related disease at €100 Billion – corresponding to €228-281 per citizen,  1% of total GDP – a sum almost equivalent to the entire annual EU budget.

Respiratory diseases – the major five are chronic obstructive pulmonary disease (COPD), asthma, lung cancer, pneumonia and tuberculosis – cause almost 20% of all deaths worldwide, and account for a financial burden of over €100 billion in Europe alone, due to health care costs and lost working days. This far outweighs the €20 billion which the CEDT president claimed would be lost in European tax revenue from directive revisions and represents just one class of diseases affected by tobacco use.

Exposure to tobacco smoke is calculated to cause 22% of all cases of cardiovascular disease (CVD) in industrialised countries. Overall CVD is estimated to cost the EU economy €192 billion a year. This represents a total annual cost per capita of €391.

COPD, a lung and airways disease, alone affects more than 3.5 million people in France, 3 million in the UK, and 2.7 million in Germany and affects between 4% and 10% of the European adult population. The World Health Organisation estimates that it will be the third cause of death worldwide by 2030. The primary cause of COPD is tobacco smoke (through tobacco use or second-hand smoke). The number of deaths from COPD has increased more than 60% over the last 20 years. We trust that health protection and disease prevention will be at the centre of the European Union review of the Tobacco Product Directive, to show support and understanding to millions of sufferers.

The dangerous health effects of secondhand smoke have been documented in over 20 reports from the International Agency for Research on Cancer, the US Surgeon General, among others. A cautious estimate is that exposure to such smoke kills at least 79,000 people in the EU each year. This estimate includes deaths from lung cancer, coronary heart disease, stroke and chronic non-neoplastic respiratory disease; but it omits deaths in childhood caused by such smoke, deaths in adults from other conditions known to be caused by active smoking and the significant, serious morbidity, both acute and chronic, caused by the smoke.

So far, Commissioner Dalli has shown himself to be a leader in the fight against tobacco use in Europe.  EPHA, SFP, ENSP and FCA look forward to a strong revision of the Tobacco Products Directive and are delighted to hear that the European Union may be looking to follow Australia’s ambitious lead in implementing plain packaging and trust that the Union will be similarly steadfast in its strong stance to not be bullied by threatening industry."

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