Belgium urged to limit tobacco lobby interference in its health policy

The Sciensano Institute has published for the first time an assessment of how Belgium protects its public health policies against interference from the tobacco industry.[1]. Conducted as part of the Global Tobacco Industry Interference Index, this analysis places Belgium at 38th^e ranking out of 100 countries and 9^e out of 25 European countries. With a score of 55 out of 100, the country performs better than the global and European averages, but several shortcomings remain. Sciensano identifies five areas for improvement, including the establishment of a code of conduct and a transparency register.

Political commitments without concrete implementation

The Global Tobacco Industry Interference Index (GTIII) assesses how countries protect their health policies from the influence of the tobacco industry. Based on 20 questions grouped into 7 indicators (political participation, transparency, conflicts of interest, etc.), it relies on publicly available data. Each country receives a score from 0 to 100: the higher the score, the greater the interference. The index, coordinated by the Global Center for Good Governance in Tobacco Control, is used to compare practices and recommend transparency and prevention measures.

For several years, the Belgian federal government has strengthened its anti-smoking policies, notably through a ban on the sale of tobacco in vending machines in 2023, the extension of smoke-free zones to open public spaces and around the entrances and exits of public buildings in 2024, and the ban on disposable electronic cigarettes since January 1st.^er January 2025, the ban on displaying cigarettes, cigars, cigarillos, rolling papers, filters, pipe tobacco, chewing tobacco, snuff, electronic cigarettes and their e-liquids in retail outlets since 1^er April 2025 or the ban on smoking and vaping on terraces from 2027.

However, measures to limit the influence of the tobacco industry remain limited. Belgium nevertheless committed itself by ratifying the WHO Framework Convention on Tobacco Control on 1^er November 2005, to protect its public tobacco control policies from any interference from the tobacco industry.

This commitment was reaffirmed in the 2022-2028 inter-federal strategy for a tobacco-free generation, which aims to reduce daily consumption to less than 6 % among 15-24 year olds by 2028, before reaching almost 0 % of new smokers by 2040.

However, the operational implementation of these commitments regarding the protection of its public policies, in particular the creation of a transparency register and a code of conduct, has not yet been completed.

In practice, the tobacco industry is not allowed to participate directly in the development of public policy. However, beyond the general lobbyists' register, no formal measures limit interactions between public decision-makers and industry representatives.

The lack of transparency also remains significant regarding the lobbying activities or corporate social responsibility.

Between 2020 and 2025, Sciensano did not observe any unjustified interactions between authorities and industry, but noted some forms of indirect interference, particularly through partner organizations or collaborations in environmental campaigns related to cigarette butt waste.

Five recommendations to strengthen transparency and protect against the tobacco lobby

To better protect public tobacco control policies, Sciensano recommends 5 concrete steps to ensure Belgium meets its international commitments:

Firstly, the creation of a public and mandatory transparency register listing contacts and details of meetings between public officials and representatives of the tobacco industry.

Secondly, the adoption of a code of conduct at all levels of government governing these interactions, including a ban on partnerships, the obligation to limit financial relations to the payment of taxes and only those reparations demanded from industry for damages caused by its activities. All decisions concerning the definition and implementation of public policies must exclude industry.

Thirdly, a ban on the tobacco industry and its front groups developing or implementing awareness campaigns related to anti-tobacco policy and all related policy areas, such as environmental policy.

Fourth, an obligation of transparency regarding its lobbying activities, its CSR, its political contributions, its affiliated organizations, its funding, its research and its marketing activities.

Lastly, the end of "revolving doors," by prohibiting current or former industry leaders from holding positions in public authorities, and vice versa.

Sciensano will continue this monitoring every two years in order to measure the progress made.

Traditional smoking and new forms of smoking remain a major public health issue in Belgium: 17.6 per 1,000 people over the age of 15 smoke, 12.8 per 1,000 daily, and 8 per 1,000 deaths are attributed to it, at an estimated annual cost of €534 million in healthcare expenditure. Furthermore, e-cigarettes are increasingly used, with 6.3 per 1,000 vapers projected for 2023-2024, compared to 4.1 per 1,000 in 2018.

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[1]Silke Cnockaert, Suzannah D'Hooghe, Stefanie Vandevijvere, Belgium – Tobacco Industry Interference Index 2025, Sciensano, published in November 2025, accessed on November 6, 2025

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