Smokeless Tobacco: The Struggle over Tobacco Control in the EU

The counterproductive war on smokers
6 December 2010
Revue Politika
Tom? Břich?ček
The European Commission is preparing a general ban on smoking in public areas. However, a Czech legal expert argues that the desire to legislate to improve public health could ultimately undermine civil liberties.

The European Commission is currently preparing proposals to be presented next year for a draconian reinforcement of anti-smoking legislation. The planned measures include the introduction of a standard cigarette pack to be extensively marked with shocking images and health warnings. But without a doubt the major change will be the imposition of a Europe-wide ban on smoking in all public areas, notably in restaurants and bars, and also at transport stops.

It is often said that history repeats itself, but only rarely are we invited to look at the preponderant role of dogmatic ideologues in this recurring phenomenon. As always, they insist that the state should re-educate their fellow citizens by imposing their vision of what is “good,” and this is the case with anti-smoking activists, who are now leading the charge of the partisans of “progress.” Over the last few years, they have successfully campaigned for the introduction of increasingly severe anti-smoking legislation in most European countries, and in so doing, they have taken advantage of a widespread phenomenon in Western civilisation: the drift towards a nanny state and the growth of a culture that is hostile to even the slightest risk.

Turning into over-solicitous parents
Caught in the vice-like grip of these two mutually reinforcing trends, states are turning into over-solicitous parents intent on protecting the safety of their citizens. As a result, people have stopped counting on themselves, and embraced the belief that someone else should pay for all of their bad decisions. In this context, it is not surprising that those who prefer to view individuals as children in constant need of education, protection and guidance, have come to consider alcohol and tobacco as two intrusive substances that must be expunged from the body politic.

Reasonable regulation in the form of bans on sales to minors, advertising restrictions and higher taxes on these products is no longer deemed to be sufficient. Now the self-proclaimed saviours of their fellow citizens have decided to interfere in what used to be the strictly private sphere of relations between restaurant owners and their customers. Specifically, they want to deprive them of the right to organise their businesses in accordance with economic imperatives and their own judgement.

Impact on the free circulation of goods
You might be forgiven for thinking it strange that the regulation of smoking is now a matter for the EU, but that is in fact the case. Tobacco products are considered as goods, and in accordance with the principle of the free circulation of goods in the Europe, they are regulated by the law of the EU internal market (in particular see article 114 of the Treaty on the Functioning of the European U nion (TFEU)). A number of directives have already set out rules for the composition and labeling of tobacco products, their radio and press advertising, and industry sponsorship of sporting events, and we now have an outright ban on audio-visual advertising for tobacco.

At the same time, the drive to reform the common agricultural policy has also reduced direct EU subsidies for tobacco growers. There are many convincing arguments to justify EU regulation of the tobacco industry, particularly with regard to the harmonisation of rules on the composition of cigarettes and indirect taxes charged on tobacco sales. Legislation in both of these areas does have an impact on the free circulation of goods. However, other laws, like those which ban advertising, restrict sponsorship, or prohibit smoking in work places, are much more contentious, because they are only vaguely related to the single market.

Social engineering projects have unexpected results
But even if we allow that they do have some legal validity, I can see no justification for a Brussels imposed ban on smoking in restaurants, at transport stops and in other public areas. Even in the US, this is a matter regulated by individual states and not by the federal government.? In its 2007 green paper “Towards a Europe free from tobacco smoke,” in support of its right to legislate on this question, the European Commission simply asserts that “binding legislation would impose a comparable, transparent and enforceable basic level of protection from the risk of exposure to environmental smoke throughout the Member States.”

Experience has shown that social engineering projects that aim to curtail fundamental freedoms often have unexpected results and in most cases prove to be unqualified failures. This is the future that I foresee for the very strict repressive measures that the EU may be about to impose on smokers, who represent more than a third of the population of Europe’s member states. A few years from now, this kind of legislation could make smoking a symbol – and not just for smokers – of resistance to intrusive and paternalist public authorities and the relentless appetite for regulation in the EU, which is an increasing source of exasperation for a growing number of its citizens.

