Towards a Tobaccofree Society The Role of Central Government

1
Towards a Tobaccofree SocietyThe Role of Central
Government

• Case Study from Sweden
• Paul Nordgren, National Institute of Public Health

2
The Swedish Tobacco Act

• was introduced in 1993
• banned smoking in schools, hospitals and indoor
  public places in general (except designated
  smoking rooms or areas) hospitality sector not
  included
• was amended in 1994, establishing the right to a
  smokefree workplace (and banning all tobacco
  advertising)
• was amended again in 1997, banning tobacco sales
  to minors (lt18).

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Making restaurants smokefree the dream

• By the mid-1990s, indoor public places were
  smokefree. Smoking was, however, allowed in
  restaurants, cafés, bars etc. (although
  restaurants with more than 50 seats should have
  smokefree sections).
• The NIPH started a project to make restaurants
  smokefree on a voluntary basis The Golden
  Fork, with some, but limited, success.

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Making restaurants smokefree the prelude

• Around 1999-2001 opportunities were given to
  discuss amendments to the Tobacco Act, e.g.
• A parliamentary Public Health Committee was
  formed to elaborate new National Public Health
  Targets, and included Tobacco Act amendments
  among its proposals.
• The NIPH was commissioned to conduct information
  activities on passive smoking to the public.
• The NIPH was appointed the responsible
  supervising authority with respect to the Tobacco
  Act.

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Making restaurants smokefree The proposal

• The Ministry of Health and Social Affairs decided
  based on the Public Health Comittee proposals
  to propose that restaurants should become
  smokefree.
• The proposal was forwarded to Parliament,
  initially saying that the reform should be made
  on a voluntary basis. Legislation, however,
  should be considered only if voluntary measures
  failed. Parliament decided in favour of the
  proposal.
• A study group (which included stakeholders) of
  the NIPH soon concluded that voluntary
  initiatives could not provide a realistic,
  satisfactory solution.
• Consequently, Parliament decided to legislate!

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Making restaurants smokefree The legislation

• The amendment of the Tobacco Act took effect from
  June 1, 2005.
• All indoor premises of restaurants, bars, cafés
  etc. must be totally smokefree. Owners have an
  opportunity but no obligation to set aside
  designated smoking rooms, where no food or drink
  may be served or consumed.

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Making restaurants smokefree the funding

• No extra governmental funding was provided to
  support the introduction of the new legislation.
• The NIPH could only use a small part of its
  regular budget for supporting activities.
• Local and regional authorities, NGOs (including
  business associations and trade unions) were
  encouraged to use funding from their regular
  budgets to support national and local
  initiatives.

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Smokefree restaurants - compliance

• From Day 1, compliance is excellent
• Local authorities performed lots of inspections
  during 2005 practically no offenses found.
• In national polls, 99 of smokers claim to
  observe the new rules, always (98 ) or almost
  always ( 1 ).
• 91 of all respondents confirm smokers
  compliance, always (71 ) or almost always (
  20 ). (8 dont know or dont answer).

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Smokefree restaurants - effects

• Improved health among restaurant workers (less
  respiratory symptoms etc.).
• Decreased number (- 160,000) of daily smokers

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Smokefree restaurants - effects

• No signs of adverse economic effects
• No signs of people going out less often
• Very few designated smoking rooms
• More outdoor serving facilities (and prolonged
  season has winter become shorter?)

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Smokefree restaurants the role of central
government

• The NIPH could and did
• provide factual information to media and the
  public on health risks of passive smoking
• provide ministers and MPs with facts and
  arguments to support the reform, incl.
  international experiences
• organise and perform education, for and by
  regional and local authorities
• provide NGOs with supportive facts, (inside)
  information and - even some funding, for advocacy
  activities
• conduct opinion polls and other
  follow-up/evaluation activities
• encourage and support initiatives by regional and
  local authorities.

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Smokefree restaurants the role of central
government (continued)

• The NIPH could and did NOT
• engage directly in public debate, in favour of
  specific legislation
• approach/lobby MPs or other key persons during
  the decision process
• attack persons (e.g. politicians) or
  organisations (e.g. business associations) with a
  (vested) interest of status quo
• conduct advocacy activities in public.

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Smokefree restaurants - acknowledgements

• THANKS
• Ireland, Norway, Italy and Malta
• for taking action before Sweden,
• thus paving the way for the land of lagom!
• (The Swedish word lagom indicates moderation,
  balance and cautiousness, which is believed - by
  Swedes - to be a prominent feature of our
  national character.)