European social insurers are calling for strong legislation against tobacco and nicotine products.

July 27[1], The European Social Insurance Platform (ESIP), which represents social security and health insurance institutions across Europe, has published its contribution to the European Commission's public consultation on the revision of the Tobacco Products Directive (TPD) and the Tobacco Advertising Directive (TAD), which closed on June 15. Its members, who bear daily "the human and financial burden of tobacco-related diseases", advocate for a coordinated and ambitious approach to the entire European regulatory framework on tobacco and nicotine.

ESIP is an alliance of compulsory social insurance organisations. Its 46 member organisations cover more than 370 million European citizens in 19 EU Member States and Switzerland.

An economic and social cost deemed unsustainable

ESIP points out that, according to the European Commission's own impact assessment, smoking costs European economies nearly €61 billion annually in direct healthcare costs and lost productivity. The organization also emphasizes that thousands of working-age Europeans have already left the labor market through early retirement or smoking-related disability benefits, and that smokers are also at increased risk of needing a disability pension. ESIP argues that its members, as health, pension, and accident insurers, ultimately bear the cost of tobacco and nicotine-related illnesses.

This finding aligns with data recently published by WHO Europe: smoking remains the leading cause of preventable death on the continent, where tobacco use continues to claim more than half a million lives each year, nearly 80,000 of which result from exposure to secondhand smoke. In 2022, 26.5 per 100,000 adults in the EU used tobacco, a rate higher than the global average of 20.9 per 100,000. Tobacco remains responsible for more premature deaths than any other behavioral or metabolic risk factor, accounting for 17 per 100,000 of all premature deaths from noncommunicable diseases in the EU. WHO Europe also notes that nearly one in four women currently uses tobacco in the EU, a prevalence higher than that observed in the rest of the WHO European Region and significantly higher than the global average for women.

In this context, Esip is fully in line with the objective of a "tobacco-free generation" by 2040, with a smoking prevalence reduced below 5 %, compared to 24 % today.

Extend the regulatory framework to new products, regulate flavors and digital marketing, and generalize plain packaging.

Faced with the rise of "new" tobacco and nicotine products, whose use among young people now surpasses that of traditional products, the ESIP (European Society for Infectious Diseases) calls for extending the scope of legislation to "all non-therapeutic nicotine products" through technologically neutral definitions. According to the organization, regulating products based on their impact on public health, rather than their origin or format, would ensure that new and emerging products are covered. Furthermore, such an approach is likely to take future innovations into account. The ESIP cites data indicating that adolescents are three times more likely to vape than adults, and that approximately one in five young users of tobacco and nicotine products began with regular e-cigarette use.

In line with this approach of broadening regulatory coverage, the organization supports a European ban on flavorings in all tobacco and nicotine products and accessories. It considers flavorings a key factor in the appeal of new products to young people, particularly first-time users. It calls for this ban to be comprehensive and also cover flavoring accessories, in order to prevent any circumvention, in accordance with the recommendations of the World Health Organization.

On the advertising front, ESIP notes that the Digital Advertising Act (DAA), adopted in 2003, no longer effectively covers the digital channels through which a large share of tobacco and nicotine marketing now passes, including online advertising, social media, and influencer marketing. The organization supports a comprehensive, Europe-wide ban on advertising, promotion, and sponsorship, coupled with strengthened enforcement rules for digital marketing, applicable to both tobacco products and new nicotine products.

Finally, ESIP calls for standardized plain packaging to become mandatory and be extended to e-cigarettes, refills, and new nicotine products, noting that several European countries have already introduced this type of measure. It also calls for extending the European traceability system beyond tobacco to address a monitoring gap and combat illicit trade.

Protecting the regulatory process from industry influence

Finally, ESIP emphasizes the need to protect the review process from any interference by the tobacco industry, in accordance with Article 5.3 of the WHO Framework Convention on Tobacco Control. The organization believes, in particular, that the overall volume of contributions received during the consultation cannot be considered a reliable indicator of public opinion, and that contributions originating from or influenced by the industry should not be given the same weight as independent scientific data.

For ESIP, a coherent and ambitious revision combining the Tobacco Tax Directive (TTD), the TPD and the TAD is a crucial step towards the goal of a tobacco-free generation by 2040. The organization stresses that beyond the adoption of new rules, their effective cross-border application and monitoring within the single market will be essential to the effectiveness of the legislation.

©Generation Without Tobacco

AE

[1] European social insurers are positioning themselves in favor of strong legislation against nicotine products, Context, published on July 30, 2026, accessed on the same day