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MEP calls for EU-wide tobacco ban

22 July 2008
By Doug Newhouse

While the European Commission continues to try and drive its plan to rise tobacco taxes throughout the 27-nation bloc, Irish MEP Avril Doyle has called for legislation to make it illegal to sell cigarettes and cigars within the European U nion by 2025.

Doyle is the leader of the Irish faction within the centre-right European People’s Party (EPP) which recently organised a conference aimed at developing ways of complying with the World Health Organisation’ s Framework Convention on Tobacco Control, Article 5.3. This obliges all countries that have signed up to outlaw lobbying by tobacco companies on any public health policies.

Effectively this means that politicians will cease to talk to tobacco companies or their lobbyists on public health issues of any kind.

Meanwhile, the European Commission is continuing with its plan to try and harmonise tobacco taxes across Europe in an effort to discourage smuggling. This is seen as ‘mission impossible’ by many because of the excise tax disparities between member states and the fact that all of them would have to agree to it – as would the European Parliament.
Any plan to harmonize taxes across the 27-nation bloc would hit eastern European smokers hardest where taxes are much lower than in countries such as Britain. But the EU claims that higher prices would reduce cigarette use by a tenth over the next five years.

Regulators say they want tax to amount to 63% of the retail price of all cigarettes across the European U nion by 2014 instead of the current average of 57%. This would mean that tax on the sale of 1,000 cigarettes would have to rise to at least E.90 ($144).

That would see cigarette prices in some eastern European member states increase by nearly half, although there would be no changes to prices in Britain, France, Germany and Ireland where tobacco taxes are already high.

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July 18, 2008
Natural Justice from the Tranzi’s? You must be joking
This week the awful Avril Doyle, leader of the Fine Gael group of MEPs over here in Brussels called for an outright ban on tobacco. Not only that she suggested that a European ban on all tobacco products could be extended beyond the EU’s borders,

“I have never favoured a nanny state attitude, the over regulation of our citizens, of dictating to anyone on what anyone can or cannot do…but the one area I can make an exception is the tobacco industry…

By 2025 it should be illegal to sell tobacco products in the EU. That would give 15 years notice for all our citizens to realise just how serious we arer about not allowing the continued sale within the EU and hopefully elsewhere of products… that may be legal but are not legitimate”.
She was speaking at a closed conference organised by the Smoke Free Partnership and supported by Pfizer. The event was called “The role of article 5.3 of the WHO Framework Convention on Tobacco Control in protecting public policy from tobacco industry influence” which refers to the way in which the health fascists wish to direct future policy making. By barring the affected parties from putting their position to policy makers.

The key bit is 5.3 which states,

“3. In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law”.
What this means in effect is that politicains and civil servants should be protected from the tobacco and assocaited industruies – such as the hospitality industry when legislating or implementing tobacco control policies. The net result of this being that if a local publican wants to put up a lean-to, to protect his customers from the rain he needs planning permission. He may well be barred from lobbying his local council’s planning department as the individuals there will be involved in implementing the tobacco ban.

At the Conference the Commissioner Vassiliou said,

“All public health policies with regard to tobacco control have to be effectively protected from the interests of the tobacco industry. My first consideration is that this this obligation cannot be fullfilled if the scope of the guidelines are not broad enough. All the actors in both the setting and the implementation tobacco Control policies should be bound by this obligation. To refer to our own environment for instance it would not make much sense if only the Commission were to act in that sense. Following any Commission proposal tobacco control policies are discussed, amended and adopted through the European legislative procedures with the Parliament and the Council, and these institutions should also act in accordance with the guidelines once adopted. The same should apply to all those involved in the implementation of the tobacco control policies…. The scope of the furure guidlines is therefore a key aspect. It needs to be as comprehensive as possible in order to have a real impact…
So the ban on contacts should spread across all public policy,

Let me also move a step forward. As Commisioner for health I am ready to commit today not to accept any invitation coming from the tobacco industry or those working to preffer its interest while I hold this office…. the ultimate goal of making tobacco use a thing of the past.”
OK, that is your personal comittment Commissioner. But you are not a private person, you are an EU official, unelected remember, and and a civil, my servant. And I believe you are a bound by The EU’s Charter of Fundamental Rights. Which states quite clearly,

