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Berlin conference charts the way forward for European #tobacco control

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European policymakers’ attention has understandably been monopolised by the coronavirus crisis. Brussels is nevertheless trying to keep its finger on the myriad other issues affecting the bloc. On March 24th, for example, ministers cheered the green light given to accession talks with Albania and North Macedonia as an encouraging sign that the European institutions are still able to move forward on important policy matters during the pandemic.

This holds true even in the public health sector. From February 19th to 22nd, the 8th European Conference on Tobacco and Health (ECToH) took place in Berlin. The event gathered European anti-tobacco associations, health professionals as well as representatives from the European Commission and pharmaceutical laboratories under the umbrella of the European Cancer League, led by famous anti-tobacco czar Luk Joossens.

This collection of allies in the fight against tobacco use—the most significant cause of premature death in the EU—used the occasion to launch a new Tobacco Control Scale which quantifies the tobacco control efforts of some 36 European countries.

The ranking system features the addition of a new criteria by which European tobacco control policies are judged: their efforts to tackle the illicit tobacco trade, which costs the EU some €10 billion a year and undermines its public health initiatives.

While many European countries scored points in this category thanks to their ratification of the WHO Protocol to Eliminate Illicit Trade in Tobacco Products, they fell short in other areas. For example, none received credit for having implemented a system to track and trace tobacco products which follows the guidelines set out in the WHO Protocol. The EU’s track-and-trace system is thus not considered compliant with international public health regulation, a situation which spurred MEPs to prepare a modification of the Tobacco Products Directive.

 

Abiding by public health priorities or industrial interests?

The principal flaw in the European bloc’s track-and-trace system is that it’s not adequately safeguarded against the tobacco industry’s perpetual attempts to influence public policy.

Europe has more broadly failed to shield its public health decision-making from Big Tobacco’s attempts to promote its own interests. ECToH host country Germany’s long history of tight ties to the tobacco industry partly explains its position at the very bottom of the European Tobacco Control scale.

Though the conference was held in Berlin, where the tobacco industry still looms large—one public health expert dubbed Germany a “developing country” when it comes to tobacco regulation—NGO representatives in attendance widely criticized the lag with which Germany is applying effective tobacco control policies. Some of Berlin’s missteps were singled out for particular criticism; stunningly, Germany is the only country in the EU which still allows tobacco advertising on billboards and in cinemas.

The consistent delays with which Germany has implemented tobacco control measures—it was also one of the last EU countries to adopt a smoking ban in restaurants—have made it clear that European Commission president Ursula Von der Leyen’s native country is far from spearheading action on Europe’s leading public health concerns.

 

Tobacco spies in disguise

The lengths to which the tobacco industry is willing to go to subvert Europe’s public health agenda were on full display at the recent gathering in Berlin. Indeed, the conference’s organiser interrupted presentations from NGO representatives to denounce the presence of envoys from the tobacco industry in the plenary room. These industry representatives had apparently managed to get inside the conference venue under the umbrella of the so-called Foundation for a Smoke Free World.

The name of this organisation is carefully crafted in order to make it sound like an anti-tobacco crusader. In reality, however, the Foundation for a Smoke Free World has been unmasked as a front group for tobacco industry giant Philip Morris. The foundation, which the WHO has warned governments not to partner with, seeks to influence regulation in the tobacco industry’s interest. It focuses on two main objectives: gathering intelligence on tobacco control efforts and building a market for new tobacco products, such as electronic cigarettes and heated tobacco devices.

The Foundation for a Smoke Free World contests the accusations.

 

The alignment of new tobacco products’ regulation to traditional ones

The global tobacco industry was counting on these next-generation products, such as Philip Morris’s IQOS or British American Tobacco’s Glo, to expand the pool of nicotine consumers as public health initiatives are finally bearing fruit in the form of falling smoking rates. European authorities had initially seemed receptive to the industry’s arguments. Public Health England even rolled out campaigns—newly revealed to have been produced in conjunction with a lobby group associated with Philip Morris—arguing that vaping was “95% less harmful than smoking”.

Following a spate of serious vaping-associated lung injuries, which began in the United States in summer 2019, however, the public health community has increasingly become convinced that these novel tobacco products require serious handling.

The WHO has warned that these products increase the risk of heart and lung conditions, and has recommended that they be regulated in the same way as traditional cigarettes. Doing so would bear important consequences in terms of how these products are taxed, what sort of health warnings they should display, and how they are tracked and traced throughout their supply chains. Whether the EU will follow through on ratcheting up oversight on e-cigarettes remains to be seen. The bloc’s stumbles on measures such as track-and-trace, in any event, suggest a bumpy road ahead.

