The 2021 Tobacco Control Scale

By Luk Joossens, Retired ECL Tobacco Control Advocacy Officer

(Don’t miss his presentation at the upcoming European Conference on Tobacco or Health 26-28 April 2023, Madrid)

Press Release from Smoke Free Partnership:

The 2021 Tobacco Control Scale is out: Ireland , UK and France are leading the ranking while Bosnia & Herzegovina, Switzerland and Serbia have the lowest score.

Brussels, 2 December 2022 – The 2021 Tobacco Control Scale was presented today at the ICO-WHO Symposium on Tobacco Control in Barcelona. The new ranking describes the tobacco control actions (price increase, smoking bans in public places, etc) implemented in 37 European countries in 2021 (EU 27 countries + Bosnia & Herzegovina, Iceland, Israel, Norway, Russia, Serbia, Switzerland, Ukraine, UK and Turkey). The scale shows Ireland, UK and France leading the ranking while Serbia, Switzerland and Bosnia & Herzegovina  show poor results.

The scale was first introduced in 2006 by Luk Joossens, Special Advisor of the Smoke Free Partnership (SFP), and Martin Raw, Director of the International Centre for Tobacco Cessation. It is based on six policies described by the World Bank, which are used to assess the level of implementation of tobacco control policies in each country. The scores can go up to 100 points, and they are determined thanks to a survey which was circulated at national level and benefited from the contribution of national organisations and international instruments.

This year’s edition of the Tobacco Control Scale shows the evolution of tobacco control policies since the last 2019 edition and shows that 17 countries still scored less than 50 points consequently urgent actions are needed.

Ireland and UK are the countries with the highest score (both 82 out of 100 points), together with France which comes third with 71 points. These countries are doing very well in the field of tobacco control: for example, Ireland has the highest prices of cigarettes in Europe (€15,40 for a pack of Marlboro in 2022). On the contrary, Switzerland and Bosnia & Herzegovina are the countries with the lowest score (respectively 35 and 25 points). Switzerland, for example, is under strong influence from tobacco companies and fails to make progress on cigarette taxation or smoking cessation support. Among countries who significantly improved their tobacco control stance are the Netherlands and Denmark (+ 9 points). This is notably due to an increase of taxes and the implementation of a display ban and plain packaging. Eleven countries (UK, France, Ireland, Norway, Turkey, Slovenia, Belgium, Israel, Hungary, Netherlands and Denmark) have adopted and  implemented plain packaging legislation whereas Finland will implement plain packagimg in 2023.

“Plain packaging for cigarettes exists now in more than ten European countries and should be the standard for all countries in the European Region” states Luk Joossens, the main author of the report. The report highlights the lack of funding for tobacco control, which was intensified by the COVID-19 pandemic.

“None of the 37 countries spends €2 per capita on tobacco control and some countries even witnessed a reduction in funding” said Dr. Esteve Fernández, director of the WHO Collaborating Centre on Tobacco Control at the Catalan Institute of Oncology and co-author of the report. The tobacco industry interference remains the main issue which prevents countries from making significant progress in tobacco control. “Raising taxes on tobacco products is one of the most cost-effective strategies to protect youth from tobacco, however taxes and prices in some countries are very low. The upcoming revision of the Tobacco Tax Directive is instrumental for ensuring increase in tobacco taxes” said Lilia Olefir, Director of the Smoke Free Partnership.

Download the Press Release