Article 20
Equality before the law
Everyone is equal before the law.
Meaning exactly what it says, no individual or group of individuals may be singled for different treatment. This is backed up elsewhere in the Charter here for example,

Article 11, Freedom of expression and information. Para 1. Everyone has the right to freedom of expression. This right shall include freedom to hold opinions and to receive and impart information and ideas without interference by public authority and regardless of frontiers.
Got that Commissioner. Whithout interference by public authority

Article 41, Right to good administration. Para2. This right includes: the right of every person to be heard, before any individual measure which would affect him or her adversely is taken.
You might think that tobacco control legislation might be harmful tothe tobacco industry, its representatives and supporters, likewise the hospitality industry. You do not have the right to make the commitment that you have made.

So what’s it gouing to be, health facism or human rights?

Your call.

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Published online before print December 14, 2007
CA Cancer J Clin 2007
doi: 10.3322/CA.2007.0006
? 2007 American Cancer Society

SMOKELESS TOBACCO: HARM REDUCTION DEBATABLE
A recent report from Britain’s Royal College of Physicians (RCP) says tobacco harm-reduction strategies are urgently needed to help hard-core smokers who can’t kick the habit—and smokeless tobacco should be among the options.
But American Cancer Society (ACS) experts counter that encouraging smokeless tobacco use is not only a dangerous tactic in the drive to reduce smoking rates, but scientifically unproven as well.
“This approach puts us at great risk of repeating the fiasco of ‘Light’ and ‘Mild’ cigarettes,” says Michael Thun, MD, ACS Vice President of Epidemiology and Surveillance Research. “There is no evidence that smokers will switch to smokeless tobacco products and give up smoking. In fact, the tobacco companies market these products as a ‘bridge’ that provides smokers with nicotine in settings where smoking is prohibited. Any product that encourages smokers to postpone quitting will increase rather than decrease their risk of lung cancer, as was the case with ‘Light’ and ‘Mild’ cigarettes.”
Lung cancer is, of course, only one of the well-documented hazards of smoking. The habit is directly responsible for some 87% of lung cancer deaths, around 30% of all cancer deaths, as well as substantial morbidity and mortality from heart disease, stroke, emphysema, and other conditions.
Yet quitting remains a challenge for the millions of smokers worldwide who are addicted to smoking and the nicotine rush it delivers. The RCP report, titled “Harm reduction in nicotine addiction: Helping people who can’t quit,” contends that this challenge is simply insurmountable for some people and that the current dearth of harm-reduction strategies is “perverse, unjust and acts against the rights and best interests of smokers and the public health.”
“This too relies on a false assumption,” says Thun. “Most people who continue to smoke have never received sufficient counseling and treatment to help them succeed at quitting. The premise that smokeless tobacco products are more effective than conventional treatments has never been tested in a randomized clinical trial. It is simplistic to assume that smokeless tobacco products will have a net public health benefit simply because they are less lethal than cigarettes. Conventional nicotine-replacement therapies have been tested extensively and shown not to be carcinogenic, to have low toxicity, and to be effective in helping smokers quit. None of these is true for smokeless tobacco products.”
The report says smokers should have access to alternative products that can deliver nicotine to satisfy their addiction, with fewer adverse health consequences.
According to the report and an accompanying Viewpoint piece published online October 5, 2007, in The Lancet (doi:10.1016/S0140-6736(07)61482-2), smokeless tobacco fits that bill, even though it is known to increase the risk of oral cancers, pancreatic cancer, heart disease, gum recession, and bone loss around the teeth.
“Whatever the true overall hazard, use of low nitrosamine smokeless products is clearly substantially less harmful than tobacco smoking,” write editorialists John Britton, MD, and Richard Edwards, MD. Britton is Chair of the RCP Tobacco Advisory Group and Professor of Epidemiology at the University of Nottingham, England; Edwards is a member of the RCP Tobacco Advisory Group and Senior Lecturer in Epidemiology at the University of Otago, Wellington, New Zealand.
They cite Swedish snus (moist snuff) in particular as a lower-hazard smokeless product that should be considered for harm reduction because it has been linked only to pancreatic cancer, but not lung or oral cancers or cardiovascular disease. There is also some data to suggest that in Sweden, some reduction in smoking is attributable to substitution of snus for cigarettes, they say.
“On the basis of the Swedish data we believe that the potential role of smokeless products at least merits further consideration and investigation to find out whether and to what extent these products can act as substitutes for smoking; whether tobacco products are more effective smoking substitutes than medicinal nicotine; and, if so, whether the product characteristics responsible can be identified and used to develop more acceptable low-risk medicinal products,” they write.
The RCP report does cite nicotine-replacement therapy as an obvious smoking alternative. However, the report notes that because these products deliver nicotine more slowly and in lower doses than cigarettes, many smokers who use them tend to relapse. Moreover, nicotine-replacement products tend to be expensive, putting them out of reach for many addicted smokers with low incomes.
Thun agrees that cost of nicotine replacement is a problem. “The solution to this is to fix the health care system, not invite the tobacco companies to sell more tobacco,” he says.
Another problem with promoting smokeless tobacco over cigarettes is the danger of youth uptake, Thun adds. “Now that all of the large tobacco companies have introduced their own lines of smokeless products, their marketing strategies will inevitably target susceptible adolescents. They have already introduced flavors such as apple, peach, and mint.”
He continues, “There is no evidence that smokers will quit rather than kids taking up the product. In fact, the last time smokeless products were marketed in the US, it was adolescent males who began using it, not smokers trying to quit.”
The RCP report calls for the creation of new national and even international nicotine- and tobacco-regulating authorities to enact harm-reduction strategies. Among the proposed reforms are the following:
•?Tightening regulations on cigarettes (the most harmful tobacco products) to discourage their use;
•?Loosening regulation on smokeless tobacco (relatively less harmful tobacco products) to encourage their use as a smoking substitute;
•?Loosening regulations on medicinal nicotine products to encourage the development of more effective nicotine-replacement products that would make better substitutes for cigarettes.
The report emphasizes that cessation and prevention should remain the primary goals of tobacco control efforts.

