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LEIA O BOLETIM nº 2 da ENSP. Actualize-se e mantenha-se informado com as notícias da Europa.



Issue 2, 7-13 January 2011

· FRANCE: Sales of electronic cigarettes rise, as does criticism

· IRELAND: Cigarette smugglers will have assets seized and cars crushed

· MALTA: Total ban on cigarette and tobacco adverts as from 1 January 2011

· NETHERLANDS: Dutch tobacco industry lobby highly effective

· SWITZERLAND: Anti-smoking campaign draws on cigarette ads

· UK: Imperial Tobacco and BAT fall as Citigroup says smoking could disappear by 2050

· PRESS CONFERENCE: Press conference on plain packaging

· WHO MONOGRAPH: ‘Empower Women - Combating Tobacco Industry Marketing in the WHO European Region’

· WHO TFI MONOGRAPH: ‘Gender, Women, and the Tobacco Epidemic’

· STUDY: More signs lung cancer screening could save lives

· STUDY: Passive and direct smoking linked to asthma in teenagers

· STUDY: Smoking around your kindergartner could raise their blood pressure

· STUDY: The dangers to children of second-hand smoke



FRANCE: Sales of electronic cigarettes rise, as does criticism

Makers of electronic cigarettes are reporting strong growth in sales as anti-tobacco laws force European smokers into the cold streets, but campaigners say the device is undercutting health efforts.

Professor Yves Martinet, head of the French National Committee Against Tobacco, said the electronic cigarette was a rip-off.

"This product offers no medical support for quitting smoking, there are some countries that have banned it," he said.

"For the moment, this product has not been evaluated in a scientific way," he said.

The French National Office for Smoking Prevention said the purpose of the electronic cigarette was "ambiguous", and condemned its sale in pharmacies.

Source: AFP, 3 January 2011

IRELAND: Cigarette smugglers will have assets seized and cars crushed

Cigarette smugglers will have their assets seized and cars crushed, as customs officials target the multi-million euro illicit trade.

Seizures of untaxed cigarettes have increased fourfold in the past five years amid a massive crackdown on ports and a blitz on shops and markets.

More than 200 million untaxed cigarettes destined for the black market - which would have sold at an estimated loss to the Exchequer of close to € 65 m - are expected to be seized by the end of this year.

A new three-year strategic plan targeting untaxed cigarettes will see a doubling in the number of customs operations targeting flights and people selling cigarettes in markets, housing estates and under the counter in shops.

Source: Irish Independent, 27 December 2010

MALTA: Total ban on cigarette and tobacco adverts as from 1 January 2011

The government has banned adverts of cigarettes and all tobacco products from appearing anywhere, even in places where tobacco products are sold such as vending machines, as from 1 January, 2011.

In a statement, the Health Department said that according to legal notice 344 (2010), “no person may advertise or allow to be advertised on any object whether moveable or not any cigarettes, cigars, tobacco or tobacco products.”

According to the same legal notice, the department added, “No person may sell or permit to be sold any other product except cigarettes and tobacco products from those automatic sales machines which are used to dispense cigarettes and tobacco products. In addition the sale from such machines is permitted only when these are continually supervised.”

The Department also said that according to a second legal notice – also coming into force on 24 April 2011 – cigarette packets are now required by law to carry pictorial warnings of the health consequences of smoking.

“All cigarettes packets which are placed on the market are to conform with the provisions of Legal Notice 302 of 2009 - that is all cigarette packets are to contain a pictorial warning,” the department said, adding that retailers should ensure that their tobacco product wholesalers supply them with the correct packaging.

The Department also reminded the public that those responsible for any public-access premises ensure that nobody smokes any tobacco product in enclosed areas therein, in accordance with Legal Notice 23 of 2010.

Source: Malta Today, 6 January 2011

Source: Di-ve, 7 January 2011

NETHERLANDS: Dutch tobacco industry lobby highly effective

Professor Marc Willemsen argues for confrontational campaigns which clearly show the damage smoking causes to the body. He also favours higher duties on tobacco and a less prominent location for tobacco products in supermarkets. "Suppose a harmful product that made people sick were introduced and put on sale at supermarkets? It would be totally unthinkable, but tobacco is exactly that product, and yet it is completely legal.”

