Ncd meri paavola_110314 final

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Ncd meri paavola_110314 final

  1. 1. Tobacco Control NCD seminar, THL 11.3.2014 Meri Paavola, Ministerial Adviser Ministry of Social Affairs and Health 1 13/03/2014 Etunimi Suku
  2. 2. Deaths from tobacco use  Tobacco use is one of the biggest public health threats  Worldwide, nearly 6 million deaths per year (8.8% of all deaths)  Globally use of tobacco products is increasing, but decreasing in high-income countries
  3. 3. Risk is big  Every second die … loosing on average 14 years of life  Many of those killed are still in middle age  Stopping smoking works 3 13/03/2014 Etunimi Sukunimi
  4. 4. Smoking prevalence globally (source: WHO Report on the Global Tobacco Epidemic)
  5. 5. Smoking prevalence in Finland and tobacco policy actions 1960–2013 19 % 13 % 0% 10% 20% 30% 40% 50% 60% 1960 1970 1980 1990 2000 2010 Men Women Tobacco Act 2010 Ban on restaurant smoking Restrictions on smoking in restaurants Smokefree workplaces Tobacco Act 1976 The North Karelia project launched Report of the Tobacco Committee Petitionary motion Health Behaviour and Health among the Finnish Adult Population 2013 (THL)
  6. 6. Percentage of 14-18-year olds who use tobacco products daily 1977-2013 6 13/03/2014 Etunimi Sukunimi 0 5 10 15 20 25 30 35 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 boys girls
  7. 7. Daily use of tobacco products among boys and girls Tobacco products daily, boys Tobacco products daily, girls Adolescent Health and Lifestyle Survey 2013
  8. 8. Daily smoking in Finland by educational group 1978-2011 (Age-adjusted; 25–64-year-old population) Satu Helakorpi, Anna-Leena Holstila, Suvi Virtanen, Antti Uutela Health Behaviour and Health among the Finnish Adult Population, Spring 2011. National Institute for Health and Welfare (THL), Raportti 45/2012. Helsinki 2012. 0 10 20 30 40 50 % Men Lowest Middle Highest 0 10 20 30 40 50 % Women
  9. 9. Daily smoking of adolescents by type of school and gender in 2000-2011 13.3.2014 www.thl.fi/tupakka 9 25 22 17 19 39 40 17 14 10 11 40 39 0 5 10 15 20 25 30 35 40 45 Pojat Tytöt Pojat Tytöt Pojat Tytöt Yläkoulu Lukio Ammatillinen koulutus % 2000/2001 2002/2003 2004/2005 2006/2007 2008/2009 2010/2011 The proportion of daily smoking adolescent (%) in secondary schools, general upper secondary education and vocational upper secondary education and training by gender 20002011. Grade level-adjusted proportions, the whole country (pooled years). School Health Promotion Study, National Institute for Health and Welfare. Online material (only in Finnish): www.thl.fi/kouluterveyskysely. School Health Promotion Study was extended to vocational upper secondary education and traing in 2008.
  10. 10. Exposure to Environmental Tobacco Smoke in Finland % 0 10 20 30 40 50 60 83 86 89 91 93 95 96 97 98 99 2000 2004 2007 2010 At home At work Health Behaviour and Health among the Finnish Adult Population (THL)
  11. 11. 13/03/2014 History of Finnish Tobacco Control legislation  1976: Advertising ban, smoke-free schools, smoke-free public transport and public premises; warning texts in packages; prohibition to sell tobacco to people under 16  1994: smoke-free workplaces except restaurants; indirect advertising also prohibited; age limit for tobacco purchases up to 18  2007: smoke-free restaurants (separately ventilated smoking room is allowed with licence)  2010: – Aim: to end the use of tobacco products – 90% of hotel rooms smoke-free, smoke-free sporting arenas (even when outdoors), smoke-free public events (also outdoors) – ban at the point of sale
  12. 12. Finnish Tobacco Act 2010 • The new aim is to end the consumption of tobacco products. • From “reducing” to “ending” the use of tobacco products => ENDGAME! • Tobacco is not an ordinary commodity and it should not be treated as one • The aim legitimize strong measures • Among other things, it means we are not promoting products based on “harm reduction” • Tobacco Free Finland 2040
  13. 13. Tobacco-free Finland 2040 0,0 10,0 20,0 30,0 40,0 50,0 60,0 70,0 80,0 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 Men Women
