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Experience of Turkey in introducing total ban on smoking in (enclosed) public spaces

Experience of Turkey in introducing total ban on smoking in (enclosed) public spaces

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Experience of Turkey in introducing total ban on smoking in (enclosed) public spaces

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  1. Experience of Turkey in introducing total ban on smoking in (enclosed) public spaces Prof. Nazmi Bilir MD Hacettepe University Faculty of Medicine Department of Public Health nbilir@hacettepe.edu.tr

  2. CONGRATULATIONS BULGARIA We win!Dear all,Let me share with you our celebration on the smoking ban accepted today, on theMay 17th 2012, by the National Assembly of Bulgaria. The Parliament accepted thetotal smoking ban on public places including working places, stadiums, open airkindergarten, schools and school hostels, summer theaters and cinemas. Ourbattle was a hard one because the strong resistance on the behalf of the TobaccoIndustry supporters, incl. restaurants, bars, café etc. owners. After “stormy”public debates and various activities performed by the NGO’s Coalition SmokelessBulgaria the dream of many generations outstanding Bulgarian people came true.About 600 health inspectors are in due to control the observing the low. Now wecan celebrate! Please join us!Kind regardsProf. Liliana Tsoneva-Pentcheva, PhDChair, Association Women Against Tobacco-Bulgaria1000 Sofia22a Dondukov Blvd.BulgariaTel: +359 2 898 8030Fax: +359 2 9819009

  3. History of Tobacco in Turkey • Turkey is a tobacco producing country • Major economic activity • Providing 4% of world production 1.7% • State-owned tobacco monopoly: TEKEL • No advertisement, no interest of market expansion • Smoking is common • Particularly among men • No restriction (until 1996) • “smoke everywhere”

  4. History of TC Activities in Turkey – phase 1/3

  5. 1601 – entrance of tobacco into Turkey British sailors 17. c. İbrahim ef. (chief medical officer) – some efforts – unsuccessful 17. c: complete ban Murat 4th.“concern; fire” 1874 – tobacco cultivation started in Turkey Before “Republic of Turkey”

  6. First phase – Before 1980’s 1924 establishment of “TEKEL” (state monopoly) First Anti-Tobacco Law initiative 13.12.1926: proposal by Dr. Fuat (MP): Smoking and drinking of children is forbidden Tobacco products shall not be sold to minors Those who violate this prohibition shall be fined from 5 to 50 TL. (repeated violation; jail for 2 months) not accepted by the Parliament

  7. Some relevant publications Besim Ömer Akalın (founder of MCH services, dean of med. school) Mükeyyifat ve Müskirattan Tütün, 1888 (Tobacco as pleasurable substance) Osman Şerafettin Çelik Tütünün Kalp Üzerine Tesiri, 1936 (Tobacco, effects on heart) Peyami Safa Sigara, Gözlerimiz ve Ruhumuz, 1938 (Smoking, our eyes and our spirit) Fahrettin Kerim Gökay – physician, Mayor of İstanbul Gençlik ve Tütün İptilası, 1942 (Youth and tobacco dependence) Sadi Irmak – Prof of medicine, Minister of Health Okullarda Sigara Yasağı, 1942 (Smoking ban at schools) Mazhar Osman Uzman – founder of modern psychiatry Tütün; Bilhassa Marazi Tesirleri, 1942 (Tobacco, harmful effects)

  8. History of TC Activities in Turkey – phase 2 / 3

  9. Changing economic system • Early 1980’s • “Liberal” economic system • Privatization of TEKEL • Reduction of tobacco production • Tobacco importation started ---- increased • Selling TEKEL to foreign tobacco industry • Development of tobacco control law

  10. New Laws • 1984: importation of “foreign” cigarettes • by TEKEL • 1986: importation by “private” companies • Abolishing of TEKEL’s right of importation • 1991: establishment of cigarette producing factories by multinational industry • Joint establishment by national companies

  11. Advertisements started Tobacco use increased

  12. Cigarette sales, Turkey, 1925-2011 102% increase betwen 1980 – 2000

  13. Hospital admissions due to lung cancer, 1964–2004

  14. Hospital admissions due to coronary heart disease, 1964–2004 Hospital admissions due to chronic obstructive pulmonary disease, 1964–2004

  15. Multinational tobacco companies decreased “domestic” production and increased “imported” tobacco

  16. Tobacco Production in Turkeyproduction decreased ---- importation increased

  17. Market shares of Tobacco Companies, Turkey TEKEL was owned by BAT in 2008 No “Turkish” cigarettes on the market. All cigarettes belong to “multinationals”