Dutch Professor Marc Willemsen says the lobby of the Dutch tobacco industry, one of the world's biggest, has been extremely effective in influencing government policy. He said lobbyists "probably popped a few bottles of champagne when the new CDA-VVD cabinet with Edith Schippers as Health Minister took office." And Defence Minister Hans Hillen used to work as a lobbyist for the tobacco industry.

Professor Willemsen made his statements in his address delivered upon his appointment as the endowed professor for Tobacco Control Research at CAPHRI, the School for Public Health and Primary Care at the University of Maastricht. He says there has always been opposition to tobacco discouragement in the Netherlands, while at the same time the country is not making much headway compared to countries such as the United Kingdom and Canada. Professor Willemsen says the opposition against effective tobacco discouragement has only grown stronger since the new cabinet took office. He pointed to a speech by Health Minister Edith Schippers in which she stated her opposition to photographs of lungs damaged by smoking on packs of cigarettes.

Perverted situation

Professor Willemsen argues that the medical costs associated with smoking amount to about € 2.4 billion a year. "No society can afford a financial loss of this magnitude." On the other hand, the government rakes in € 1.8 billion in tobacco duties a year. However, "Not a penny of this money is being spent directly on reducing the misery caused by tobacco addiction; a perverted situation, and untenable in the long run"

The professor argues that the tobacco industry has strategic connections in government circles. "The Netherlands is a signatory to the Framework Convention on Tobacco Control, an international treaty which stipulates that national governments should not communicate with the industry about tobacco policies. And that, if inevitable, such contacts should be made public. However, in the Netherlands this appears to be a taboo which should be investigated."

Source: Radio Netherlands Worldwide, 12 January 2011

SWITZERLAND: Anti-smoking campaign draws on cigarette ads

The Swiss health authorities have launched their latest anti-smoking campaign which imitates the visual language of the tobacco industry.

The three-year campaign, Stop smoking - Change to SmokeFree, is aimed at encouraging consumers to kick the habit, according to Ursula Koch, head of the prevention unit of the Federal Health Office.

The number of smokers had dropped to 23% of the population by 2007 but is now stagnating, according to Koch, putting Switzerland among the top third in Europe. The campaigners are using advertisements, leaflets in several languages targeting the immigrant population, trailers in cinemas and on television and information on the internet to spread their message against tobacco use.

Source: Swissinfo, 10 January 2011

UK: Imperial Tobacco and BAT fall as Citigroup says smoking could disappear by 2050

Could the last cigarette smoker have quit by 2050 and if so, what would this mean for the tobacco companies?

This is the question tackled today in a 72 page report by Citigroup analysts, who believe they have found evidence that smoking could virtually disappear. They say:

We think this evidence is credible and new to the investment debate, and has important implications for the next few years. However, these trends are extremely long-term in nature, and don't on their own justify any particular action now, in our view, as opposed to in January 2009 or January 2013.

Taking the very long view, it's hard to ignore 50 years of data. Smoking rates appear to be falling in a series of straight lines. If this continues, and it has for 50 years, then it means that the percentage declines in volumes will gradually accelerate. This seems to have been what is happening.

If this continues then eventually price rises won't be able to drive profit growth. However, we continue to see decent earnings growth for many years, as we believe the UK profit pool can probably continue growing until 2020-25. Most terminal values model a constant percentage decline that never gets to zero. But if volumes were to disappear, that would have very different implications.

No-one can be certain how smoking rates will play out in the distant future. [There are] three broad possibilities: Scenario A just extends the existing trend line until it hits zero. In Scenario B gradually fewer people quit, as we approach some sort of hard core of smokers, but in Scenario C smoking gets to a tipping point, as it becomes increasingly unacceptable and hence easier to regulate against. Possibly it may be (eventually) banned.

We are certainly not saying that we know which is right; plainly we don't. We think that each scenario is quite plausible. [But] it is quite possible that there will be no smokers left in Britain or many other developed countries in about 30-50 years.

It is interesting to note that Finland passed an anti-tobacco law in September that declared its aim "is "to end the use of tobacco" in Finland. As far as we know this is the first example of a country putting such an aim in law. No target date was given, but the ASH Finland says 2040 should be the target. For us, 2060-80 seems a more realistic target to us, judging by the trends in the last 20 years in Finland.

