is lithuania a success story? aurelijus veryga, md, phd lithuanian national tobacco and alcohol...
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Is Lithuania a success Is Lithuania a success story?story?
Aurelijus Veryga, MD, PhDLithuanian National Tobacco and Alcohol Control Coalition
Kaunas University of Medicine
Bratislava, 16/04/2007
Lithuania has banned smoking in bars, restaurants, café’s, clubs since January 1st 2007
Bratislava, 16/04/2007
Law of Tobacco controlLaw of Tobacco control
Article 19. Restrictions on the Consumption of Tobacco Products 1. It shall be prohibited to smoke (consume tobacco products) in the Republic of Lithuania: 1) in all educational establishments, health care facilities, Internet cafes (Internet clubs, etc.), and also in premises
where sport competitions and other events take place; 2) at indoor workplaces. Special premises (places) may be set aside in undertakings, institutions and
organisations where smoking shall be permitted. The requirements for fitting out and operating smoking premises (places) shall be set forth by the Government of the Republic of Lithuania or an institution authorised by it.
3) in common-use residential and other public premises where non-smokers may be forced to breathe tobacco smoke-polluted air;
4) in all types of public transport, except for long-distance trains where individual cars must be designated for smokers and non-smokers and also on aircraft where separate places shall be designated for non-smokers and smokers;
5) in restaurants, coffee shops, bars and other mass caterers, clubs, and discotheques, except for cigar or pipe clubs specially fitted out for this purpose. The procedure and conditions of establishing cigar and pipe clubs shall be set forth by the Government of the Republic of Lithuania or an institution authorised by it.
2. In restaurants, cafes, bars and other premises designated to provide services for people, where smoking is not prohibited, separate premises (places) must be set aside for smokers. Premises where smoking is not prohibited must be fitted out to protect clients (visitors) and staff members from tobacco smoke. The requirements for fitting out and operating such premises (places) shall be set forth by the Government of the Republic of Lithuania or an institution authorised by it.
Paragraph 2 of Article 19 has been repealed. 6) Municipal councils shall have the right to prohibit smoking in public places (parks, squares, etc.) and other
public places falling within the scope of their competence. 7) The administrative bodies of a legal person must ensure that its personnel, clients and visitors are not forced to
breathe tobacco smoke-polluted air; they must also ensure that non-smoking warnings or signs are displayed in visible locations and special premises (places) be set aside and fitted out for smoking with notices or signs indicating their location.
Background
Total ban of tobacco advertisement (2000) Ratification of FCTC (2004) Joining EU – new excise taxation policy (2004) Change of tobacco products labeling (2004) Smoking ban in bars, restaurants, cafe’s, clubs
(January 2007) Inclusion of tobacco and alcohol control issues
into National Drug prevention program (2005) National vide public awareness campaigns (“I
am born a non smoker”) competitions (“Quit and win”, “Smoke-free class” competition)
Bratislava, 16/04/2007
Smoking prevalence (adults)(regular smokers aged 20 – 64 years)
* p<0.05 comparing with year 1994
FINBALT study
%
43,3
47,3
48,5* 51,2
43,7
39,4
43,4
6,39,4
12,5*15,8*
12,8 14,2 14,5
0
20
40
60
Man Woman
1994
1996
1998
2000
2002
2004
2006
Bratislava, 16/04/2007
School children smoking prevalence year 1993-1994 (HBSC)
1
2
5
3
6
4
7
18
19
20
21
22
23
24
25
11
12
13
14
15
16
17
8
9
10
Mergaitės Berniukai
13.6 Denmark
18.8 France
14.2 Norway
24.8 Austria
Wales 18.5
0 020 20 3010
%%
12.7 Scotland
10.4 Sweden
13.6 Wales
7.1 Israel
17.1 Czech Republic
18.0 Canada
15.2 Germany
France 19.8
Israel 5.5
Lithuania 3.5
Sweden 12.3
Denmark 16.7
Austria 17.0
Germany 19.8
Russia 9.4
Estonia 4.2
Canada 21.1
Norway 13.8
Slovakia 5.5
Hungary 16.0
Scotland 16.1
Czech Republic 10.1
HBSC AVERAGE 13.8
Poland 8.0
30
Greenland 26.0
Spain 16.3
Latvia 11.9
Belgium-Fren 13.4
Belgium-Flem 13.3
N.Ireland 17.9
Finland 16.2
10
22.7 Latvia
11.3 Lithuania
19.7 Hungary
14.6 Estonia
16.7 Poland
16.7 Russia
19.8 Belgium-Flem
16.3 HBSC AVERAGE
15.4 Slovakia
13.8 Belgium-Fren
13.1 Spain
19.4 Finland
16.8 N.Ireland
24.5 Greenland
4040
Girls Boys
Bratislava, 16/04/2007
School children smoking prevalence year 2001-2002 (HBSC)
12
5
3
6
4
7
1819202122232425262728
11121314151617
8910
Mergaitės Berniukai
13.3 Denmark
16.5 France
15.2 Norway14.8 USA
19.8 Austria
Wales 18.8
0 020 20 3010
%%
9.8 Scotland10.5 Sweden
