Europe Region: Between Uneven Progress and New Threats

The World Health Organization (WHO) Europe has published fact sheets on the evolution of tobacco control, through the implementation of MPOWER measures. Beyond a certain amount of progress made across the continent, and the variability of national situations, WHO underlines the need for greater vigilance with regard to the threat posed by new tobacco and nicotine products, as well as the imperative to better combat smoking among women.[1].

In 2008, WHO, in accordance with its Framework Convention on Tobacco Control (FCTC), established the MPOWER programme, which proposes a set of six cost-effective measures to reduce the global tobacco epidemic. In particular, the MPOWER programme includes monitoring tobacco consumption and prevention policies, protecting the population from tobacco smoke through the banning of smoking in public places and the development of smoke-free places, providing assistance to people who wish to quit their consumption, warning against the dangers of tobacco, enforcing the ban on advertising, promotion and sponsorship activities by the tobacco industry, as well as implementing a policy that discourages tax increases on tobacco products.

The development of new tobacco products in Europe, a threat to public health

The majority of the data in the fact sheets come from the WHO's Eighth Report on the Global Tobacco Epidemic, published in 2021. This highlights in particular the new threat posed by new tobacco and nicotine products. In particular, the European region shows a very high variability in e-cigarette consumption, with a prevalence among adults ranging from 0.7% in Spain (2020) to 10.5% in Estonia (2018). In Monaco, 41% of adolescents were consumers of e-cigarettes in 2019. As WHO points out, e-cigarettes must be considered harmful products. The presence of nicotine and other chemicals can have deleterious effects on brain development, starting with that of adolescents. However, WHO notes that these products are regularly presented as less harmful alternatives, particularly by tobacco manufacturers, and are the subject of marketing campaigns aimed at younger generations.

A great variability of the situations observed

On some criteria, the European region is a global good student. For example, on the issue of taxation, 53% of European countries have taxation levels at least in line with WHO recommendations, compared to 21% in the rest of the world. For the World Health Organization, it is imperative that the remaining 47% implement an ambitious tax policy, with the aim of reducing smoking, but also of reducing the pressure of the tobacco sector on public spending. In other areas, Europe is lagging behind the world average. For example, only 26% of European countries have implemented a ban on smoking in public places, often incomplete, compared to 34% worldwide. However, the establishment of smoke-free spaces is necessary both to protect the population from passive smoking, but also to involve society in a process of denormalizing tobacco consumption.

The issue of female smoking a priority in Europe

The European Region is the only WHO region that is not expected to meet the 30-% reduction target for women by 2025. Among young women, WHO also notes a worrying situation. Indeed, in 26 out of 42 countries, smoking rates among young women are equal to or higher than those of men. To address this situation, WHO recommends further integrating gender issues into tobacco control policies, as well as better anticipating the social determinants of health that may predispose certain groups to use tobacco or nicotine products.

According to WHO, the uneven progress made should prompt governments to fully implement the Framework Convention on Tobacco Control. While almost all countries have ratified the FCTC, many have not fulfilled their commitments, despite the public health emergency that these represent.

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[1] World Health Organization, Recently launched MPOWER factsheets show uneven progress against the tobacco epidemic in the WHO European Region, 12/04/2022, (accessed 13/04/2022)