Source: The Guardian, 7 January 2011

Smoking could almost vanish in Britain by 2050
Daily Mail, 8 January 2011

Smoking Could Disappear by 2010 Says Citigroup
The Telegraph, 8 January 2011

PRESS CONFERENCE: Press conference on plain packaging

On 12 January 2011 the Belgian Foundation against Cancer and the Association of European Cancer Leagues (ECL) held a press conference in Brussels to convince the European Union to make plain packaging mandatory on all tobacco products in all EU countries, because of the devastating effect of appealing packaging on young people.

Except for the brand name (which would be presented in a standardised way), all other trademarks, logos, colour schemes or graphics would be prohibited. The package itself would be required to be plain coloured and to display only information (such as health warnings) required by law.

Six research projects, conducted by university teams in three EU countries using different methodologies with young and adult people, smokers and non-smokers all came to the same convincing findings:

  • plain cigarette packs are less attractive than the current ones;
  • plain cigarette packs reduce the promotional appeal of the packs;
  • plain cigarette packs enhance the visibility of the health warnings.

Luk Joossens, ECL tobacco control expert stated: “It is unacceptable that a carcinogenic product, such as tobacco, is still sold in such an appealing package. Plain packaging would mean an enormous step forward in our fight against smoking.”

View the press release, fact sheets and presentations from the press conference on the ECL web site:

WHO MONOGRAPH: ‘Empower Women - Combating Tobacco Industry Marketing in the WHO European Region’

This European Region Monograph was published in December 2010 to support World No Tobacco Day 2010.

Over the last two decades, smoking by women and girls in many parts of the WHO European Region has increased, largely owing to skilful and successful marketing by the tobacco industry. It has tailored campaigns to target women and girls, and the tobacco control community needs to do the same. The WHO Framework Convention on Tobacco Control (FCTC) expresses alarm at the increase in women and girls’ use of tobacco.

This monograph uses examples of action taken in the Region to provide countries with a guide and ideas about what action could and should be taken, in the context of the WHO FCTC’s articles and guidelines.

Source: World Health Organization (WHO) Regional Office for Europe, December 2010

A PDF version may be downloaded from the WHO website:

WHO TFI MONOGRAPH: ‘Gender, Women, and the Tobacco Epidemic’

The World Health Organization (WHO) monograph “Gender, Women, and the Tobacco Epidemic” (2010) provides an overview of research on women and tobacco and highlights the need to address tobacco use among women through policy, education, and additional research.

Key findings:

  • Tobacco use among women is rising in many parts of the world. Increased use poses a growing problem in terms of reproductive health, infant health, children’s exposure to second-hand smoke, and health issues specific to women.
  • Tobacco companies are increasingly targeting women through marketing campaigns that associate tobacco use with independence, beauty, femininity, and sex appeal.
  • Many women are unaware of the health risks of tobacco use and believe that use relieves tension and facilitates weight loss.
  • Women seem to be less successful than men at quitting smoking. More effort is needed to understand and support women’s quit attempts and, in particular, pregnancy and post-partum quit attempts.

View the full text at:

Source: World Health Organization (WHO) Tobacco Free Initiative, 2010

STUDY: More signs lung cancer screening could save lives

More research is suggesting that heavy smokers may benefit from screening for lung cancer, to detect tumours in their earliest stages.

A new study finds that regular smokers who received three-dimensional X-rays to look for the presence of early tumours had a significantly lower risk of dying over a 10-year period.

The results are in keeping with those of a much larger study published last month, which showed that these 3-D X-rays, or CT scans, reduced the death rate among 53,000 current and former heavy smokers by 20% compared with screening using regular chest X-rays. That previous finding was "very good news in the field," said Dr. Bruce Johnson of the Dana Farber Cancer Institute, who treats lung cancer patients and reviewed the results for Reuters Health.

This latest study, published in the journal Lung Cancer, looked at death rates in a different, smaller population of heavy smokers, and estimated that those who received up to two CT scans would have between a 36% and 64% lower risk of dying, compared to those who went unscreened.

Source: Reuters, 28 December 2010

STUDY: Passive and direct smoking linked to asthma in teenagers

Results from a Swedish study show that exposure to environmental tobacco smoke (ETS) and personal smoking are both associated with an increased risk for asthma and wheezing in teenagers.

Writing in the journal Thorax, Linnéa Hedman (Sunderby Central Hospital of Norrbotten, Luleå) and team explain: "ETS has been reported as a significant risk factor for childhood asthma [and], among adults, personal smoking is a major cause of respiratory symptoms and diseases."

