1. World No Tobacco Day 2013 Do tobacco control measures reduce tobacco use? Evidence from research and practice Kristina Mauer-Stender WHO European Office

2. Presentation Objective Revision of the Tobacco Products Directive is the opportunity for the European Union to be leader in tobacco control again!

3. Key Message 1 European Region has little to be proud of regarding tobacco

4. Mortality from Tobacco European Region has one of the highest proportions of deaths attributable to tobacco 16% of all deaths in adults over 30 are due to tobacco, the global average is 12% 7

6. Youth Prevalence of Tobacco • WHO European Region has high prevalence of youth tobacco smoking • Prevalence of female youth considerably higher in European Region than in other Regions 4

7. Key Message 2 Tobacco package - one of the last powerful advertising tools Tobacco Product Directive – an opportunity to keep young people from starting to smoke

8. WHO FCTC article 11 - a powerful tool that works 7

9. Tobacco Products Directive • Tobacco use is addiction of adolescents • 70% of smokers start before they are 18 years old and 94% start under 25 years old • In the Region, the increase in youth smoking – particularly girls – is alarming • Several countries (Latvia, Czech Republic, and Lithuania) have similar prevalence of youth and adults • The gap in boys and girls is much smaller (21% boys, 17% girls) than the gap in men and women (40% men, 22% women)

10. Tactics of Tobacco Industry • Tobacco Industry is innovative and has created an effective advertising medium on the package – many tailored specifically to young women and girls

11. Tactics of Tobacco Industry: Pack Design • Slim packs reinforce belief that smoking helps to control appetite and prevent weight gain • Global sales of slim cigarettes, targeted at females, are expected to grow from 4% to 13% of the market between 2011 and 2016

12. Key Message 3 Large pictorial health warnings and standardized packaging will not lead to an increase in illicit trade in tobacco

13. Protocol to Eliminate Illicit Trade in Tobacco Products 7

14. Tobacco Products Directive • TPD will not increase the illicit market in tobacco • Impact Assessment accompanying the TPD confirms that there is no convincing evidence submitted by the tobacco industry that larger health warnings and pictorial warnings will lead to increase in illicit trade • Member States that have introduced pictorial warnings have seen no increase in illicit trade • Illicit trade can be counteracted through the use of chips and invisible ink on tobacco products

15. Key Message 4 Tobacco Products Directive proposals do not break any international law or Treaty provisions

16. Tobacco Products Directive • Plain packaging does not violate intellectual property law • Plain packaging measures would still allow the owners of the trademarks to own their trademarks and be protected against unauthorized use • It would merely regulate the use of logos or colours for public health purposes, which is specifically allowed under both international intellectual property law and EU law • The Supreme Court of Australia recognized that plain packaging was not in violation

17. Tobacco Products Directive • Plain packaging does not violate international trade and investment law • International trade law provides exceptions, for public health purposes, as long as they are not “arbitrary” or “disproportionate” • Plain packaging effectiveness is supported by a large body of evidence and their adoption is recommended by the Guidelines of the WHO FCTC

18. Key Message 5 Electronic Nicotine Delivery Systems to be regulated as tobacco products and as medicinal products

19. Tobacco Products Directive • Use of e-cigs has grown in recent years: 7% of citizens have at least tried them • Trends and limited regulation suggest that e-cigs use will continue to grow despite limited understanding of the product’s characteristics • By the acquisition of e-cigs, cigarette manufacturers believe this is the next frontier for their companies

20. Tobacco Products Directive • ENDS undermine Articles 6 (taxation) and 8 (second-hand smoke) of the WHO FCTC • WHO suggests ENDS should be regulated through a two-pronged approach as both tobacco products and as medicinal products to prevent a situation in which loopholes are exploited and ENDS escape control

21. Key Message 6 The European Community, as a Party, has committed itself to the comprehensive approach embraced by the WHO FCTC It is crucial to strengthen the Tobacco Products Directive in line with the WHO FCTC – we know it works!

22. WHO Framework Convention on Tobacco Control • First international treaty to be negotiated under the auspices of WHO • Entered into force on 27 February 2005 • 49 countries in the Region and the European Community are Parties • WHO FCTC is a powerful evidence-based tool for tobacco control – it works! 7

23. Example from Turkey Prevalence of current tobacco smoking by gender, GATS Turkey 2008 and 2012 Turkey is an inspiration to countries: achievement of decreasing smoking prevalence among adults from 31.2% in 2008 to 27.1% in 2012

24. “We know that tobacco use is not a choice. It is a powerful addiction. The true choice is between tobacco and health” Director General of WHO