The impact of the EU accession on Croatia Public health policies on tobacco Marta Čivljak, MD, PHD Research Fellow Department of Medical Sociology and Health Economics, Andrija Štampar School of Public Health

Tobacco smoking: global public health problem  There are 1.3 billion smokers worldwide  Every day over 13,000 people die from tobacco-related diseases  If current trends continue, by 2025 tobacco will contribute to the death of 10 million people worldwide each year

 ESPAD (European School Survey Project on Alcohol and Other Drugs)  38% girls and boys are smokers  GYTS (Global Youth Tobacco Survey)  24.8% currently smoke cigarettes (Boys = 22.4%, Girls = 25.8%)  9.3% currently are daily cigarette smokers (Boys = 8.4%, Girls = 9.2%)  9/10 (92.2%) live in homes where others smoke in their presence  HZA 2003 (Croatian Health Survey)  34% male and 22% female smokers Tobacco smoking: public health problem in Croatia

Interventions and programs for smoking cessation in Croatia ( )  National public health interventions  International programs for smoking cessation  National tobacco control policies

National public health interventions Interventions Importance Long-term effectiveness Self-help materials +- School based educational programs +- Program “Say YES to no smoking” ++ Interventions for smoking cessation in dental setting +-

International programs for smoking cessation Interventions Importance Long-term effectiveness World No Tobacco Day +- “Quit and Win” contest for smoking cessation ++ WHO Framework convention on Tobacco Control (WHO FCTC) ++

National tobacco control policies  This legislation provides measures determined to improve public health : - measures to reduce exposure to tobacco smoke and demand on tobacco - product control and consumer information (regulates the levels of tar nicotine and carbon monoxide in cigarettes / health warnings) - Education, communication, training and public awareness - supervision of law enforcement

Laws restricting the use of tobacco products in Croatia  Tobacco control policy, 1999 (Zakon o ograničavanju uporabe duhanskih proizZvoda. NN 1999;(128): )  Tobacco control policy 2008 (Zakon o ograničavanju uporabe duhanskih proizvoda. NN 2008;(125):2-6.)  Corrections of Tobacco control policy, 2009 (Ispravak Zakona o ograničavanju uporabe duhanskih proizvoda. NN 2009;(55):63).

WHO Framework Convention on Tobacco Control (WHO FCTC)  is the first treaty negotiated under the auspices of the WHO.  was developed in response to the globalization of the tobacco epidemic  it presents an evidence-based treaty that reaffirms the right of all people to the highest standard of health  was adopted by the World Health Assembly on 21 May 2003 and entered into force on 27 February  with 168 signatories has become one of the most widely embraced treaties in UN history

The core demand reduction provisions in the WHO FCTC (contained in articles 6-14) Price and tax measures to reduce the demand for tobacco, and  Non-price measures to reduce the demand for tobacco, namely:  Protection from exposure to tobacco smoke;  Regulation of the contents of tobacco products;  Regulation of tobacco product disclosures;  Packaging and labeling of tobacco products;  Education, communication, training and public awareness;  Tobacco advertising, promotion and sponsorship; and,  Demand reduction measures concerning tobacco dependence and cessation

The core supply reduction provisions in the WHO FCTC (contained in articles 15-17)  Illicit trade in tobacco products;  Sales to and by minors;  Provision of support for economically viable alternative activities

Tobacco control in Croatia today  Croatia was among the first countries that have signed the Convention (June 2, 2003).  Has ratified the treaty on 14 th July  Ratification of the treaty influenced most of all non-price measures to reduce the demand for tobacco

Conclusion Croatia must continue to work intensively on the following measures for tobacco control : Price and tax measures to reduce the demand for tobacco (the most effective measures to reduce smoking prevalence in the population) Supply reduction measures Enforcement of the law on complete ban on smoking in public places