But they add: "The effects of these exposures on the prevalence of asthma and wheeze among teenagers are less well known."

To investigate further, the team studied data from a longitudinal study of 3430 Swedish schoolchildren that started in 1996 when they were aged 7-8 years.

The children completed annual questionnaires on asthma and allergies, parental smoking habits, and personal experiences of smoking until the age of 16-17 years in 2005.

At the age of 16-17 years, 13.6% of boys and 13.0% of girls had doctor-diagnosed asthma, 21.9% and 26.1%, respectively, reported having wheezed at some point in their lives (ever wheeze), and 16.5% and 24.8%, respectively, had current wheeze.

The researchers found that the prevalence of doctor-diagnosed asthma, ever wheeze, and current wheeze was significantly higher among those exposed to maternal ETS and daily smokers than among other participants.

Indeed, after accounting for confounding factors, such as a family history of asthma and allergies, the 538 participants exposed to maternal ETS were a significant 1.3 times more likely to have doctor-diagnosed asthma, and 1.5 times more likely to have suffered from wheezing than unexposed individuals.

Individuals who were daily smokers at the age of 16-17 years (n=123) were 2.0 times more likely to have current wheeze than non-smokers.

Daily smokers who were also exposed to maternal ETS (n=111) had the greatest risk for asthma and wheeze, at odds ratios of 1.7 and 2.5, respectively.

Exposure to paternal ETS was not associated with asthma or wheeze among the teenagers, the researchers note.

Hedman and team conclude: "We found that both exposure to maternal ETS and personal smoking were independently related to asthma and wheeze among teenagers."

Source: Medwire News, 12 January 2011
Thorax 2011; 66:20–25

STUDY: Smoking around your kindergartner could raise their blood pressure

Kindergartners whose parents smoke have higher blood pressure than those with non-smoking parents.

The study of more than 4,000 pre-school children in Germany is the first to show that exposure to nicotine increases the blood pressure of children as young as 4 or 5.

If you smoke around your children, they could have high blood pressure or be headed in an unhealthy direction before learning their ABCs, according to research reported in Circulation: Journal of the American Heart Association.

The study is the first to show that breathing tobacco smoke increases the blood pressure of children as young as 4 or 5 years old.

"The prevention of adult diseases like stroke or heart attack begins during childhood," said Giacomo D. Simonetti, M.D., first author of the study at the University of Heidelberg in Germany and currently assistant professor of paediatrics at the Children's Hospital of the University of Berne in Switzerland. "Parental smoking is not only negative for children's lung function, but poses a risk for their future cardiovascular health".

Source: PR Newswire, 10 January 2011

Alternative source: American Heart Association:

STUDY: The dangers to children of second-hand smoke

Two studies show the particular risks of passive smoking to children. Researchers believe smoking in a car which is also carrying children should be made illegal.

The risks of second-hand smoke aren’t 100% known, but a study has found that there’s enough evidence to support new laws banning people from travelling with children while smoking.

Professor Ray Pawson from the University of Leeds and a team of co-authors analysed the risks, and their findings are published in the Canadian Medical Association Journal.

The authors first looked at the mixture of chemicals that make up second-hand smoke and its concentration in cars under different conditions such as volume, speed and ventilation. They then looked at how long a person would be in the car and how long they would be exposed to the second-hand smoke.

A simple conclusion:

The extent of difference between how second-hand smoke affects children compared to adults was added to the risk equation, and finally the authors looked at the health impact - which is hard to determine because of the different chemicals and toxins a person is exposed to in their lifetime.

Pawson writes, “We hope to show that, though the relevant data is rich and complex, a simple conclusion is possible”.

“The evidence permits us to say that smoking in cars generates fine particulate concentrations that are very rarely experienced in the realm of air-quality studies, and that will thus constitute a significant health risk because exposure to smoking in cars is still commonplace, and children are particularly susceptible and are open to further contamination if their parents are smokers.”

