Strategies like MPOWER lack enforcement in most Central European countries. Implementing the EU Tobacco Product Directive Austria extended existing smoking bans, advertising bans and mailing bans for tobacco products to e-cigarettes. Still missing is an enforced smoking ban without exceptions in the hospitality industry, an advertising ban and display ban at point of sale, ban of vending machines, increase of age limit for buying any cigarettes and tobacco products to 18 years, enforcement of age control by regular test purchases, ban of free cigarettes, extension of warnings and ban of aromas to cigars and pipes, smoke-free hospitals, health care centers, school premises, playgrounds, cars carrying children and stations of public transportation. Other Central European countries, except Hungary, are facing similar problems. All of them should raise tobacco tax, with a levy for tobacco prevention. 13 of 16 federal states of Germany, the Czech Republic, Slovakia and Switzerland did not succeed yet to ban smoking without exceptions in the hospitality industry and enforce it. Germany is still violating the EU tobacco advertising ban and the Czech Republic recently failed to ban the use of water-pipes and e-cigarettes in enclosed spaces. The FCTC smuggling protocol was only ratified by Austria. Switzerland did not even ratify FCTC and might become a platform for international tobacco smuggling if the Track-and-Tracing-System of TPD is not joined. Without enforced legislation and higher investments into tobacco prevention (including e-cigarettes) increases in smoking rates of minors, women, unemployed or poorly educated parts of the population are expected, followed by increases of related diseases and deaths. WHO-Europe should reprove governments for violating article 5.3 FCTC by cooperation with lobbyists of tobacco industry and trade, instead of independent scientists and physicians. NGOs should write shadow reports on poor implementation of FCTC and demand the foundations of national tobacco control agencies.
Neuberger Manfred, Medical University of Vienna