Laura Graen & Katrin Schaller
According to the World Health Organization, Germany is a high burden country regarding tobacco use. Approximately 16 million people are current smokers, and 127,000 people die from the health effects of smoking every year. In addition Germany has the worst tobacco control policy implementation out of 36 European countries and lags far behind other non-European countries like Australia, New Zealand or Brazil. On World No Tobacco Day 2021, more than 50 public health and civil society organizations published the “Strategy for a Tobacco-Free Germany 2040”. It is a call on the government to implement tobacco control measures that will lead to less than five per cent of adults and less than two per cent of adolescents in Germany using tobacco products, e-cigarettes or other related products by 2040.
The organizations call on legislators and the government to adopt a binding, sustainable tobacco control strategy with a mandatory timeline for the implementation of the following ten measures for a tobacco free Germany 2040:
- Significantly increase tobacco taxes every year
- Support smokers in quitting and ensure that the costs of tobacco dependence treatment are covered
- Completely ban advertising of tobacco and related products and introduce plain packaging (currently in Germany advertising is still permitted in cinema for films 18+, at point of sale and on billboards, the latter will be phased out between 2022 and 2024, sports sponsorship and promotional product extensions are also still permitted)
- Significantly reduce the availability of tobacco and related products
- Effectively protect from second-hand smoke and ensure completely tobacco-free living environments
- Consistently implement children’s rights with regard to tobacco and improve the protection of minors
- Conduct regular campaigns to raise awareness of the risks of tobacco use, motivate people to quit and make living tobacco-free the norm
- Support tobacco control initiatives and alternatives to tobacco cultivation within the framework of development cooperation
- Effectively protect political decisions from the influence of manufacturers of tobacco and related products and their associations
- Regularly review, adapt and further develop the measures
Rather than individual level interventions which place responsibility on smokers for smoking, the outlined measures focus on political action and population level interventions which aim to change the role of smoking in society to create a tobacco-free Germany. They are based on evidence and on the Framework Convention on Tobacco Control. They aim at largely restricting the tobacco industry‘s ability to market its products, to promote cessation and support smokers who want to quit, and to prevent young people from taking up smoking. The strategy covers both tobacco and related products such as heated tobacco products and e-cigarettes because these products are also addictive and harmful to health. The Strategy for a Tobacco-Free Germany 2040 adopts the precautionary principle towards novel products whose risks are not yet fully quantified.
Throughout the strategy, it is emphasized that special attention needs to be paid to reach marginalized groups with higher smoking rates, such as those at a disadvantage through socio-economic status, immigration, mental health conditions or incarceration.
Tobacco-Free Germany 2040 is synonymous with the recently published Europe‘s Beating Cancer Plan that states it would like to achieve a smoking prevalence of less than five per cent across the European Union (EU) by 2040. Without great progress in Germany, the EU will not be able to achieve this.
The development of the strategy was led by the German Cancer Research Centre in collaboration with a working group of experts from academia, public health and civil society for a multidisciplinary approach. It was presented to the public in the days before World No Tobacco Day and achieved overwhelming media coverage. It was sent to federal and state politicians and will support advocacy activities during and after the campaigns for the upcoming federal elections in September 2021.
The strategy was welcomed by several political decision makers and has already been cited in a federal parliamentary debate. The authors hope that it will be the starting point for a profound change in tobacco control in Germany and that the next government will include a strategy for a tobacco-free Germany 2040 into the next governing coalition’s agreement.
Laura Graen, M.A., is a research associate at the Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control at the German Cancer Research Center.
Dr Katrin Schaller is the Interim Head of the Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control at the German Cancer Research Center.