Source: WebMD, 11 January 2011

1º Boletim da ENSP do ano de 2011 PDF Versão para impressão Enviar por E-mail
Quinta, 06 Janeiro 2011 23:04

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EUROPEAN NEWS BULLETIN 2011.1 : 1-6 January

Produced by the European Network for Smoking and Tobacco Prevention (ENSP)



National Tobacco Control News

BELGIUM: More than 13% of Restaurants Failed to Comply with Smoking Ban

BULGARIA: Smoking Ban Widely Ignored

FINLAND: Finns Willing to Pay More Tax on Alcohol and Tobacco

POLAND: Tobacco Industry Faces Tough Times

NETHERLANDS: Smoking Ban Widely Ignored, Ashtrays are Back in Half the Bars

SPAIN: Spain Gets Tough Anti-Smoking Law



PUBLICATION: Spain: Beyond The 'Spanish Model' To A Total Ban

STUDY: Europe Reins In the Smoking Habit

STUDIES Decipher How Anti-Smoking Drugs Work

STUDY: Pregnant Women Often Deny Smoking

STUDY: Smoking Tied To Miscarriage Risk


Institutional News

WHO FCTC COP-4 Decisions




National Tobacco Control News


BELGIUM: More than 13% of Restaurants Failed to Comply with Smoking Ban


Just over 13 percent of pubs serving food and restaurants in 2010 did not comply with the smoking ban, which is twice as more as in 2009, VTM news reported on Monday referring to figures from the Federal Agency for the Security of the Food Chain (FAVV).

In 2010, the Federal Agency held 12,540 inspections. On this total, 1.670 bars serving food and restaurants flouted the smoking ban (13,32 %).

In 2009 on a total of 11,738 controls 7,5 percent failed to respect the ban.

According to the Federal Agency, this increase is due to the extension of the smoking ban in early 2010. "The reason for the increase is simple: legislation became more stringent, there are more and more controls and we found more violations ", said Geert De Poorter, of the Agency.

Since January 1st, 2010, the smoking ban does not only apply to restaurants but also to all hospitality venues where fresh food is served, including small pubs serving fresh food. It is mainly the pub owners that ignore the smoking ban.


Source: De Standaard, 3 January 2011



BULGARIA: Smoking Ban Widely Ignored

Even though a smoking ban in public places came into force in Bulgaria five days ago, reporters' checks across the country have shown that it is being widely ignored.

Reports say this may be due to the delay in official checks, which will start at the beginning of next year and give an opportunity to owners of restaurants, coffee shops and bars to take advantage of the 2-week grace period and provide the necessary walls, tight-closing doors and good ventilation equipment.

The requirements will affect all smoking spaces inside commercial and administrative buildings, railroad stations and airports as well.

Owners of coffee shops and restaurants with less than 50 square meters have the right to decide whether smoking would be allowed. In case smoking is allowed, individuals under the age of 18 would not be admitted as they are banned from smoking in all indoors spaces.

In larger establishments, at least 50% of the space must be dedicated to non-smokers.

In night clubs, smoking will be allowed at all times regardless of how large they are.

Open-space coffee shops and restaurants inside shopping malls are becoming non-smoking facilities.

Owners face fines for inadequate ventilation and lack of sings designating the non-smoking sections and the smoking ban for those under 18.

Fines for owners range from BGN 500 to BGN 10,000. Individuals, who violate the ban, would also face fines, but only if they agree to provide their ID card.

Similar measures were imposed as part of a partial smoking ban in 2005 but have been widely ignored.

Bulgaria ranks second after Greece in the EU in terms of number of regular smokers as a percentage of the population, according to a Eurobarometer survey.


Source: Novinite, 22 December 2010




FINLAND: Finns Willing to Pay More Tax on Alcohol and Tobacco

Finns appear willing to favour increases in taxation on alcohol, tobacco, confectionery and capital gains in order to balance public finances, a survey commissioned by YLE indicates. However, there is little enthusiasm for higher income or energy taxes.

The pollster asked over 1,000 Finns just before Christmas what taxes could be raised to balance public finances.

Some 61 percent of those asked say they were ready to accept an increase on taxation on alcohol and tobacco products. Next on the list was capital gains tax with 42 percent giving their approval for a tax rise. One third of those questioned favoured a tax rise on confectionery and soft drinks.

When asked about income, energy or real estate taxation, the responses were far from enthusiastic. Only five percent favoured tax rises in these sectors to balance public finances.

Source: Yle, 27 December 2010



NETHERLANDS: Smoking Ban Widely Ignored, Ashtrays are Back in Half the Bars

Some 50% of the country’s cafés and discotheques allow smoking, despite the ban for all except small, one-man operated bars, according to new figures from the food and safety inspectorate.

