Unfinished business – Tobacco control in the Nordic countries

7th ECToH, Conference on Tobacco or Health, Porto, Portugal, 22-25 March, 2017

Unfinished business – Tobacco control in the Nordic countries

Status of smoking and tobacco control in the Nordic countries

Niels Them Kjær (DK)

Strengths and drawbacks in each country

Astrid Knudsen (DK), Mervi Hara (FI), Guðlaug B. Guðjónsdóttir (IS),

Ingrid Stenstadvold Ross (NO), Margaretha Haglund (SE)

Future challenges and possibilities

Ewy Thörnqvist (SE)

Status of smoking and tobacco control in the Nordic countries

Niels Them Kjær (DK)

Nordic countriesDenmark: 5.7 mio. – 16 % daily smokers

Finland: 5.5 mio. – 14 % daily smokers

Norway: 5.2 mio. – 12 % daily smokers

Iceland: 0.33 mio. – 10 % daily smokers

Sweden: 10.0 mio. – 9 % daily smokers

All numbers from 2016

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Daily smoking women, Nordic countriesDenmark Norway Finland Iceland Sweden

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Daily smoking men, Nordic countriesDenmark Norway Finland Iceland Sweden

Tobacco Control Scale – Nordic countries

www.tobaccocontrolscale.org

L. Joossens, 2017

Strengths and drawbacks in each country

Astrid Knudsen (DK), Mervi Hara (FI), Guðlaug B. Guðjónsdóttir (IS),

Ingrid Stenstadvold Ross (NO), Margaretha Haglund (SE)

Strengths of tobacco control in Denmark

Smoke Free Future Partnership initiated

Smoking cessation counselling

• Local, free access to smoking cessation interventions, apps and a central quitline

Local engagement

• Smokefree working hours (15 out of 100) municipalities

• Cities with their own endgame goals

Drawbacks of tobacco control in Denmark

Tobacco industry interference

Smoking ban with exemptions

• Designated smoking rooms

• Smoking allowed at bars (< 40 m2)

• Private daycare homes

Point of sales marketing

• Point of sale marketing

• Music festivals: Promotion and sponsorships

Lessons from Finland

Strengths:

• Long-term experience, legislation dates from 1970’s

• Comprehensive cooperation

• Public/media support

• Political will

• Clear aim: Endgame

Lessons from Finland

Drawbacks:

• Slow progress

• Lost political interest, ”ready-made legislation”

• Poor price and tax policy

• Interference from the tobacco companies

- Make friends with third parties

• Early start of tobacco control

• Comprehensive ban on tobacco advertising and promotion. Display ban

• The biggest foodstore chains not selling tobacco

• Funding (0.9% of gross tobacco sales)

• Low frequency of smoking

Strengths of tobacco control in Iceland

Drawbacks of tobacco control in Iceand

• Lack of new legislation and strategy

• The tax and price policy (price index)

• Lack of political support

• Lack of resources (cessation) – the health care inactive

Strengths of tobacco control in Norway

• Continuing decline in smoking prevalence

• Interdisciplinary approach and a broad network of global civil society actors and academics in tobacco control

• Political will to protect children and youth against the harm of tobacco.

Together we can seize these opportunities to:

• Implement Plain Packaging

• Adopt a new tobacco control strategy

• Ratify the protocol to eliminate illicit tobacco products

• Introduce a licensing system for sale of tobacco products

• Potential tobacco industry challenge, especially to the plain packaging law

• Implementation of FCTC 5.3

• Election year: still political momentum?

• We need more focus on tobacco cessation!

• Financial resources for tobacco control, especially tobacco cessation: lack of funding for prevention in the public sector led to the closure of the national quit-line in January this year.

Drawbacks of tobacco control in Norway

Lessons from Sweden

Strengths:

• Step by step legislation - the early start already in the 1970’s

• The NGO advocacy

• The early start of smoke-free movement already in the 1970’s

• The precise targeting of women in the 1990’s

• Continuity in the advocats

Lessons from Sweden

Drawbacks:

• The social acceptability of snuff and the snuff industry

• The tax and price policy

• The weak political support

• Lack of continuity in funding

• The relocation incl. change of the task of the Public Health Institute

Future challenges and possibilities

Ewy Thörnqvist (SE)

Challenges in the Nordic countries

• Tobacco industry interferenceand threats

• New nicotine/tobacco products

• Health inequalities

• Politics

• Advocates a step behind

• Resources

Opportunities in the Nordic countries

• FCTC, law and protocol

• EU Tobacco Products Directive

• Endgame: Governmental goals/strategies for a Smoke Free future in 2025, 2030....

• Public support and opinion

• History of the welfare states

• Long term appropriate funding of NGO’s

• New allies: HR Movement, NCD, SDG

• Strong strategic Nordic cooperation