  14. 14. Tobacco point of sale display ban Finland 2012 Other countries  Iceland 2001  Thailand 2005  Canada 2005  Ireland 2009  Australia 2009  Norway 2010  New Zealand 2012  Kosovo 2013  UK 2012-2015
  15. 15. Tobacco-Free Finland 2040  Not possible to prohibit the sale of tobacco  The aim should be achieved by other means  Tobacco use should reduce by 10 % annually  A comprehensive and multisectoral strategy: 1+1>2  Domestic measures are not enough; FCTC and EU tobacco directive are helpful
  16. 16. Tobacco control strategy  Legislation (+implementation!)  Taxation (price)  Prevention  Cessation  Media and public awareness  Communities  Evaluation, monitoring and surveillance
  17. 17. WHO’s Framework Convention on Tobacco Control (FCTC)  Treaty was adopted 2003  Roadmap for successful global tobacco control  Demand reduction and supply reduction  guidelines, protocols  176 parties, 90 % of world’s population  Important tool worldwide www.fctc.org
  18. 18. Demand reduction  Price and tax  Exposure to tobacco smoke  Regulation of the contents of tobacco products  Regulation of tobacco products disclosures  Packaging and labelling  Education, communication, training and public awareness  Tobacco advertising, promotion and sponsorship  Tobacco dependence and cessation 18 13/03/2014 Etunimi Sukunimi
  19. 19. Supply reduction  Illicit trade  Sales to and by minors  Provision of support for exonomically viable alternative activities 19 13/03/2014 Etunimi Sukunimi
  20. 20. 20 13/03/2014 Etunimi Sukunimi
  21. 21. 21 Main elements of the new Tobacco Products Directive (1) Ingredients • Ban of products with characterising flavours • 4 year transitional period for flavoured products with market share > 3% (e.g. menthol) • Certain additives (vitamines, caffeine, etc.) are prohibited • Reporting obligations for all ingredients
  22. 22. 22 Main elements of the new TPD (2) Packaging and labelling  Combined (picture and text) warnings (65%) on both sides of the unit packet  Position at the top  Health warnings on the lateral sides  Some standardisation of packets  No promotional elements  Slim cigarettes not covered by TPD  MS can introduce plain packaging
  23. 23. Future pack of cigarettes 23 13/03/2014 Etunimi Sukunimi
  24. 24. No more ”lipstick packs”
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  28. 28. 13/03/2014 Plain packaging  Only brand name and health warning on cigarette packages  A law on plain packagaing was passed in Australia in 2012
  29. 29. Main elements of the new TPD (3) Illicit trade • EU-wide tracking and tracing system at unit pack level • Covering the supply chain excluding retail Smokeless tobacco products • Ban on oral tobacco maintained • Reinforced labelling provisions • No ingredients regulation for snus 29
  30. 30. Main elements of the new TPD (4) Cross border distance (internet) sales • Member States are entitled to ban cross border sales • If not banned, notification obligation for cross border distance retailers and age verification system Novel tobacco products Herbal products for smoking 30
  31. 31. Main elements of the new TPD (5) Electronic cigarettes (including nicotine) • Regulatory framework: consumer vs. medicinal • Safety and quality requirements • Rules on packaging and labelling, advertising • Rules on monitoring and reporting on market developments National competence: regulation of flavours in e- cigarettes, age limits and sales points 31
  32. 32. Legislation of e-cigarettes in Finland  Nicotine liquids classified as medicinal products Private persons can import for own use (Internet)  Device and nicotine-free liquids no-medicinal, can be sold in shops  Advertising banned
  33. 33. Use of e-cigarettes in Finland, 2013 Adults  2 % daily or occasionally (15-64 years) Adolescents, experimented Boys Girls  16 years 29 % 21 %  18 years 29 % 27 % – most often liquids with nicotine – one in ten had never tried tobacco products  the worst scenario: e-cigarettes do not help to quit smoking, but make adolescents addicted to nicotine and is a gateway to tobacco products?!
  34. 34. 34 13/03/2014 Etunimi Sukunimi Thank you! Kiitos! meri.paavola@stm.fi
  35. 35. Is it possible? 35 13/03/2014 Etunimi Sukunimi

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