Towards tobacco-free generations: emerging threats for children in the Region

WHO/Malin Bring

Several Member States in the WHO European Region are moving towards becoming “tobacco-free”, which means having a smoking prevalence of 5% or less. To achieve this, countries must address a number of tobacco-related issues that specifically impact children, and work to protect children from the harmful effects of tobacco.

A new report from WHO/Europe identifies tools and offers novel approaches that can – and should – be used to pave the way towards a tobacco-free Region. A series of web stories highlights some of the report’s key findings and recommendations, and shares examples of measures being taken within countries of the Region to fight the harmful effects of tobacco.

A number of emerging issues related to high smoking rates among children in the Region require greater attention. Firstly, tobacco-marketing industries are using gender-specific messages to encourage smoking uptake among young girls. Using strategies similar to those of the 1920s, industries are promoting cigarettes to females as a symbol of glamour, fashion, success and sex appeal, and as a means of staying slim.

According to the 2013/2014 Health Behaviour in School-aged Children survey, the prevalence of smoking is greater among girls than boys in certain eastern and southern countries of the Region where these techniques are widely used. For example, whereas 20% of boys are regular smokers in Italy, the prevalence among girls is 22%.

Secondly, increasing numbers of children are using electronic nicotine delivery systems (ENDS) as a form of smoking. ENDS are devices that deliver nicotine to the lungs through a vapour that is heated via an electronic mechanism. They are being advertised through online platforms and marketed in a variety of flavours, shapes and designs. They do not resemble cigarettes, but rather everyday items such as pens, which enhances their appeal among children.

The use of ENDS is potentially harmful. Some have been found to contain poisonous chemicals such as formaldehyde at a level similar to that of cigarettes. Moreover, ENDS reinforce nicotine addiction and normalize smoking. Since ENDS are relatively new to the market, they are still largely unregulated.

Finally, tobacco-related health inequalities in the Region are growing. Smoking rates are high among people with low education levels and/or low income. This puts children in low socioeconomic groups at a higher risk of smoking initiation, addiction and second-hand smoke exposure. Due to socioeconomic conditions, these groups are also less responsive to otherwise effective tobacco control measures.

Reducing tobacco sales to children

In order to reduce sales to children, most Member States have set 18 as the legal age for buying tobacco. The age is higher in other parts of the world, such as New York City, United States of America, where it is 21. An alternative approach being considered in Singapore and the United Kingdom is the phasing out of tobacco sales to people born after a certain date, such as 1 January 2000, in order to protect younger generations from the harmful effects of tobacco use.