The European Commission is calling for stricter actions on tobacco regulations in a bid to have a tobacco-free generation in the EU by 2040. However, the global number of smokers continues to grow.

On May 27, the renowned Lancet medical journal published a research on tobacco usage, which gathered data from 204 countries, showing that although the prevalence of smoking has decreased significantly since 1990, population growth has led to a great rise in the total number of smokers worldwide. 

“Smoking is a major risk factor that threatens the health of people worldwide, but tobacco control is woefully insufficient in many countries around the world,” warned Emmanuela Gakidou, senior author of Lancet research. 

Even though the EU has been seeing a slight decline in smoking prevalence since 2006, the Commission has repeatedly recognised that more efforts are needed.

The EU’s goal to have a ‘Tobacco-free Generation’ by 2040 is set in Europe’s Beating Cancer Plan. Tobacco is known as “the single largest avoidable health risk in the EU”, with  27% of all cancers attributed to its use. 

As the EU’s Health Commissioner Stella Kyriakides remarked on World No Tobacco Day (31 May), there is a very clear objective “to create a smoke-free generation in Europe, where less than 5% of people use tobacco by 2040.” This would mean a drop of 20 percentage points as around 25% of EU citizens use tobacco now. 

“EU legislation on tobacco has clearly had a positive impact on smoking rates in the EU, but to meet our target, we must set our sights higher. The upcoming review of the Tobacco Products Directive will be an important part of this work,” Kyriakides added 

On May 20, the European Commission published its first report on the Tobacco Products Directive, which became applicable in 2016. 

The Directive put in place enlarged combined health warnings, a track and trace system, a ban on characterising flavours, the creation of an ingredients database and the regulation of electronic cigarettes. 

Smoking prevalence decline is not the whole story

Despite those measures, the Lancet research has found that several countries in Europe had the highest tobacco consumption per person in 2019, with Montenegro, North Macedonia, Bulgaria, Slovenia, and Greece all having consumption exceeding 2,350 cigarette equivalents per person. 

Cigarettes smoked per day is an important predictor of disease risk, although smokers who consume only a few cigarettes each day still have considerable excess risk compared with non-smokers, researchers warn.

Furthermore, countries in central and eastern Europe, and East Asia regions had high rates of deaths attributable to smoking tobacco use among males. In the meantime, females in four countries, Denmark, Montenegro, Serbia, and Greenland, had rates of deaths attributable to smoking tobacco use higher than 180 per 100,000 females.

Moreover, although the smoking prevalence declined in the EU across both sexes, for females in Lithuania and Portugal, it increased significantly over the past 30 years. 

On the bright side, the largest decreases in age-standardised prevalence of smoking tobacco use for both sexes, reaching around 50%, were observed in Norway and Denmark.

Another research, published on 26 May by French national health agency Santé Publique France, says that, while the countries had seen a decline in smoking between 2014 and 2019, the figure was stable in 2020.

In 2020, more than three out of ten French people aged between 18 and 75 reported smoking (31.8%), and a quarter were daily smokers (25.5%).

However, the daily smoking rate increased among the lowest-income third of the population, from 29.8% to 33.3%. This increase is mainly due to an increase between 2019 and early 2020, before the first lockdown. Social inequalities thus remain very pronounced, with a 15-point gap between the lowest and highest incomes.

The Commission is focusing on the youth 

In the report on the Tobacco Products Directive, the Commission is calling for focusing on enforcement at the national level and better consideration of new market developments, such as novel tobacco products.

“We need to step up our game and ensure that EU tobacco legislation is enforced more strictly, especially as regards sales to minors and campaigns on giving up smoking,” Kyriakides said. She added that keeping up with new developments of tobacco products is “particularly important to protect younger people”.

The Lancet research has revealed that 89% of new smokers become addicted by age 25, therefore protecting young people from nicotine addiction during this “critical window” is crucial for eliminating tobacco use among the next generation

“If a person does not become a regular smoker by age 25, they are very unlikely to become a smoker. This presents a critical window of opportunity for interventions that can prevent young people from starting smoking and improve their health for the rest of their lives,” said Gakidou, the author of the research.

The research has shown that more than half of countries worldwide are showing no progress in reducing smoking among 15-24-year-olds. Anne Damiani and Giedre Peseckyte | EURACTIV.com

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