Experts say limiting smoking in outdoor areas such as beaches, parks, and restaurants could be the next move for many countries to tackle tobacco smoking.
ADVERTISEMENTSmoking rules could soon become more strict in Europe, with the UK reportedly considering a possible ban on smoking on pub and restaurant terraces and the European Commission set to propose new recommendations on smoke-free environments tomorrow.
While some European countries have banned smoking in the vicinity of schools, outside workplaces, or at sports stadiums, Sweden is the only European country that has fully banned smoking on restaurant and bar terraces, according to the Smoke Free Partnership (SFP), a coalition of European NGOs.
Cigarette smoking has been decreasing in Sweden since the early 1980s and it now has the lowest rate of cigarette smoking across Europe. Overall, nearly a quarter of Europeans smoke, according to the 2022 Eurobarometer survey, with the figure ranging from around 8 per cent in Sweden to 37 per cent in Bulgaria.
Tobacco is also the largest avoidable health risk in European Union (EU) countries, killing roughly 700,000 people a year, but countries all have somewhat different rules on smoking. Secondhand smoke is also known to cause lung cancer and heart disease in non-smokers.
The European Commission is aiming, however, to create a “tobacco-free generation” where less than 5 per cent of the EU population uses tobacco by 2040 as part of its plan to beat cancer.
Differences in legislation across Europe
There are EU-wide directives that require states to have a minimum tobacco tax rate, a ban on flavoured products, and certain common packaging rules, but smoke-free legislation is decided by member states, according to Lilia Olefir, the director of Smoke Free Partnership (SFP).
Olefir expects that the Commission’s new recommendations could cover new tobacco products and limits on outdoor smoking.
“It's all about gradual improvement of how well we can protect people from secondhand tobacco smoke,” Olefir said.
“It's a matter of time because there are countries in Europe that want to ban smoking on terraces, parks, and beaches. It will be happening in the next five years or so,” she added.
The Swedish legislation to ban smoking on bar and restaurant terraces in 2018 “had very good results among adults, but we still have a lot of other problems,” said Helen Stjerna, general secretary of the Swedish organisation A Non Smoking Generation.
Stjerna points out that “adults with less education smoke more” and is concerned that “new nicotine products” such as e-cigarettes and Sweden’s tobacco powder snus could lead young people to pick up the habit.
While the lowest proportion of daily smokers in Sweden is young people aged 16 to 29, they do represent the highest proportion of occasional smokers, according to the country’s public health agency.
In some European countries, there are partial bans such as specific smoking areas in parks and other public places, instead of a wider ban.
That’s the case in Lithuania, for instance, where “smoking is allowed only in designated areas” at restaurants’ outdoor terraces, a spokesperson for the health ministry told Euronews Health. Local municipalities can also prohibit smoking at beaches or in parks or squares.
Could more European countries bring in smoking bans outside restaurants and bars?
Yves Martinet, a retired pulmonologist and president of the French National Committee against Tobacco, said that while it’s “extremely important that we advance on [banning smoking on terraces], in France, no one is interested in this issue”.
ADVERTISEMENTStill, France has some of the strictest anti-tobacco legislation, based on a 2022 SFP report.
The first tobacco legislation in France was in 1976, when the government targeted marketing for cigarettes and added a health warning to packaging. Restrictions were then tightened in 1991 with a ban on direct and indirect advertising and on smoking in some public spaces outside of designated areas.
It was in 2007 that France banned smoking in all indoor areas and in 2016 that they put in place neutral packaging, with one colour and enlarged health warnings. The government’s latest programme, unveiled last year, includes plans to ban smoking on beaches, parks, and outside schools, measures that could be implemented by 2025.
In the Netherlands, which also ranks high for anti-tobacco smoking legislation in Europe, the price of a pack of cigarettes is currently €11.10. Since 2020, the country has had neutral packaging and a ban on smoking at educational facilities.
ADVERTISEMENTDesignated indoor smoking areas were banned in the Netherlands in all sectors from 2022, with further restrictions on where tobacco products and e-cigarettes can be sold coming into effect over the next several years.
The countries with the most restrictive anti-smoking measures, according to SFP, are Ireland and the United Kingdom (UK). The price of a packet of cigarettes in Ireland is the highest in Europe at €16.75. The government also unveiled a bill in June that would raise the minimum age for buying cigarettes to 21.
A potential ban on smoking outside pubs in the UK, however, was criticised by the hospitality industry as a move that could harm business.
“A ban on smoking in outdoor spaces comes with the prospect of serious economic harm to hospitality venues,” Kate Nicholls, Chief Executive of UKHospitality, said in a statement last month.
ADVERTISEMENT“You only have to look back to the significant pub closures we saw after the indoor smoking ban to see the potential impact it could have,” Nicholls added, saying the government should assess whether it would achieve its aims.
The UK has not yet proposed such a measure, however, with a Department of Health and Social Care spokesperson saying they would not comment on leaks, but adding that tobacco smoking “claims 80,000 lives a year, puts huge pressure on our [National Health Service], and costs taxpayers billions”.
“We are determined to protect children and non-smokers from the harms of second-hand smoking,” the spokesperson said in a statement provided to Euronews Health.
“We’re considering a range of measures to finally make Britain smoke-free”.
ADVERTISEMENTTaxes and neutral packaging should be extended
Anti-smoking advocates say there is much that needs to be done, particularly in European countries with high smoking rates that do not have plain packaging or high prices for cigarettes.
Eva Králíková, a professor of medicine at Charles University in Prague, said that the number of smokers remains high in the Czech Republic – around a quarter of the population – due to a lack of basic tobacco control policies.
"We need plain packaging. We don't have it. We need to sell it in special shops with permission like tobacco shops, because the majority of Czech cigarettes are sold together with food. It should not be [like this]. Also, we need the price to be about twice as high as it is now compared to the income 20 to 30 years ago,” she said.
“This is basic. This costs nothing. So it's just political will,” Králíková added.
ADVERTISEMENTOlefir, meanwhile, said it’s “difficult to identify” a single measure where “if we do that, then we are all done”.
“It’s a set of various measures,” she said, including preventing loopholes in the directives, raising taxes on tobacco, and regulating novel products.
