The Tobacco Control Scale 2019 in Europe

Three countries (Slovenia, Greece, and Austria) improved their score with 14 or more points. Israel was included in our survey for the first time and was doing very well at prices, with the highest price score for the 36 countries. Overall, countries that failed to undertake new initiatives lost points and fell in the ranking. The countries that are leading tobacco control in Europe are those that have comprehensive tobacco control policies.

Seven countries (UK, France, Ireland, Iceland, Norway, Finland, and Israel) have 60 points or more, 15 countries have scores in the 50s (Slovenia, Hungary, Spain, Belgium, Romania, Greece, Netherlands, Sweden, Italy, Turkey, Malta, Croatia, Portugal, Austria, Ukraine), and the remaining 14 countries failed to reach 50% of the total score possible. Three countries (Germany, Switzerland, and Luxembourg) had very low scores, with fewer than 45 points, lowest ranking 40 out of 100 (Germany).

The EU Tobacco Products Directive obliged EU countries to introduce pictorial health warnings. Nine countries in this survey (UK, France, Ireland, Hungary, Norway, Slovenia, Turkey, Israel, and Belgium) adopted plain packaging legislation, although Israel and Hungary had not yet implemented their legislation on 1 January 2020. (Israel 8/1/2020 and Hungary 1/1/2022)

Since 2013, 13 countries have introduced a smoking ban in private cars when minors are present. (Ireland, UK, France, Finland, Italy, Malta, Cyprus, Lithuania, Slovenia, Luxembourg, Austria, Greece, and Belgium).

All countries in this survey (with the exception of Switzerland) have ratified the WHO Framework Convention on Tobacco Control and nineteen countries have ratified the WHO FCTC Protocol to Eliminate the Illicit Trade in Tobacco Products.

Were this a test requiring a minimum score of 50 to pass, then 14 countries, or 39 % of the field, would fail. Their end-of-term report would undoubtedly say: “Must do better.” They urgently need to improve their tobacco control score in the next few years.

Here, in slightly end-of-term report style, we comment briefly on individual countries, in reverse order of their 2019 ranking (with, in brackets, the 2016 ranking and up or down movement on the scale).

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