Germany: The challenge of a tobacco- and nicotine-free generation by 2040

Around 127,000 people die in Germany each year from the consequences of their smoking. Despite its international commitments and obligations by ratifying the WHO Framework Convention more than 15 years ago, the situation is not improving. In May 2021, more than 50 public health and civil society organizations published the "Strategy for a Tobacco-Free Germany 2040."[1]This is a call for the government to implement tobacco control measures aimed at a tobacco-free generation by 2040.

The goal of a tobacco-free Germany means that fewer than 5% of adults over the age of 18 and fewer than 2% of adolescents will use tobacco and nicotine products by 2040. The strategy document sets out ten concrete tobacco control measures and provides a timetable for their implementation.

The burden of smoking in Germany

The country is in last place in the European ranking of tobacco control policies out of 36 countries.[2]: no other European country is doing less to reduce tobacco consumption and implement the proven measures of the CCLAT. Thus, tobacco taxes have not been increased significantly and effectively since 2007, there is no comprehensive legislation on tobacco/smoke-free spaces, and the laws that are implemented contain significant exemptions; Germany also remained for a long time the only EU country allowing tobacco advertising on billboards.

The need for an effective public policy to combat tobacco use is all the more essential given that the country is one of the ten countries in the world with the highest number of smokers. More than one in five Germans over the age of 18 is a smoker (23% of the population). Significant differences are observed between the different Länder (21% in Saarland and 28% in Mecklenburg-Western Pomerania). Each year, smoking causes 85,000 cases of cancer and 127,000 deaths in Germany, which corresponds to one death every four minutes. In addition to the health and social costs, as tobacco consumption particularly affects the poorest, the cost of tobacco to German society has been estimated at €97 billion per year. Finally, it hinders sustainable development goals.

An arsenal of 10 measures to achieve a generation without tobacco and nicotine

The strategy is based on the proven provisions contained in the WHO Framework Convention:

1. Significantly increase tobacco taxes every year : Increases in tobacco taxes, which lead to a significant increase in prices, reduce consumption and therefore sustainably reduce the cost of tobacco to society.
2. Supporting smokers in quitting smoking and ensure treatment coverage. Currently, only 20% of smokers make at least one attempt to quit per year in the country.
3. Completely ban tobacco advertising and nicotine and introduce the plain packagingThe tobacco industry in Germany invests more than 200 million euros a year in marketing campaigns, mainly in advertising its products.
4. Significantly reduce the accessibility of tobacco and nicotine productsThere are approximately 390,000 tobacco sales outlets in Germany: supermarkets, gas stations, kiosks, pharmacies, stationery stores, vending machines and specialist shops.
5. Effectively protect against passive smoking and create smoke-free public spaces: Only three federal states (Bavaria, North Rhine-Westphalia, and Saarland) have comprehensive legislation to protect against secondhand smoke. In most states, smoking rooms are permitted in workplaces and smoking is permitted in children's playgrounds.
6. Ensure that children's rights are respected with regard to tobacco and improve protection for minors: The minimum purchase age for tobacco and nicotine products should be raised to 21. Studies show that delaying legal access reduces the prevalence of smoking among adolescents and young adults.
7. Conduct regular risk awareness campaigns tobacco consumption: Campaigns should not only focus on presenting the dangers of tobacco, but also on the strategies of tobacco manufacturersThis would contribute to the denormalization of the consumption of these products and their industry. Currently, the budget for communication campaigns, with 2.9 million euros per year of public funds, is insufficient.
8. Support both tobacco control initiatives and alternatives to tobacco growing within the framework of development cooperation.
9. Effectively protect political decisions from the influence of tobacco manufacturers and their allies: The tobacco industry lobby is particularly powerful in Germany and greatly influences public decisions. This is evidenced by the recent tobacco tax law, whose measures are favorable to this industry.
10. Regularly review, adapt and develop tobacco control measures: Regular monitoring and evaluation of the measures implemented are essential in order to adapt them and strengthen them if necessary.

Germany tobacco-free and nicotine-free by 2040: an important contribution to the SDGs

In 2015, the members of the United Nations adopted the 2030 Agenda for Sustainable Development, entitled Agenda 2030. In terms of health policy, the third goal, SDG 3: Good health and well-being, is a precursor. It aims, among other things, to better prevent the spread of non-communicable diseases (NCDs) such as cardiovascular diseases, lung diseases and cancers. Given that tobacco use is the most important risk factor for these diseases, reducing tobacco consumption contributes significantly to the achievement of SDG 3. In this objective, the implementation of the WHO Framework Convention on Tobacco Control (FCTC) is designated as the most important instrument.

Germany is also one of the world's largest cigarette exporters, importing around 150,000 tonnes of raw tobacco annually from tobacco-producing countries. In these countries, tobacco cultivation and production hinder the achievement of other SDGs, including the fight against poverty (Goal 1) and the implementation of decent working conditions (Goal 8). In addition, the tobacco industry creates a significant ecological footprint and thus damages ecosystems (Goals 13, 14, 15). To achieve sustainability goals, phasing out tobacco cultivation and establishing economically viable alternative crops is an important step. It can ensure better living and working conditions for those currently involved in tobacco cultivation.

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