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EU Tobacco Products Directive: A bittersweet victory for public health?
Figures from the European Commission estimate that tobacco is responsible for 700,000 deaths every year in Europe. Meanwhile, according to the World Health Organisation, tobacco consumption, physical inactivity, unhealthy diet and the harmful use of alcohol have demonstrated to represent the four major behavioural risk factors that dramatically contribute to the development of non-communicable diseases (NCDs). And smoking tends to start at a young age, as figures from the European Commission show that almost three quarters of smokers start before the age of 18.
In a bid to reduce the rate of smoking, the European Parliament (EP) plenary voted on first reading on the Tobacco Products Directive (TPD). The text aims to revise a previous version of the Tobacco Products Directive approved in the EU in 2001. In particular, the Members of European Parliament (MEP) have been called to decide on 189 amendments adopted by the European Parliament's Environment and Public Health Committee (ENVI) in July 2013. Over the last months, health organisations have vigorously campaigned in favour of the introduction of stringent controls of tobacco consumption. Furthermore, support to the legislation has also come from the World Health Organisation which has officially backed the TPD by declaring in an official statement published on 7 October 2013:
'Europeans who are concerned about the toll of the tobacco epidemic and all of us in the public health community are urging you to hear our collective voices as we call on you to support the adoption of the Tobacco Products Directive. WHO stands ready to support the process and the future steps which will be necessary to implement the new European Tobacco Products Directive.'
Main changes introduced by the legislation The TPD voted by the EP plenary introduces substantial changes that are expected to reduce tobacco consumption in particular among young people. In particular, the legislation establishes:
- Mandatory warning labels on health risk will cover 65% of cigarettes' packages. Furthermore, labels will be placed at top at the packages to ensure they are fully visible when cigarettes' packages are displayed for sale.
- Cigarette packages containing less than 20 cigarettes will be banned.
- E-cigarettes will be subjects to the same advertisement regulation that are applied to tobacco. Furthermore they will also be banned for young people under the age of 18.
- Additives and flavourings in tobacco will be prohibited by 2016 while menthol cigarettes will be banned by 2022.
The full text of the legislation voted by the EP is available here.
Next steps Further to the plenary vote, the EP and the Council are requested to reach an agreement on the legislation over the next months. Ms Linda McAvan, United Kingdom MEP and rapporteur of the European Parliament on the TPD has been given the mandate to negotiate with the EU ministers. If negotiations fail, the text will go back to the Parliament for the second reading. Once the text is approved and published on the official gazette of the EU, the 28 EU Member States are required to transpose the new provisions into national legislation within 18 months.
The European Council presidency will pass from Lithuania to Greece in January 2014. As many commentators highlight, this may represent an obstacle for the TPD as it appears that Greece could be not as favourable as the current Lithuanian presidency to the legislation.
Implications The TPD certainly represents a step forward in introducing more stringent controls on tobacco consumption. Having said that, the text emerged by the plenary vote on 8 October has been perceived by the health campaigners as "a mixed victory for tobacco control", as remarked in a joint press release issued by European Public Health Alliance. It is an undeniable fact that some of the provisions approved by the ENVI committee were mitigated by the plenary vote. For example, dimension of the health warnings on the packages has been reduced from 75% to 65% by the plenary. Furthermore, e-cigarettes will not be subject to the same regulatory requirements as medicinal products. In addition, ban on menthol cigarettes has been delayed by five years. Finally, the plenary rejected the ban on slim cigarettes.
However, the text as approved has actually scored important points in favour of tobacco control. The ban on small cigarette packages as well as on flavoured cigarettes, which are particularly attractive for young people, is expected to drive down tobacco consumption among the younger generations.
A tightening up of the rules concerning tobacco consumption, in particular among the young population, may pave the way for positive public health outcomes in the medium and long term. The European Member States that are now called to decide on the legislation should certainly consider the economic toll imposed by NCDs on the healthcare systems. Among other evidence, recent data published by the British journal The Lancet, the EU Member States spent in 2009 approximately USD171 billion on cancer cost. Therefore, in a situation where budgets of governments are tight and financing on healthcare get systematically curtailed, prevention of NCDs should in my opinion represent a number one priority on policy makers' agenda.
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