Zero level of tobacco use by minors: is it real in Ukraine?

Global tobacco use is a significant risk factor, and WHO and partners are monitoring the problem. Every two years, WHO informs the international community about the state of tobacco control in the WHO Report on the Global Tobacco Epidemic. It was presented in the summer of 2021, and a little later, there was a report on trends and a comparative analysis of countries. A few days ago, the report was presented in Ukraine so we compare global trends with European and Ukrainian ones.

The devastating effects of smoking prevalence are relentless: tobacco-related diseases take the lives of 8 million people each year, including 1 million people who die from second-hand smoke. In Ukraine, 85,000 Ukrainians die from this addiction every year. Every day it is 233 people. Tobacco use is a №1 risk factor for non-communicable diseases, which account for more than 90% of the premature mortality rate in Ukraine.

The comprehensive anti-tobacco policy pursued under the WHO Framework Convention on Tobacco Control (WHO FCTC) and the MPOWER measures have so far saved millions of lives, a major achievement in the fight against the tobacco epidemic.

M — Monitor tobacco use and prevention policies.

Р — Protect people from tobacco smoke.

О — Offer help to quit tobacco use.

W — Warn about the dangers of tobacco.

Е —Enforce bans on tobacco advertising, promotion, and sponsorship. 

R — Raise taxes on tobacco. 

To monitor the world's implementation of the aforementioned set of anti-tobacco measures, the WHO prepares a "Global Tobacco Epidemic Report" every few years, outlining global and national trends in tobacco use and recording the implementation of MPOWER.

In 2021, the WHO prepared its Eighth Report, which reported on successes in the fight against the tobacco epidemic and focused on the threats posed by new nicotine and tobacco products, in particular, electronic cigarettes and heated tobacco products (HTPs).

According to the report, the number of tobacco users has decreased in most countries: now there are 1.30 billion smokers in the world compared to 1.32 billion 6 years ago. However, there's sad news; almost a quarter of humanity continues to use tobacco. Thus, 22.3% of the world's population still uses tobacco products: 36.7% of men and 7.8% of women. By the way, it's significant that today about 80% of smokers — about 1 billion people — live in low- and middle-income countries.

But since 2017, 102 countries have fully implemented one or more MPOWER activities. During this period, the number of people covered by at least one of the MPOWER events increased more than 4 times; it's 5.3 billion people.

• According to the Report, thanks to implementing MPOWER measures, Ukraine has made some progress in overcoming the tobacco epidemic. Thus, the increase in taxes on electronic smoking devices in Ukraine was noted in the WHO Report as the best international practice! This achievement was made possible by the adoption of the Law № 466-IX in 2020, which introduced taxes on liquids used in electronic cigarettes and HTPs.
• At the same time, Ukraine worked to raise public awareness of the risks of tobacco and nicotine use by reaching the highest level of implementation of the Anti-Tobacco Information Campaigns strategy, including two national anti-tobacco information campaigns, Tobacco Smoke – Invisible Killer and Safe Smoking Doesn't Exist.
• Another achievement of Ukraine is the highest level of implementation of the item "Monitoring of tobacco consumption." It's possible due to numerous independent studies conducted regularly in close cooperation between government agencies and international expert organizations and the public sector.

However, Ukraine still faces many unresolved challenges. And perhaps the most important of them is the problem of the prevalence of electronic smoking devices, which are first mentioned in the WHO Report 2021. And the worst thing is that children suffer from smoking electronic cigarettes and HTPs.

Thus, one of the main directions of MPOWER's policy is to achieve zero levels of tobacco use by minors. According to the report, there are currently around 38 million children aged 13-15 in the world using tobacco products, and e-cigarettes and HTPs are particularly common among minors. For example, in Ukraine, one in five schoolchildren aged 13-15 is a current consumer of e-cigarettes.

What is the reason? The answer is simple: this is manipulative marketing of the tobacco industry, aimed at the youngest audience. Cigarette manufacturers are aggressively promoting electronic smoking devices among children and adolescents through thousands of flavorings, social media ads, and misleading product claims.

According to the WHO, it's very concerned that children who use e-cigarettes are almost three times more likely to become regular consumers of tobacco in the future. Therefore, in its Report, the WHO recommends that governments introduce regulations to protect children from e-cigarettes and HTPs and to counter smoking tolerance in society.

What can Ukraine do to protect its youngest citizens? It has been proven that the most effective way to implement MPOWER measures is to improve legislation. In June, a comprehensive anti-tobacco draft law №4358 was adopted in the first reading, the norms of which are based on the WHO FCTC. Its basic norms offer, in particular:

• to expand smoking-free spaces in all public places and prohibit smoking of heated tobacco devices in these places;
• to regulate HTPs as tobacco products and introduce a ban on their sale to children;
• to ban advertising activities and sponsorship of electronic smoking devices;
• to ban ordinary and electronic cigarettes and tobacco for self-rolling with a characteristic taste and aroma.

Adopting the draft law №4358 as soon as possible will save thousands of Ukrainians from becoming addicted to deadly tobacco addiction, so maybe it's time to think about a future healthy nation and a generation of tobacco-free Ukrainians?

Authors:

Anastasia Bonkovska, the leader of the Youth Anti-Tobacco Movement

Oksana Levytska, specialist of the NGO "Zhyttia"