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The EU has been actively contributing to the reduction of tobacco consumption for more than twenty years. This contribution has evolved from prevention, training and research within the scope of the fight against cancer, to a broad strategic tobacco control approach. The current EU-wide efforts are based on four mutually reinforcing pillars: legislation, support for prevention, integrating tobacco control into other EU Community policies, and international cooperation. EU action focuses on supporting prevention, collaboration between Member States, and research. The quest for a smoke free EU also forms part of the Environment and Health Action Plan, through which passive smoking is now more actively tackled.
Legally, these efforts are firmly grounded in the Community Treaties and supported further by a range of specific regulations. The legal competencies of the EU enable it to make some unique contributions to tobacco control in Europe, and indeed globally. The WHO Framework Convention on Tobacco Control, which all Member States and the Community have signed, has been a significant factor in the further advancement of tobacco control at EU and Member State level.
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There is broad consensus on the effectiveness of six policy measures that can be implemented at (sub)national level. These measures differ as to the extent of their impact. Prices and taxation policies (1) are attributed most impact, followed by smoking bans in workplaces and public places (2). Bans on advertising of tobacco products (3), appropriate consumer information (4), warning labels (5) and treatment for those wanting to quit smoking (6) complete the six effective measures. A comprehensive strategy incorporating all six measures is most effective.
Policy makers can therefore build on a range of policy options that have been proven to be effective in the past. It is, however, also important that they remain vigilant to newly emerging challenges, such as internet sales.
Smoking is almost invariably more common among the poor. Consequently, the harmful effects of smoking add to their existing disproportionate health burden. There is clear evidence that tobacco control measures can make a considerable contribution to reducing social inequalities in health in Europe.
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