 

The way forward after Berlin?

The recent ECToH conference closed its doors with the unanimous adoption of a declaration setting the stage for the future of European anti-tobacco policy. Delegates notably committed to align all new regulation of tobacco products (electronic cigarettes as well as heated tobacco) with regulations on traditional tobacco products, with explicit references to excise taxes, health warnings, and advertising restrictions.

Amidst the spread of the coronavirus pandemic and early data indicating that both tobacco smoke (from traditional or heated tobacco productions) and e-cigarettes makes people more likely to suffer severe complications from COVID-19, the urgency for such reinforced oversight couldn’t be clearer.

 

Cancer

Europe’s Beating Cancer Plan: Time to back vaping and beat cancer

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Europe’s Beating Cancer Plan needs bold action on tobacco, and MEPs must Back Vaping to Beat Cancer, according to the World Vapers’ Alliance. The Special Committee on Beating Cancer (BECA) today identified that  ‘tobacco use, in particular cigarette smoking is the main risk factor for cancer death in Europe’.

Commenting on the new document, World Vapers’ Alliance (WVA) Director Michael Landl said: “To succeed in its mission, the BECA committee and the European Parliament must be brave enough to endorse new approaches. Vapers across Europe are calling on policymakers to recognise the benefits of vaping, and its potential to massively reduce the harm of smoking. Policymakers cannot ignore the facts any longer.

"We appreciate the commitment from MEP Mrs. Véronique Trillet-Lenoir and the entire Special Committee on Beating Cancer to fight smoking-related cancer. The Europe Beating Cancer Plan needs to endorse vaping as an effective tool to help smokers move to a safer alternative. That’ Back vaping, beat cancer!”

The new working document presented in today’s Special Committee on Beating Cancer (BECA) by the Committee's rapporteur MEP Véronique Trillet-Lenoir states that:  “Tobacco use, in particular cigarette smoking, is the main risk factor for cancer death in Europe. Various measures to fight against smoking appear heterogeneous and inconsistently implemented. Overall, the WHO Europe region is the global area with the highest tobacco consumption, with major discrepancies between Member States, as the proportion of smokers varies by a factor of up to 5 from one country to another.”

  • The European Parliament’s Special Committee on Beating Cancer (BECA) met for the second time today for an exchange of views with Health Commissioner Stella Kyriakides.

  • As part of the Committee’s work, a draft WORKING DOCUMENT on Inputs of the Special Committee on Beating Cancer (BECA) to influence the future Europe’s Beating Cancer Plan was released by the Committee and its rapporteur Veronique Trillet-Lenoir. It identifies that tobacco is the main risk factor for cancer death in Europe. You can find the document here.

  • The World Vapers’ Alliance (WVA) amplifies the voice of vapers around the world and empowers them to make a difference for their communities. Our members are vapers associations as well as individual vapers from all over the world. More information available here. 

  • Michael Landl is the director of the World Vapers’ Alliance. He is from Austria and based in Vienna. He is an experienced policy professional and passionate vaper. He studied at the University of St. Gallen and worked for several public policy outlets and as well in the German Parliament.

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Backing #Vaping to beat #Cancer

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The upcoming European Union's Beating Cancer Plan is a historic chance to improve public health in Europe. Cancer is the second leading cause of death in the EU. 1.3 million people die from cancer each year in the EU and 700,000 of those deaths are associated with smoking. Despite these terrifying numbers, approximately 140 million Europeans are still smoking. The European Union is right to tackle the disease with a holistic approach, writes Michael Landl (pictured).

A comprehensive approach needs to include prevention and harm reduction. While it is important that lawmakers do everything, they can to prevent people from starting smoking, it is equally important to support current smokers in their quest to quit. Including e-cigarettes (vaping) in the EU Beating Cancer Plan will help millions of European who are struggling to quit smoking and consequently prevent many deaths associated with cancer from smoking.

E-cigarettes contain liquid which is heated and turned into vapour. There is no tobacco nor tar in e-cigarettes and many of the toxins in cigarettes are not present in e-cigarettes. In 2015, Public Health England declared that vaping is 95% less harmful than smoking and began recommending that current smokers switch to electronic cigarettes. Countries like Canada and New Zealand followed their lead and have helped save millions of lives. In fact, these policies promoting vaping arguably achieved more in a short period of time than what lawmakers tried to accomplish for years: fewer people smoking cigarettes. 

