Letter to leaders of WHO-Europe member states

In May 1997, WHO-Europe Director Dr Jo Asvall sent an open letter addressed to the heads of government of the 51 European member states calling for a range of measures to upgrade smokefree policies and activities. The letter urges governments to back their health and medical administrations in their work to tackle the tobacco threat, and appeals to government leaders individually to use their influence to bolster such activities. "They need support and active cooperation from a number of other ministries--and, for that, they need your personal commitment."

Dr Asvall proposes that, if they have not already done so, the heads of government carry out the following steps:

appoint an inter-sectoral coordinating committee for tobacco control, responsible for drawing up effective and comprehensive action plans on tobacco, with clear time-tables for implementation and specific targets for reductions in tobacco use, and adequately funded commensurate with the burden of disease caused by tobacco, possibly from tobacco tax or a special levy on tobacco products;
persuade colleagues in the ministries of finance that regular increases in tobacco tax can raise revenue, correct for externalities such as health costs, and deter tobacco consumption;
persuade colleagues in government that there is a causal relationship between advertising and smoking behaviour, particularly in young people, and that effective action requires a total ban on tobacco advertising, and the prohibition of sponsorship associated with a tobacco brand name or product;
persuade colleagues in government that restricting the access of people younger than 18 years of age to tobacco products is effective in reducing the number of adolescents and young adults who become daily smokers;
ensure that all health-related premises and particularly those within the jurisdiction of the ministries of health are smoke-free environments;
ensure that support for smoking cessation is made widely available, particularly through primary health care professionals, including physicians, nurses, pharmacists and dentists;
persuade colleagues in the ministries of customs and excise that failure to control tobacco smuggling is costing the country revenue and lives.

Dr Asvall points out that every year over 1.2 million deaths in the WHO-Europe Region are caused by tobacco consumption.

"...why are we failing so miserably to deal with this problem when we so clearly know what to do?"

"By the year 2020, unless we really change things, that number will rise to 2 million deaths. This will represent 20% of all deaths, the single greatest killer in the European Region....The facts are simple. manufactured tobacco products deliver regulated doses of the addictive drug nicotine. Tobacco products cause one third of all cancers and a large proportion of heart disease, as well as many other health problems, and half of all regular smokers die from a condition caused by smoking. Over one third of adults in the Region are regular daily smokers and smoking is increasing in two fifths of the countries in the Region, particularly among young people and women. Although there are some notable exceptions, why are we failing so miserably to deal with this problem when we so clearly know what to do?" n

Smoke Free Europe - A Forum for Networks - 14 AUG 1997

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