Tobacco control achievements and priority areas in the WHO Europe Region: A review

INTRODUCTION

Tobacco control efforts have been advancing globally, including the adoption and entry into force of the World Health Organization (WHO) Framework Convention of Tobacco Control (FCTC), as well as the adoption of the European Union EU Tobacco Products Directive. With the present review, the European Network for Smoking and Tobacco Prevention (ENSP) and European Respiratory Society (ERS) aim to provide a comprehensive overview on the status of WHO FCTC implementation, policy achievements and priority areas across countries in the WHO Europe Region.

METHODS

The review was conducted through a triangulation of data extracted from a survey administered to ENSP members, the WHO FCTC Implementation Database, Tobacco Control Laws and the Tobacco Control Scale 2016.

RESULTS

Using the WHO MPOWER measures as a framework, we report on the implementation status of nine FCTC articles across 47 countries in the WHO Europe Region. The average number of articles fully implemented was 3.58. FCTC articles least fully implemented were: Article 5.3 on Tobacco Industry Interference (25.5%, n=12), Article 20 on Research (34.0%, n=16), and Article 15 on Illicit trade (40.4%, n=19). The most commonly fully implemented articles were: Article 8 on Smoke-free legislation (63.8%, n=30), Article 16 on Underage sales (57.4%, n=27), and Article 6 on Price and tax measures (51.2%, n=24). Policy achievements and recommended priority areas for future national tobacco control activities varied greatly among countries.

CONCLUSIONS

Findings highlight the multitude of successes in tobacco control efforts across the region in recent years, but point out the need to address gaps in FCTC implementation.

Opinions and practices regarding electronic cigarette use among Romanian high school students

OBJECTIVE

The study assessed awareness, opinions, practices regarding electronic cigarettes (e-cigarettes) and factors associated with their use among Romanian high school students.

METHODS

A cross-sectional study was conducted in 2013 in two major Romanian cities, distributing anonymous questionnaires to 342 high school students aged 16-18.

RESULTS

52.3% of the smokers, 29.2% of the ex-smokers and 7% of the never-smokers had tried e-cigarettes at least once in their life; 7.8% of the smokers and 4.6% of the ex-smokers had used e-cigarettes in the last month. Among smokers, e-cigarette use was associated with lower participation in school health education regarding e-cigarettes and with having parents using e-cigarettes.. Among ex-smokers and never-smokers, e-cigarette use was associated with intention to use e-cigarettes in the next year and with having friends who use e-cigarettes.

CONCLUSION

Health education programmes and regulatory interventions addressing e-cigarettes are needed in Romania. More research is necessary on how to develop effective public health messages.

Smoking prevention for adolescents in Romanian schools

This study had two objectives. The first was to assess the frequency and content of school-based anti-smoking education received by Romanian adolescents aged 14-15. Secondly, the study aimed to evaluate to what extent the implementation of a specific 5 lessons smoking prevention program influences the quality of anti-smoking school education among Romanian adolescents. The investigation was performed in twenty schools from Cluj- Napoca, Romania, which were randomly assigned to the control and experimental conditions, resulting in 55 participating classes from the seventh grade (28 in the control group and 27 in the experimental group). The experimental group participated in a school-based smoking prevention program consisting of 5 lessons. The control group beneficiated only in the standard anti-smoking education offered by their schools. Six months after the program implementation, students from both experimental and control groups filled in a questionnaire, assessing several issues regarding their exposure to anti-smoking school education in the last year. The results showed a low exposure to anti-smoking school education among the Romanian adolescents. The implementation of the specific school-based smoking prevention program increased the exposure of Romanian adolescents to a higher number of lessons of smoking prevention and influenced positively the quality of these lessons. The study identified several gaps with respect to anti-smoking education in Romanian schools. It underlines the benefits of the implementation of a school based smoking prevention program with a clear structure, which contains appropriate educational messages and it is easy to implement.