12.2 Wales
16.0 Italy15.9 England
16.7 Israel
14.1 Netherlands
16.2 Switzerland
20.5 Czech Republic
12.1 Canada
22.0 Germany
France 16.5
Israel 9.3
Lithuania 14.6
Portugal 18.2
England 20.6
Netherlands 15.7
Sweden 13.7
USA 10.6
Denmark 13.9
Austria 22.9Germany 22.9
Russia 13.8
Estonia 14.5
Canada 12.2
Norway 18.7
Slovenia 15.2
Italy 17.0
Macedonia 6.5
Hungary 19.2
Switzerland 15.2
Scotland 14.9
Czech Republic 18.5
HBSC AVERAGE 16.3
Poland 14.1
31
3332
3435
30
2930
Croatia 13.7
Greenland 42,0
Spain 18.5
Latvia 13.9
Belgium-Fren 11.5
Belgium-Flem 16.5
Ireland 13.8
Malta 17.1
Finland 22.2
Ukraine 15.1
10
28.0 Ukraine
22.0 Latvia
23.6 Lithuania22.3 Hungary
21.5 Estonia
20.3 Poland
17.5 Portugal
13.2 Croatia
20.0 Russia
16.0 Belgium-Flem
16.8 HBSC AVERAGE
8.2 Macedonia
11.1 Belgium-Fren
16.5 Spain
18.2 Finland
16.4 Slovenia
13.6 Ireland
16.2 Malta
29.5 Greenland36
8.9 GreeceGreece 8.0
4040
#
Girls Boys
Bratislava, 16/04/2007
School children smoking prevalence year 1994-2006 (HBSC)
Berniukai Mergaitės
% 4 5 2 3 2 35 1 8 1 35 8 23 27 30 47 17 7 2 19 7 18 12 16 8
1994 1994 19941998 1998 199820062002 2002 2002 2006200611 metų 13 metų 15 metų
GirlsBoys
years years years
Bratislava, 16/04/2007
Positive external factorsPositive external factors
Smoke – free policies in other European countries (Ireland, Italy, Malta etc.)
Evidence from other countries that ban does not damages business
FCTC
Positive internal factorsPositive internal factors
Active position of minister of health (professor of public health)
Strong NGO movement (Lithuanian National Tobacco and Alcohol Control Coalition - member of ENSP)
European Commission project “HELP – for a life without tobacco” in place
Existing ban of tobacco advertisement Already high public awareness about smoking
harm
Lessons we have learnedLessons we have learned
First voting in Parliament (ban introduced by one parliamentarian) was unsuccessful
Main reasons: No strategy Strong opposition from industry coming from
industry supported NGO’s
Second proposal from the Ministry of Second proposal from the Ministry of HealthHealth
Common strategy of MoH and NGO’s was developed Minister meetings with all Parliament comities (evidence
based information and facts for lobbying prepared by tobacco control advocates)
NGO coalition meetings with other NGO’s and petitions writing campaign development
Public opinion survey Youth manifesto (EC “HELP” campaign) Large public relation campaign
Public opinion surveyPublic opinion survey (age 18-74)(should smoking be banned in bars, restaurants and other hospitality places?)
1,8%
23,5%
74,7%
0% 10% 20% 30% 40% 50% 60% 70% 80%
Has no meaning
Smoking shouldnot be banned
Smoking should bebanned
RAIT, 2006Bratislava, 16/04/2007
1,8%
12,3%
85,9%
1,8%
47,3%
50,9%
0% 20% 40% 60% 80% 100%
Has no meaning
Smoking shouldnot be banned
Smoking shouldbe banned
Smokers
Nonsmokers
Public opinion surveyPublic opinion survey (age 18-74)(should smoking be banned in bars, restaurants and other hospitality places?)
RAIT, 2006Bratislava, 16/04/2007
Very strong message: people want to Very strong message: people want to have smoking ban in placehave smoking ban in place
Public relation campaignPublic relation campaign
Main messages generated: Constitutional right of
workers to safe and health working place
Protection of customers from passive smoking
Positive influence to children (making smoking socially unacceptable)
Intensive use of evidence Ventilation does not
work Smoking ban does not
damage business Smoking ban can
improve hospitality workers and customers health
Main elements of public relation Main elements of public relation campaigncampaign
Special section in MoH websiteArticles in newspapers Participation in TV and radio debatesPress conferences
Youth manifesto (presenting opinion of hundreds NGO’s, presented to Parliament Youth manifesto (presenting opinion of hundreds NGO’s, presented to Parliament speaker, asking to ban smoking in bars, restaurants etc.speaker, asking to ban smoking in bars, restaurants etc.
Tobacco industry oppositionTobacco industry opposition
Mainly done by industry supported NGO’s
Main arguments used: Already made big investments to ventilation systems Smoking ban will cause financial problems for
hospitality industry Rights of smokers should be respected and there
should be separate rooms for smokers
Partially successful work (inclusion of exception to law for pipes and cigars clubs)
Changes afterChanges after
Some initiatives to discredit smoking ban
Increased public awareness (especially about smoking in common-use residential and other public premises)
Smoking ban is respected and implemented without problems
Thank you!Thank you!
WNTD celebrationWNTD celebration““I am born a non smoker”I am born a non smoker”