Luk Joossens, advocacy officer, ECL. Barcelona 21 February 2017

1. The past, present and future of
the Tobacco Control Scale
Luk Joossens
Advocacy Officer, ECL
Barcelona
21st February 2017

2. Tobacco Control Scale is more than 10 years old
and is cited by more than 600 articles or reports

3. Effective tobacco control policies
• Higher prices
• Smoking bans and
restrictions
• Media campaigns
• Advertising bans
• Prominent warning
labels
• Smoking cessation
support
Source: World Bank
2003

4. MPOWER
Six Proven Polices to Reverse the
Global Tobacco Epidemic
• Monitor tobacco use and prevention policies
• Protect people from tobacco smoke
• Offer help to quit tobacco use
• Warn about the dangers of tobacco
• Enforce bans on tobacco advertising,
promotion and sponsorship
• Raise taxes on tobacco

5. The expert group (2003-4)
Ken Warner (USA),
Albert Hirsch (France),
Witold Zatonski (Poland),
Paul Nordgren (Sweden),
Ann McNeill (UK),
Joan Ramon Villalbi (Spain),
Fiona Godfrey (Luxembourg),
Tibor Szilagyi (Hungary),
Marc Willemsen (Netherlands)
Luk Joossens (Belgium)

6. Tobacco control scores
• Prices : 30 points
• Smoking restrictions/bans: 22 points
• Tobacco control funding : 15 points
• Ad ban: 13 points
• Smoking cessation : 10 points
• Labelling: 10 points
Source: Effective tobacco control policies, 2004

7. ‘Effective tobacco control Policy’ scores
1st January 2004.

8. Countries ranked by ‘Effective tobacco control Policy’
scores (out of 100)
NB. Data of 1st January 2004.
Decrease in prevalence during period 1985-2003 of  more than 25%  more than 20%  more than 15%
Less than 15%
0
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
Iceland
U
K
N
orw
ay
Ireland
M
alta
Sw
eden
France
N
etherland
Finland
Poland
H
ungary
Estonia
Slovenia
C
yprus
D
enm
ark
Slovakia
Italy
G
reece
Belgium
Portugal
G
erm
any
Lithuania
Sw
itzerland
Spain
Austria
Latvia
C
zech
R
epublic
G
rand
Luxem
bourg
MeanTotalScore100points(roundedup)

9. Tobacco Control Scale article
in Tobacco Control, 2006

12. 30 points for cigarette prices in
2016
The country with the price of the Weighted
Average Price of €10 a pack and an EU average
Purchasing Power Standard receives 30 points.
 Bulgaria would receive 30 points, if the price
of a pack would be €4,60 , Spain €9,10, Ireland
€14,50, Norway €16,90 and Luxembourg
€27,10 .

13. The last time you visited a bar, were people smoking
inside?

14. 8 points for smoke free
bars and restaurants
 A country will receives 8 points for a smoking
ban in bars and restaurants, without
exceptions (no smoking rooms) which is
enforced.
 Enforced legislation means that in the
eurobarometer survey of 2012, less than 25%
have seen people smoking in a bar or
restaurant during the last visit in the last six
months.

15. The last time you visited a bar, were people smoking
inside? (Eurobarometer, 2012)

16. TCS scores 1st July 2005

17. Ranking 2005 and 2007

19. Fifth ranking Tobacco Control Scale
• Legislation 1st January 2014
• Cigarette prices 1st July 2013
• Tobacco control budget 2012

20. Ranking 2010-2013

23. Sixth TCS will be presented at ECTOH
In Porto on 23rd March 2017

24. Stimulate the debate on tobacco
control policy
“The purpose of this new scale is to introduce a new
level of systematisation into scoring tobacco control
at country level. (..)we hope the scale will be used
even more widely, encouraging comparisons
between countries and thus motivation to
strengthen weak polices.”
Joossens, Raw, 2006

25. The leading countries adopted or are
considering plain packaging

26. Comments on price scores
• Weighted average price (WAP)= good indicator
• Power purchasing standards is problematic for
some countries
• Some countries don’t have WAPs
• RYO tobacco is not included
• Exchange rates influence scores and makes
trends difficult.
• The maximum level of points = abitrary

27. Comments on smoke free
• Enforcement is measured by the
Eurobarometer survey
• Sampling size is low
• Some countries don’t Eurobarometer results
• Difference between different types of smoking
rooms is no more justified
• Scores take into account good legislation and
enforcement

28. Comments on advertising
• Answers of repondents are not always reliable
• Problems of the measurement of enforcement
• Is the ban on internet advertising enforced?

29. Comments on budgets
• Difficult to collect the data
• No measurement of the quality of the
campaigns
• Only Iceland and Switzerland have high scores
• 15 points is probably too high

30. General comments
• Some respondents want high, others low
scores
• Some repondents never reply
• Answers of respondents need to be verified by
other sources such database EU, WHO Europe,
MPOWER, FCTC, SFP, TFK, etcera

31. Other policies?
• Article 5.3
• Smoking in open areas
• Electronic cigarettes
• RYO tobacco
• Illicit trade measures.

32. Future of the TCS
• Initially 28 countries, now 35 countries. How
many in the future?
• Review of the TCS in 2019
• Decisions on future steering group
• Website?

33. Thank you
Joossens@gmail.com