We know that abstinence is not as effective as alternatives, such as vaping. According to a 2019 study from Queen Mary University London of 100 smokers trying to quit cold turkey, only three to five succeed - while according to the same study, vaping is even more effective for smoking cessation than nicotine-replacement therapy, like patches or gums.

Despite the weight of evidence, a number of governments have considered new restrictions on vaping, rather than make it more accessible. While often well intentioned most newly proposed regulations, such as flavour liquid bans or higher taxes, would disproportionately harm smokers who are trying to quit. This runs directly against the goal of beating cancer.

The EU Beating Cancer Plan is a massive opportunity to ramp up the fight against smoking. Lawmakers should include vaping in the plan as a harm reduction tool to prevent cancer. The European Union's institutions and governments should follow the lead of countries like the United Kingdom, Canada and New Zealand and encourage the use of vaping as a less harmful alternative for adult smokers.

If the European Union is serious about improving health, we must back vaping to beat cancer.

About the World Vapers' Alliance

The World Vapers’ Alliance (WVA) amplifies the voice of passionate vapers around the world and empowers them to make a difference for their communities. The alliance partners with 19 groups representing vapers worldwide and represents individual vapers. Michael Landl, the WVA’s director, is an experienced policy professional and a passionate vaper.

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New EU rule changes would mean bad news for #Smokers and #Vapers alike

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In its conclusions in June, the European Council approved a new consensus on excise duties on tobacco. The member states suggest rule changes that would increase the price of tobacco, and equally affect non-tobacco products such as e-cigarettes, writes Bill Wirtz. 

Since 2011, the European Union has had a common minimum excise duty on tobacco products, which notably increased the price of cigarettes in those European countries where the prices are comparatively low. Neighbouring countries with higher taxes were claiming that the prevalence of cross-border purchases was subverting their own public health goals. For instance, German commuters buy tobacco in Luxembourg, as the price is lower than in their local shops.

Now that the 2011 directive has not yielded the benefits that some member states expected, or more plausibly, hasn't produced the number of tax revenues that member states need in the current economic situation, they would like a revision. This revision, however, is not only targeting conventional tobacco products such as cigarettes, snuff, shisha, or cigars and cigarillos. For the first time, the European Council is asking for non-tobacco products also to be included in the… tobacco excise directive. This would make it hard for member states to pretend that the objective is public health and not reducing treasury deficits, as the logical equivalent of this move would be to classify non-alcoholic as an alcoholic beverage.

E-cigarettes or heat-not-burn devices represent viable alternatives for consumers of conventional tobacco products. We know that while not harmless, vaping is 95% less harmful than smoking cigarettes. By every available logic, governments should rejoice in the prevalence of these alternatives. However, the European Council concludes that "it is therefore urgent and necessary to upgrade the EU regulatory framework, to tackle current and future challenges in respect of the functioning of the internal market by harmonising definitions and tax treatment of novel products (such as liquids for e-cigarettes and heated tobacco products), including products, whether or not containing nicotine, that substitute tobacco, to avoid legal uncertainty and regulatory disparities in the EU".

Adding excise taxes to reduced risk products sends the wrong signal to consumers that these products are just as risky as cigarettes. Research from the United States shows that every 10% increase in the price of vaping products results in an 11% increase in cigarettes purchases.

How serious are EU member states about increasing public health if their go-to method of prevention is raising the tax burden on consumers? E-cigarettes are one thing, but we should not disillusion ourselves with the idea that taxing cigarettes more does anyone any good either. The Council conclusions themselves recognize that Europe is facing a wave of the illicit tobacco trade, and asks for more solutions to fight it. Illegal trade correlates with increased tax burdens: by taxing low-income households out of cigarettes, which remain a legal product nonetheless, we are pushing them on the black market, where criminal elements profit off of bad public health management. In France for instance, a 2015 report found the country to be Europe’s largest consumer of fake cigarettes, with 15 per cent of the market share.

With a lack of quality control, these illegal smokes represent are much more endemic threat to consumer health. Adding to that, the revenues from the sale of these cigarettes benefits international terrorism -- the French Centre d'analyse du terrorisme (Centre for Terrorism Analysis) even showed that illicit tobacco sales finance 20 per cent of international terrorism. Organizations such as the IRA, Al-Qaida and ISIS fund their activities that way.

The European Council's suggested changes to the Tobacco Excise Directive is counterproductive to the goals of public health, and are set to reduce consumer choice and health. We need to analyse rule-changes for more than just their intentions, but look at their prospective results.

Bill Wirtz is the senior policy analyst for the Consumer Choice Center. He tweets @wirtzbill

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