Since the government overturned the ban in small bars, more and more large cafes are allowing their customers to smoke. In June, inspectors found smoking in 28% of the bars they visited. That has now increased to 51%.

According to the Volkskrant, the new government says around half of the country’s bars are smaller than 70 m2, meaning they are exempt from the ban, provided they do not employ staff. However, the Dutch catering association says the figure is closer to 25%.



Not only is there confusion about the size of bars, but bigger cafe owners say they are faced with unfair competition.

‘Since the government said it would soften the ban, the whole sector has been discussing it,’ Ben Francooy, chairman of catering workers’ union FNV Horecabond told the paper. ‘If you are going to make [the ban] more flexible, you open the door to fiddling the figures.’

In some places, cafe owners have an alarm light to alert each other if inspectors are spotted, Francooy said.


Source:, 6 January 2011



POLAND: Tobacco Industry Faces Tough Times

It is estimated that cigarette sales in Poland will have fallen by over ten percent between this year and 2014, Rzeczpospolita writes.

According to the Euromonitor International research company, Poles bought almost 57 billion cigarettes in 2010, around four percent fewer than the year before. In four years, the number is estimated to fall to around 50.5 billion cigarettes.

"The size of the legal cigarette market in Poland will continue to shrink because of the increasing excise duty, which translates into higher prices," said Krzysztof Kępiński, head of the government relations department at British American Tobacco.

Since January 1, 2011, excise duty on cigarettes will increase by four percent. According to different estimates, this will push up the price per packet by 60-90 groszy. Excise duty on cigarettes will continue to rise, as Poland needs to keep up with its obligations towards the EU.


Source: Warsaw Business Journal, 28 December 2010



SPAIN: Spain Gets Tough Anti-Smoking Law

Spain has brought into force an anti-smoking law that is likely to turn the EU's fourth largest tobacco producer into one of Europe's most stringently smokeless.

The law prohibits lighting up in enclosed public places, although hotels are allowed to reserve 30% of their rooms for smokers. In a particularly tough measure, outside smoking is banned in open-air children's playgrounds - even those inside parks - and at access points to schools and hospitals.

Parliament approved an anti-smoking law in 2006 that prohibited smoking in the workplace but allowed bar and restaurant owners with premises under 1,100 square feet to decide whether to allow smoking or not - and almost all permitted it. Critics called the law a failure.

Health Minister Leire Pajin said around 50,000 people died each year in Spain as a result of smoking-related illnesses, with around 1,200 of those being non smokers who inhaled secondhand smoke.

Larger restaurants were allowed to build hermetically sealed smoking sections, but now those spaces can no longer be used for smoking - a revolution for Spaniards used to wining, dining and lighting up.

The law stipulates that a minor infringement should be penalised with fines from 30 euro (£25) to 600 euro (£514) while very serious breaches will attract fines from 10,000 euro £851,000) to 600,000 euro (£514,000).

The Health Ministry said similar laws put in place in recent years in nations ranging from Britain to France and Italy did not hurt business badly.


Source: The Press Association, 2 January 2010



Related articles:

Spain’s Bars Go Smoke-Free in Tough New Law, AFP, 2 January 2011

Smoking at Spanish Restaurants, Bars Banned, CNN, 1 January 2011

Spain gets Tough in Second Attempt at Smoking Ban, Irish Times, 3 January 2011

Spain Enacts Tough Anti-Smoking Law, AP, 2 January 2010

Spain says ‘Adios’ to Smoking Bars, Cafes, Eateries, MSNBC, 21 December 2010





Publication: Spain: Beyond The 'Spanish Model' To A Total Ban

Spain was one of the first European countries to implement a tobacco control law. However, the ban of smoking in enclosed workplaces had an important exception in the hospitality sector—bars, pubs, taverns, restaurant and hotels (Tobacco Control 2006;15:79–80).

This type of partial legislation, known from that moment on as the ‘Spanish model' (Tob Control 2010;19:24–30), allowed smoking in hospitality venues of less than 100 square metres, subject to the decision of the owner. Not surprisingly, this model has been strongly supported by the tobacco industry when lobbying against smoke-free policies. The ‘Spanish model’ has been advocated, with slight variations, in other European and Latin American countries considering the implementation of smoke-free policies (ie, the recent or forthcoming bans in Portugal, Greece, Germany, Chile and Peru).