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EU asked to study risks of tobacco product
By Andrew Bounds in Strasbourg
October 25 2007
Snus, tobacco that is placed in the mouth rather than smoked, took a step towards legalisation in the European U nion on Wednesday after lawmakers requested research into its effects.
Health campaigners criticised the European parliament vote, which called for the European Commission, the bloc’s executive arm, to study whether snus could wean addicts off cigarettes.
The product, which is inserted under the lip in an edible pouch, was banned in the EU in 1992 after the World Health Organisation said it could cause cancer. Sweden was allowed to keep selling it when it entered the bloc in 1995.
Swedish MEPs, backed by Liberals, on Wednesday voted through an amendment pressing the Commission “to investigate the health risks associated with consumption of snus and its impact on the consumption of cigarettes”.
Markos Kyprianou, health commissioner, dismissed the call. His spokesman said: “He considers snus to be a harmful product. There has been sufficient investigation to determine that. It is not desirable to replace one harmful product with another.” The Cypriot, a reformed smoker, vowed to continue his quest for a smoke-free Europe by the time he leaves office in 2009.
Sir Alexander Macara, vice-president of the standing committee on European doctors, warned against “legalisation of a substance that has been found to cause oral, pancreatic, neck and other cancers, as well as increasing the risk of heart disease and strokes. There is a real danger that research into snus, and discussions about its possible legalisation, will serve to distract policymakers from the need to prevent, and help people overcome, their addiction to nicotine.”
The Scientific Committee on Emerging and Newly Identified Health Risks, which advises the Commission, is reviewing research on snus’s health effects.
British American Tobacco, which sells snus in Sweden and Norway and has been testing in Canada, South Africa and Japan, says the product is less harmful than cigarettes. BAT and other companies see it as a chance to maintain profits as smoking becomes more restricted.

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