World No Tobacco Day 2018 – a time for stocktaking

Florin Dumitru Mihălțan, Ruxandra Ulmeanu, Dragoș Vinereanu, Gabriel Tatu-Chițoiu

On the occasion of the World No Tobacco Day (initiated by the World Health Organization in 1987), the Romanian Society of Cardiology, the Romanian Society of Pneumology, and the Romanian Heart Foundation, in the forefront of the fight against smoking in Romania, are launching a new appeal to authorities and the public: “Tobacco destroys hearts!” It was a milestone first marked by a round table meeting with lawmakers, authorities and patient NGOs, followed by a press conference.

The meeting commenced with a review of the positive and negative aspects related to tobacco control in Romania. Despite the significant legislative progress made, 115 Romanians die every day as a result of the harmful effects of smoking. This means about 42,000 deaths each year. Smoking kills, in particular, through lung cancer (85% of lung cancers are caused by smoking) and cardiovascular disease (smoking is the number one risk factor for myocardial infarction). As a result, the life expectancy of Romanian smokers is now 10 years lower compared to that of non-smokers. It is appreciated that in Romania, out of the total potential years of healthy life lost through various disabilities or premature deaths, 13% are lost due to severe smoking-induced illnesses. The data is completed by the Eurobarometer 2017 results, revealed by the European Commission, showing that tobacco is still relatively highly used in Romania, with a smoking preva-lence of 28% among those over the age of 15, close to the European average (26%). In men, the prevalence is still very high, with 38%, and among women the prevalence is 19%. Romania ranks 9th in the European Union. Although Romanians smoke less compared to Greeks (37%), Bulgarians and French people (36%), they smoke much more than the Swedes (7%) and the English people (17%). Extremely worrying in this context is the data on the increase in the number of smokers among young people. According to this report, the percentage of young smokers and of those aged 15-24 has increased from 25% in 2014 to 29% in 2017. In addition, a study conducted by IRES in January 2016 showed that 82% of smokers started to smoke before the age of 22 and half started smoking before the age of adulthood. Referring to the logo chosen by the World Health Organization (WHO) for this year – “Tobacco breaks hearts. Choose Health, No Tobacco!” –, prof. Dragoş Vinereanu, president of the Romanian Society of Cardiology, reviewed the worrying figures of the evolution of cardiovascular diseases in our country, pointing out that although the population has decreased by almost 15%, the number of total deaths by cardiovas-cular disease decreased by only 3-5%, and a notable con-tribution is due to tobacco use in a significant percentage, with a death rate three times higher than cancer. It is still an issue that explains why life expectancy is 10 years lower than the European average. Prof. Ruxandra Ulmeanu contributed to these figures, stressing the impact on res-piratory diseases, with 85% of lung cancers where smoking is a pervasive factor. All independent studies unquestion-ably demonstrate that tobacco is one of the greatest public health hazards and a major risk factor, and under these circumstances, WHO’s conclusion of 2009 that “smoking is the leading cause of death THAT CAN BE PREVENTED” remains valid. In this context, Romania has made signifi-cant progress over the past two years as a result of the implementation of Law no. 15/2016, prohibiting smoking in enclosed public spaces. According to Eurobarometer 2017, exposure to tobacco smoke in bars has fallen from 80% to just 11%, and in restaurants it dropped from 59% to 6%. This report led to an important leap for Romania, jumping 12 positions, from 19th to 7th in the European ranking of tobacco control policies. There are direct effects of this type of policy that have emerged rapidly, just like in other countries that have passed similar laws. There were also discussions about electronic cigarettes and heated tobacco. Although Romanians are largely in favour of more restrictive measures regarding tobacco use, which are meant to discourage starting smoking, such as prohib-iting the use of electronic cigarettes in places where smok-ing regular cigarettes is not allowed (59%), similar labelling (54%), and so on, the new strategy of transna-tional tobacco companies will probably bring about a revival of consumption through “generous” offers of “healthy” tobacco.


Regarding 2018, the year of ostentatious promotion of new tobacco products (the electronic cigarette and the heated tobacco), presented as “less harmful than the classic cigarettes”, whose victims are mainly children and young people, we talked with dr. Raed Arafat, the head of SMURD. The position of the Romanian Society of Cardiology, of the Romanian Society of Pneumology and of the Romanian Heart Foundation was announced as being unchanged: “Any product that damages public health, regardless of its degree of harmfulness, must be countered, and the state, the authorities must honour their constitutional duty to guar-antee the right to health of the citizens of Romania”. This press conference and dinner revealed the legislative chang-es that can solve the “public health emergency” of tobacco consumption in Romania, especially among adolescents and young people, the changes that we proposed in an interest-ing debate in which the members of the Health Commission of the Chamber of Deputies and the Senate of Romania participated. These requests are proposed by the “Initiative 2035 – No Smoking Generation”, the Romanian Society of Cardiology, the Romanian Society of Pulmonology and the Romanian Heart Foundation, being part of the member associations of the initiative. Discussions from the repre-sentatives of the Senate and the Chamber of Deputies gen-erated by these exposures of the representatives of professional societies have demonstrated that all political parties are supportive of the new legislative amendments and that the resumption of this legislative approach will be able to protect future generations. This was also supported by representatives of the authorities and patient associa-tions. This year’s initiative of the partnered professional societies was also continued with a Facebook campaign and active promotions in the media. The final message was that tobacco does not only destroy the hearts, but also the future of younger generations.


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