Totally smoke-free policies are urged by the WHO's Framework Convention on Tobacco Control (FCTC). The effectiveness of smoke-free policies and their lack of negative effects on hospitality businesses, have been confirmed by research, including a tobacco control report by the International Agency for Research on Cancer. Moreover, three years after the Spanish law entered into force, the evidence generated from its scientific evaluation clearly indicates that the exceptions in bars and restaurants have limited its effectiveness. Several studies have shown that exposure to secondhand smoke in workplaces has reduced (although not disappeared) whereas exposure during leisure—mainly due to exposure in hospitality venues—has not. Moreover, exposure of hospitality workers in venues where smoking continues to be allowed (80 per cent of all venues) has not decreased, but has even increased.


In the context of an increasingly favourable social climate for smoke-free environments (almost 80 per cent of Spaniards agree with smoke-free policies) and the accumulated evidence of the law's failure to protect hospitality workers, the Spanish parliament changed the partial ban to a total ban.


From 2 January 2011, the ban on smoking in all enclosed workplaces now includes bars and restaurants, with no exceptions. Moreover, smoking is now banned on the campus of hospitals and in healthcare centres. Thus the ‘Spanish model’ will no longer be that of a partial and weak ban, but a total one, as recommended by the FCTC.



What happened in Spain clearly illustrates how partial bans, voluntary policies or ‘courtesy of choice’ programmes, as promoted by the tobacco industry and parts of the hospitality sector, do not protect people against secondhand smoke. Spain has finally become an example of good practice for those countries aiming to go smoke-free.

Authors: Esteve Fernández, Institut Català d'Oncologia, Barcelona, Spain ( Este endereço de e-mail está protegido de spam bots, pelo que necessita do Javascript activado para o visualizar )

Manel Nebot, Agència de Salut Pública de Barcelona, Spain

Published in Tobacco Control. 2011; vol. 20, No. 1, p. 5-6.

The article can be already freely accessed as PDF or HTML text at



STUDY: Europe Reins In the Smoking Habit

A study led by the Smoking Control Unit of the Catalan Institute of Oncology (ICO) has confirmed that the anti-tobacco laws in Europe have a direct effect on the reduction in consumption and passive exposure to smoke. This conclusion was reached by relating the Tobacco Eurobarometer and the Tobacco Control Scale (TCS).

The new study, published online in PLoS ONE, has confirmed the hypothesis that the greater the restrictions, the lower the consumption and passive exposure to smoke. The study was carried out in the 27 countries of the EU and relates the Eurobarometer survey on tobacco and the Tobacco Control Scale (which takes into account the main measures taken in order to control smoking at international level).

"The countries with the highest score in the TCS apply active control policies and the consumption of tobacco and the proportion of the population exposed to smoke, both at home and in the work place, is more reduced," explained Esteve Fernández Muñoz, co-author of the study and the Head of the Tobacco Control Unit of the ICO.

In countries such as the United Kingdom, Ireland, Malta and Sweden, which score higher on the TCS (that is to say, they adopt stricter controls on smoking), the consumption is "relatively low" - 28.8% lower - as is exposure to smoke -13.8% lower in the home and 23.4% lower in the work place.




Progressively more measures in Spain


Fernández Muñoz pointed out that the reform of Law 28/2005 on health care measures concerning smoking, which came into force recently, "is an example of the very important progress in the control of smoking and means the abolition of the 'Spanish model' of supposed tolerance."


Although Spain scores high on the TCS, there are some aspects in which its score is low, such as the price of tobacco. He assured us that, "It is one of the countries in Europe with the cheapest prices."


"It has been demonstrated that increasing the price of tobacco is the most effective measure for controlling smoking (30 points out of 100 on the TCS scale) as compared with other action, such as, treatment to quit smoking (10 points on the TCS)," pointed out the researcher.


The experts forecast that these measures will reduce the incidence of cardiovascular disease in the short and medium-term, as well as the incidence of cancer, mainly lung cancer, in the long-term. In Spain, passive exposure to smoke leads to between 1,200 and 3,200 deaths per year due to lung cancer and heart attacks.


