Why EU policy on tobacco control is not working

65% of smokers in the European Union believe that EU decision makers do not consider the impact to smokers when deciding rules and regulations on tobacco and nicotine-containing products. What’s more, 66% of general population adults across Europe agree that organisations like the EU and WHO should put more focus on harm reduction by encouraging smokers to use less harmful products rather than trying to eliminate tobacco use altogether, writes Political Editor Nick Powell.

The results of a new survey released by Povaddo reveal there is wide acceptance among Europeans that smoke-free alternatives, such as e-cigarettes and heated tobacco, are reasonable ways to stop smoking and that the EU should carefully consider the impact of any taxes on them. Two thirds (66%) of adults surveyed in Europe believe smokers can be encouraged to switch to scientifically proven alternatives by taxing these products at a lower rate than cigarettes but still high enough to discourage use by youngsters or by non-smokers.

Conducted by the independent public opinion research firm Povaddo for Philip Morris International (PMI), the survey of more than 14,000 adults in 13 EU member states and Ukraine shows how Europeans hold strong opinions about how these products should be treated by governments, both at a national level and in the EU as a whole:

o Adult smokers should be given accurate, scientifically substantiated information that smoke-free alternatives to cigarettes are less risky than continued smoking, even if these alternatives are not risk free (69%).

o Governments can help improve public health by endorsing policies which encourage adult smokers who don’t quit altogether to switch to innovative smoke-free alternatives that have the potential to be less harmful than continued smoking (67%).

o The EU should dedicate time and resources to eradicating smoking by encouraging all smokers to either quit completely or switch to a scientifically substantiated less risky alternative (67%).

“These survey results suggest there is a disconnect between policymakers and the citizens they govern and represent when it comes to tobacco policy,” said Povaddo’s President, William Stewart. “The EU policy approach seems more focused on an unrealistic objective, the complete eradication of nicotine use”.

In contrast, he told me, the public throughout Europe is broadly receptive to the concept of tobacco harm reduction, the idea of moving people away from cigarettes to these scientifically proven less harmful alternatives, such as e-cigarettes, oral nicotine pouches or heated tobacco products.

The problem is with the policy makers. “They look at it as an either-or situation, you either smoke or you don’t smoke. That’s very much an outdated way of thinking because there is something in the middle, there are alternative products … that were not available 20 years ago. As the public learns more and more about these products, they are in fact very receptive to this idea of simply encouraging [smokers] to get off of the product that they know to be the most harmful, which is cigarettes”.

The survey also measured attitudes to the illicit trade in smuggled and counterfeit cigarettes, driven by the attraction of evading high taxation. Throughout the different EU countries surveyed, 60% of people view the illicit trade as a problem within their country.

“The public gets the joke on illicit trade”, William Stewart told me. They know that the illicit trade makes it more difficult to reduce smoking rates overall, it doesn’t really do anything to help protect youth from smoking, they know that it can cause crime and security issues”.

Of those fourteen countries surveyed, five that stand out as more likely to say their country has a problem with illicit trade, Greece, Lithuania, Croatia, Romania and France. The French in particular are right to have noticed that their country has a problem that’s getting out of control.

“France is really the problem child of Europe when it comes to the illicit trade issue. They’re losing an absolutely massive amount of tax revenue”, William Stewart explained. In 2021, it recorded a 33% increase in counterfeit cigarette consumption, the highest in the EU.

“France remains the largest illicit market in the EU with a total consumption of 15 billion illicit cigarettes consumed. It comprises 29% of total cigarette consumption, it only stood at 13% in 2017. It is worth calling attention to France because it’s a larger country with a larger economy and so it really does stand out as particularly problematic”, he added.

He described France as a country that seems to have lost sight of its tobacco policy objectives, as ministers “continue to implement higher taxes time after time after time”, presumably both to raise revenue and to reduce smoking rates. “They’re achieving neither of those. Smoking rates aren’t declining and because the illicit market is getting larger, they’re really not reaping any benefit of higher tax revenue.

“Tobacco issues I fully admit are not high on people’s radar. It’s not something they think about very often but that doesn’t mean that it’s not an important issue. It’s easy for lawmakers and decision makers to overlook public attitudes on the issue because they aren’t very vocal on it.

“Being strongly anti-tobacco and thinking that you can score political points on that is very outdated political thinking. There was truth to that generally speaking, maybe 20 years ago. There was a lot of animosity and hostility towards the tobacco industry, certainly in the 1990s, maybe in the early 2000s … that transitioned to more ambivalence”.

The problem, William Steward reiterated, is that political leaders’ thinking has not caught up. “They’re stuck two decades in the past, thinking that being anti-tobacco is going to score them political points. The reality is that the public is rather open-minded that there needs to be some sort of other approach to tobacco policy.

“There are a billion smokers on the planet and the reality is that a billion people are not going to quit smoking anytime in our lifetimes. We have to look for alternative solutions and approaches.

He sees alternative products as the only viable way of both achieving the health benefits of reduced cigarette smoking and tackling the illicit trade. “Once people start consuming a product at a lower price, how are you going to get them back to the legal market? We are talking about cigarettes largely when we’re talking about the illicit market, if they can be encouraged to more to less harmful alternatives, where there is some tax differential, there could be some hope”.

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