The European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) is the umbrella organisation representing the voice of patients living with chronic respiratory diseases such as allergy, asthma and chronic obstructive pulmonary disease (COPD). The control of tobacco and related products in the EU region ranks among EFA’s key advocacy priorities, given the strong association of these products with harmful effects on human health and, in particular, the respiratory system.
When it comes to diseases such as allergy, asthma and COPD, scientific research has clearly demonstrated causal links between smoking and negative health outcomes, including the onset of the diseases in previously healthy individuals. In patients, tobacco use is typically associated with more symptom exacerbations, increased hospitalisations and visits to the emergency department, and higher mortality. In light of this compelling scientific evidence, EFA calls on the EU to take steps, including legislative measures, to further reduce tobacco consumption. Examples include encouraging smoking cessation programmes and exchange of best practices among Member States; and supporting dissuasive campaigns against industry practices. To attain a tobacco-free generation by 2040, as per Europe’s Beating Cancer Plan, the EU framework on tobacco control must be strengthened through, among other things, stricter legislation on packaging, alignment of rules among conventional tobacco and novel products such as electronic cigarettes and heated tobacco products (HTPs), and stronger tax-related measures. All along this process, patient perspectives must be integrated and included in decision-making.
Another key aspect is the exposure to second-hand smoke (SHS). Tobacco smoke represents a major pollutant, mostly linked with decreased indoor air quality but affecting outdoor settings as well. There is extensive evidence showing that the exposure to SHS of tobacco bears serious risks for respiratory health, including declined lung function and increased disease symptoms. In addition, recent evidence strongly associates exposure to SHS from e-cigarettes and other novel (non-)tobacco products, such as HTPs, with worsening respiratory health.
Therefore, it is important to ensure the expansion and proper implementation of 100% smoke-free environments at the national level, in line with the Framework Convention on Tobacco Control (FCTC). This includes public outdoor settings such as parks and beaches, as well as indoor spaces such as bars, restaurants, sport facilities, hospitals and educational establishments. The upcoming update of the Council recommendation on smoke-free environments presents a key opportunity to advance in this direction.
Overall, EFA wishes to see a stronger EU tobacco control framework that prioritises public health, protects vulnerable groups and reduces the health burden associated with the use of tobacco and related products, as well as the exposure to SHS. Together with the restriction of conventional tobacco use, the EU must tackle the re-normalisation of smoking through novel products such as e-cigarettes and HTP, and step-up research on the effects of novel tobacco and related products on respiratory health.