Source: Sciencedaily, 4 January 2010


Related article: Anti-Smoke Laws 'Have Direct Effect’


Source Reference : Research Paper: Smoking Behaviour, Involuntary Smoking, Attitudes towards Smoke-Free Legislations, and Tobacco Control Activities in the EU

Authors: Jose M. Martínez-Sánchez, Esteve Fernández, Marcela Fu, Silvano Gallus, Cristina Martínez, Xisca Sureda, Carlo La Vecchia, Luke Clancy

The complete article is available for download below.




STUDIES Decipher How Anti-Smoking Drugs Work

Brain changes spurred by the medications seem to help cut cravings

Two drugs that help people stop smoking - bupropion and varenicline - may change the way the brain reacts to seeing someone else smoke, new studies report.


And that may be how they cut cravings.


Bupropion (Wellbutrin, Zyban) is prescribed around the world to help people resist smoking cues. But it has not been clear how the drug does this. Using brain scans, Christopher S. Culbertson, of the University of California, Los Angeles, and his colleagues examined what happened in the brains of 30 smokers who took the drug or a placebo for eight weeks.


The researchers gauged how much the participants craved cigarettes by asking them to respond after watching "neutral" cues that did not involve smoking or 45-second videos of actors and actresses smoking.


Those who took the drug instead of the placebo reported less craving. They also showed less activity in areas of the brain linked to craving.


"These results demonstrate that treatment with bupropion is associated with an improved ability to resist cue-induced craving and a reduction in cue-induced activation of limbic and prefrontal brain regions," the study authors wrote.


Source: HealthDay (HealthScout) 3 January 2010

Source Reference: Archives of General Psychiatry




STUDY: Pregnant Women Often Deny Smoking


Overall, about one in four women who smoke while pregnant deny it, a new study hints. The numbers could be even higher in certain groups of women, like those in their early 20s.


In the United States, smoking by moms-to-be is one of the most common preventable causes of illness and death among infants, Dr. Patricia Dietz from the division of reproductive health at the Centers for Disease Control and Prevention in Atlanta, and colleagues note in their report.


In their study, they estimated how many pregnant and non pregnant smokers aged 20 to 44 years did not disclose their habit on a health questionnaire.


How did they catch the deception? They took blood samples from the women to measure levels of cotinine -- a byproduct of nicotine that serves as a marker of exposure to tobacco smoke. Their analysis included 994 pregnant women and 3,203 non pregnant women.


Overall, 13 percent of pregnant women and 30 percent of non pregnant women were active cigarette smokers. The pregnant smokers smoked an average of 11 cigarettes a day, while the non pregnant smokers averaged close to 14 cigarettes a day.


According to the investigators, far more pregnant than non pregnant smokers failed to disclose their habit - 23 percent versus nine percent - and were identified by their cotinine concentrations.


Source: msnbc, 31 December 2010

Source Reference: American Journal of Epidemiology, Published online December 22, 2010.




STUDY: Smoking Tied To Miscarriage Risk

A new study may offer women one more reason to kick the smoking habit before becoming pregnant: a potentially reduced risk of early miscarriage.

In a study of nearly 1,300 Japanese women with a past pregnancy, researchers found that those who smoked heavily early in pregnancy were more than twice as likely as non-smokers to suffer a miscarriage in the first trimester.

There are many reasons for women to quit smoking before becoming pregnant. The habit has been linked to increased risks of stillbirth, preterm delivery and low birthweight.

But studies so far have come to conflicting conclusions as to whether smoking might contribute to miscarriage risk.

These latest findings, reported in the journal Human Reproduction, support a connection.


Source: Reuters, 5 January 2011


Source Reference: Risk factors of early spontaneous abortions among Japanese: a matched case–control study

Hum. Reprod. (2010) doi: 10.1093/humrep/deq343 First published online: December 14, 2010




Institutional News


WHO FCTC COP-4 Decisions Available

Document FCTC/COP/4/DIV/6 - Decisions - is available in English on the FCTC website ( and

Translation into all other languages is being processed.

Source:Ulrike Schwerdtfeger, Technical Officer

Convention Secretariat, WHO Framework Convention on Tobacco Control

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December 2010



If you would like to inform other members about new publications or events in your organization or country, please send contributions to Sophie Van Damme Este endereço de e-mail está protegido de spam bots, pelo que necessita do Javascript activado para o visualizar

This bulletin receives the financial support of the European Commission.


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