Smoking continues to be the largest single cause of death and disease in the EU

Smoking continues to be the largest single cause of death and disease in the European Union (EU), despite the progress that has been made in tobacco control.

Over 650,000 Europeans are killed every year because they smoke, one in seven of all deaths across the EU, and over 13 million more are suffering from a serious, chronic disease as a result of their smoking. It is also now established, beyond doubt, that tobacco smoke is a serious environmental health hazard, killing around an additional 100,000 non-smoking Europeans, with many millions more having illnesses exacerbated by inhaling other people's smoke.

Smoking harms nearly every organ of the human body, causing a broad range of diseases, but the full extent of the damage is still unknown, as even today, over 50 years after the first links between smoking and lung cancer were established,more diseases are being found to be caused by smoking. However, it is known that about half of all continuing regular smokers will be killed by their smoking and those that die in middle age as a result of their smoking lose on average 22 years of life, with a larger proportion of that shortened life span being spent in ill health.

Although the tobacco epidemic is at different stages in different countries across Europe, it is clear that millions more Europeans will die and suffer ill health as a result of their smoking over the decades to come. Smoking attributable deaths among females are still increasing and the full extent of the epidemic among females has not yet been realised. Even among males, lung cancer mortality rates are still rising in four countries within the EU. Smoking is also becoming increasingly associated with poverty, making a significant contribution to the widening gap in health inequalities across the EU.

Tobacco is the most heavily subsidised crop per hectare in Europe. The EU spends nearly €1,000 million annually on these subsidies: 2.3% of the Common Agricultural Policy budget, and 1.1% of the total Commission budget. The EU has wisely determined to phase out these subsidies by 2010.

Tobacco manufacturing in the EU/European Free Trade Association region keeps steady at an estimated 25% of global cigarette production. The EU is a net importer of raw tobacco and a net exporter of manufactured tobacco products, providing 20% of the world's supply. Tobacco farming and manufacturing jobs represent a mere 0.13% of EU employment, and this figure is declining. The impact of tobacco-control efforts on employment would be negligible, because money currently spent on tobacco and related medical care will be spent on other goods and services, or saved for investment in other activities.

The EU bears a substantial economic burden due to smoking. A conservative estimate of these costs falls between €98-130 billion a year, or between 1.04-1.39% of the region's Gross Domestic Product for 2000. The true costs are undoubtedly higher, and will continue to escalate if appropriate measures are not taken. This increase in costs will result from higher smoking rates in the new EU10 Member States, healthcare improvements and increasing demand for healthcare services. Smokers, but also non-smokers, governments and employees have to cover these costs. Empirical evidence shows that tobacco consumption represents a net burden for state budgets even after accounting for collected tobacco tax and savings in social security payments due to premature mortality among smokers.

EU Member States impose both ad valorem and specific excise taxes on tobacco products, in addition to Value Added Tax. The choice of the type of excise tax has profound implications for the amount of tax paid per cigarette pack, and is one of the reasons why cigarette prices vary substantially among Member States. Specific excise taxes are more efficient; they are easier to administer and better support the EU's public health goals because they discourage the smoking of all cigarette brands equally, rather than encouraging substitution of less expensive brands.

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The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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