BREATHING IN A NEW ERA
A COMPARATIVE ANALYSIS OF LUNG CANCER POLICIES ACROSS EUROPE
In many of the countries in our study, tobacco control programmes need to be strengthened.
For example, several countries have only partial bans on smoking, and some have no smoke-free
legislation in place. For example, Belgium has banned smoking on public transport but not in offices, or
in restaurants, cafes, pubs or bars. The opposite situation is found in Finland, where smoking is banned
in offices and various eateries, but not on public transport. The Netherlands has enforced no smoking
bans in any of the areas we studied.*
On the plus side, a national agency for tobacco control exists in all 11 countries, and each country has
signed up to WHO’s Framework Convention on Tobacco Control. Likewise, national advertising bans
for tobacco exist in all countries, and mandatory health warnings must appear on all tobacco packages
in each country. However, anti-tobacco mass-media campaigns were not conducted during the 2014-
period in Belgium, Finland, Spain and Sweden.Electronic cigarettes: help or hindrance?
Electronic cigarettes, or e-cigarettes, are devices that simulate smoking without burning tobacco.
There is some evidence that they help adult smokers to quit smoking, though their benefit has not
been shown to be greater than smoking cessation medication.^44 The long-term health impact of
using e-cigarettes (vaping) is unknown, and some have expressed concern that usage may lead to
tobacco use in teens. This presents several challenges for health professionals and policymakers. Are
e-cigarettes to be welcomed, or are we in danger of a new epidemic? Certainly, the view of our advisory
panel was the latter. E-cigarette use needs to be strictly regulated.
Policies on e-cigarette availability and usage vary widely across our countries; this is an area that
is rapidly evolving, and policymakers have to act somewhat in the dark. However, e-cigarettes are
regulated in some form in each country. Sales of e-cigarettes to people under a specific age (usually
16 or 18 years of age) are banned in nine of our countries, but not in Romania or Spain. E-cigarette
advertising is banned in nine countries, but not in the Netherlands or the UK. Five countries ban
e-cigarette use in public areas—the six who do not are Finland, the Netherlands, Romania, Spain,
Sweden and the UK.Table 2: Current tobacco smoking in Europe
WHO region Male prevalence Female prevalence Both sexesEurope 38% 19% 28%
Western Pacific 48% 3% 26%
Eastern Mediterranean 37% 3% 20%
America 22% 13% 17%
South-East Asia 32% 2% 17%
Africa 25% 2% 13%
Global 36% 7% 21%
Source: WHO, report on the global tobacco epidemic, 2015.- We did not award a score
when smoking rooms
are allowed. Allowing
such rooms dilutes the
effectiveness of smoking
bans.