In recent months, the EU has launched several initiatives around tobacco policy and legislative frameworks, setting out the ambition for a ‘Tobacco-Free Generation’. Arising from Europe’s Beating Cancer Plan, the EU aims to reduce the size of its smoking population to less than 5% by 2040, compared to 25% today.
To this end, the European Commission launched a call for evidence to evaluate the EU legislative framework for tobacco control. This first step took stock of the gaps in the existing legal framework that aims to safeguard public health from tobacco-related harm.
According to evidence from 2019, tobacco use was responsible for over 907,000 premature deaths, while exposure to second-hand smoke accounted for over 73,000 deaths. Smoking is also the primary cause of chronic obstructive pulmonary disease (COPD), the third leading cause of mortality worldwide, and affects more than 36 million people in the European region.
Gaps in current legislation
EFA warmly welcomed the Commission’s initiative, which paves the way to the revision of the legislation in 2023 that we, as patient representatives, hope will be bold and forward-looking to protect the health of those living with asthma and COPD.
In our response, EFA underlined the urgency to tackle the tobacco epidemic, given the heavy burden of smoking on respiratory health. Electronic cigarettes (e-cigarettes) and novel products such as heated tobacco products (HTPs) are of particular interest, as they are subject to industry practices targeting the youth. In addition, we discuss the health risks from the exposure to second-hand smoke, and the need for 100% smoke-free environments.
Electronic cigarettes and novel tobacco products: A heavy toll on respiratory diseases
With the consumption of novel tobacco products rapidly increasing, EFA flags the loophole in legislation which exempts e-cigarettes and heated products from the ban on characterising flavours such as candy and menthol, considered as a key reason for their popularity among the youth.
While research on such novel products is still emerging, there is scientific consensus that they lead to negative effects on health. For example, e-cigarettes contain harmful chemicals linked to increased symptoms, more exacerbations and a more rapid decline in pulmonary function in asthma and COPD patients. Similarly, heated tobacco products contain various toxic and irritant substances, including nicotine and tar levels that are almost identical to conventional cigarettes.
When looking at the tobacco harm reduction strategies, the smoking industry typically promotes novel tobacco and non-tobacco-based products as ‘reduced risk products’, and even as a step towards quitting. Contrary to this narrative, however, studies reveal that e-cigarettes, often serve as an initiation to smoking, with users moving on to other smoking products soon after.
Packaging and labelling aspects: imbalances leading to health harms
EFA also reflected on the imbalances leading to health harms when it comes to packing and labelling aspects. It is encouraging to see India implementation report of the Tobacco Products Directive (TPD) that the eight Member who have gone beyond the TPD labelling provisions by implementing a mandatory plain packaging for tobacco products, report today increased awareness of tobacco-related diseases and associated illnesses and motivation to quit, including among young people.
Exposure to smoke: patients find themselves unprotected
EFA also highlighted the effects of being exposed to second-hand smoke (SHS). This is a factor of growing concern, especially for vulnerable groups such as children, pregnant women and people with chronic respiratory conditions.
Notably, latest research prove a strong association between exposure to SHS and an increase in respiratory symptoms. In the EFA ‘Access’ report of 2019, patients ranked tobacco smoke as their biggest concern, with 9 in 10 asthma and COPD patients considering it as the main indoor pollutant that triggers most of their symptoms. Moreover, 1 in 3 patients thinks that more should be done to protect citizens in this respect, as exposure to second-hand smoke indoors remains high.
Despite progress being made towards smoke-free environments, there are considerable gaps that remain to achieve a truly smoke-free region within the EU and ensure full protection of people from exposure second-hand smoke. In this respect, EFA welcomes the newly launched call for evidence of the update of the 2009 Council recommendation on Smoke-Free Environments.
Next steps
Given the extensive harm on health caused by both the use of tobacco products and the exposure to second-hand smoke, EFA considers the EU’s revision of the Tobacco Products Directive and the update of the Council Recommendation on Smoke-Free Environments as key opportunities to #ShowLeadership and take bold actions for the purpose of achieving a Tobacco-Free Generation by 2040.
You can access the full EFA response here.