EU Health Ministers Support Expansion of Smoke-Free Areas to Combat Cancer
In early December, a significant majority of European Union health ministers expressed their endorsement for extending smoke-free zones to help diminish cancer-related fatalities. The proposal received unanimous support from all member nations, with Germany and Greece abstaining, highlighting existing political divisions on the matter.
The objective of the new guidelines is to limit smoking in public locations frequented by children and other vulnerable groups, such as playgrounds, amusement parks, public swimming pools, restaurant terraces, and on public transportation.
Additionally, these recommendations aim to address emerging tobacco products, including electronic cigarettes and heated tobacco devices, to deter youth from smoking. The EU press release emphasized that reducing exposure to second-hand smoke and aerosols would provide better safeguarding for non-smokers.
Just a week earlier, the European Parliament voted against a related resolution when right-leaning lawmakers introduced amendments to distinguish between traditional tobacco and electronic products. The parliamentary resolution, however, would have had only symbolic significance.
The European Commission proposed an update to the existing guidelines from 2009, as approximately 700,000 individuals die annually in the EU due to tobacco use, according to the new EU Health Commissioner Olivér Várhelyi prior to the vote. Várhelyi noted, “Tobacco use is the largest avoidable health risk in the EU.”
Globally, tobacco use accounts for more than eight million deaths each year, including around 1.3 million non-smokers who perish from exposure to second-hand smoke, according to statistics from the World Health Organization (WHO).
European data indicates that smoking is responsible for a quarter of cancer deaths in the EU, Iceland, and Norway, establishing tobacco as the primary risk for cancer. However, health policy remains under the jurisdiction of EU member states, meaning that the new recommendations are non-binding, leaving it to individual capitals to decide on their implementation.
As part of the European “Beat Cancer” initiative, the European Commission aims to establish a “tobacco-free generation,” targeting less than 5% tobacco use among the EU populace by 2040. To support these measures, the EU has earmarked substantial funding.
Through the EU4Health program, a €16 million grant has been allocated to promote anti-smoking initiatives, while the Horizon program has set aside €80 million for tobacco control research and addiction prevention.
Decline in Tobacco Use but Rise of E-Cigarettes
Tobacco consumption across the EU has decreased over the past few decades, although the reduction rate varies significantly by country.
A recent Eurobarometer survey revealed that nearly a quarter of the EU population (24%) smokes, a slight decline from one percentage point since the 2020 survey. However, the figures vary greatly between nations, with Bulgaria (37%), Greece (36%), and Croatia (35%) having the highest smoking rates, while Sweden (8%) and the Netherlands (11%) report the lowest.
Despite the increasing popularity of e-cigarettes, particularly among young individuals aged 15 to 39, traditional cigarettes remain the preferred choice. Average consumption remains unchanged from 2020, with users smoking an average of 14 cigarettes per day.
Josef Hamoud from Germany’s University Medical Center Göttingen, who led a study on the concurrent use of vaping and smoking, noted, “With the extensive marketing of vapes as healthier alternatives, they have gained traction among those attempting to quit.” He also mentioned, “There is still much we do not know about the long-term health impacts of vaping.”
In light of concerns about youth taking up vaping en masse, some countries have implemented bans on e-cigarettes or restricted disposable versions and flavored options.
In the Netherlands, a court recently upheld a government ban on non-tobacco flavors for e-cigarettes, arguing that such flavors entice youth to smoke. This ban, which came into effect on January 1, 2024, resulted from a ruling against tobacco giant British American Tobacco.
Medical researchers have urged that vaping should remain legal as a cessation tool for smokers, while simultaneously minimizing youth access to either habit.
Varied Approaches to Smoking Regulation Across the EU
Research from the Smoke Free Partnership, a coalition of NGOs advocating for tobacco control, reported that in 2022, half of the countries in Europe maintained “good” or “very good” measures to protect citizens from second-hand smoke through smoking bans in designated areas.
Some nations have prohibited smoking near schools, workplaces, and in sporting venues. Yet, Sweden stands out as the only European country to implement a complete ban on smoking in restaurant and bar terraces.
In Sweden, where daily smoking rates are low, the traditional use of “snus”—a moist tobacco product placed under the lip—has contributed significantly to this trend. Recent data shows that 22% of Swedish men and 10% of women use snus daily.
Since 2014, tobacco-free snus with added nicotine has gained popularity
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