Because they do not do what they know

Tobacco control – an unknown word on the agenda of German governments

23.02.2020 – Congratulations, dear Federal Government and predecessors, you have finally made it! Your tireless commitment to the free development of tobacco addiction has paid off: Germany has arrived at the long-awaited last place in the Tobacco Control Scale (TCS) and will certainly be able to hold its place unchallenged in the coming years. 120,000 tobacco deaths every year are the result.

A Europe-wide comparison of the efforts of European countries (new: plus Israel) to curb tobacco use clearly shows that Germany is still a non-smoker’s worst country. “If this were a test requiring at least 50 points to pass,” says the latest TCS report, “14 countries (…) would fail.” The worst candidate with 40 out of a possible 100 points, worse even than Switzerland, which has not even ratified the WHO Framework Convention on Tobacco Control, is Germany.

No wonder, because in this country there is not only a lack of a recognisable and long-term strategy and funding, but simply a lack of motivation. Ultimately, efforts for more tobacco control at federal level have always failed because of the governing parties, more precisely: primarily because of the CDU/CSU, or even more precisely: because of the economic wing of the CDU/CSU. For years, this sub-group of a single party has managed to maintain the influence of the tobacco industry and uncritically adopt its arguments into its own rhetoric.

The recurring argument against more protection for non-smokers or advertising bans is particularly hypocritical: “We don’t want bans… Bans don’t achieve the goal… We rely on education and prevention.” After all, preventive measures against tobacco consumption are in a sorry state in Germany. The building blocks of an effective package of measures are

  1. The price of cigarettes. Although Germany is in the top third in a European comparison, the price increases for cigarettes since 2015 have been borne exclusively by the manufacturers. There have been no tax increases for five years. The gradual increase planned by Finance Minister Scholz, which is incidentally a desired goal of the tobacco industry, has been cancelled for the time being. Pipe tobacco (including the highly sought-after tobacco for shishas and tobacco heaters) will continue to be tax-privileged.
  2. Smoke-free workplaces, smoke-free public places: By amending Section 5 (2) of the Workplace Ordinance, the federal government could have ensured non-smoker protection in all workplaces with a single stroke, including catering establishments, meaning that this would have put an end to the different regulations in the federal states. In 2014, we had urgently asked former Minister Nahles for the deletion – unfortunately without success. The opportunity was missed.
  3. Information campaigns about the harms of tobacco consumption: apart from the already rather outdated materials and the Be smart don’t start campaign at schools by the Federal Centre for Health Education (BzgA), there are none. 14 billion euros in tobacco tax revenue are offset by a total of 2.9 million (!) in expenditure on tobacco control.
  4. Comprehensive advertising and promotion bans. The attempts to enforce an advertising ban are now in their fourth year. The CDU/CSU – again in the driving seat – has come up with a so-called key issues paper, which provides for long transitional periods and numerous exceptions, e.g. advertising at the point of sale, including outside, or in cinemas for adult films is to remain permitted. Sponsorship, which has been receiving more and more money from the tobacco lobby for years, is not to be restricted at all, so that the CDU/CSU and SPD party conferences can continue to be co-financed with tobacco money. This position paper is just mouldering away somewhere – after all, they have other problems at the moment.
  5. Health warnings: Germany has implemented the EU’s minimum requirements – nothing more. Legislation has not effectively prevented the obscuring of warning images in the presentation of goods on shelves and in vending machines. It is better to wait for successes in court proceedings, which are being pursued by Pro Rauchfrei, for example, at its own expense.
  6. Cessation programmes: There is neither a guideline strategy nor a nationwide network that provides low-threshold services nationwide. Of the six links to subsidised projects on the Drug Commissioner’s website, two do not work. Reimbursement of costs for participation in cessation programmes is at the discretion of the health insurance companies.
  7. Fight against tobacco smuggling: Germany is active in this area as it involves direct revenues.
  8. Measures against tobacco industry influence peddling: Germany is inactive in this area as it concerns direct revenues.

Conclusion: Although tobacco advocates constantly refer to tobacco prevention and education, they prevent the former (no tax increase, no advertising bans, no expansion of smoke-free places… ) and provide hardly any funding for the latter. This is the perfect prevention policy.

To list the tobacco control activities of various institutional and social groups individually would go beyond the scope of this article – for example, individual federal states are endeavouring to ban smoking in cars or playgrounds, cities are planning tobacco advertising bans or smoke-free bus stops, members of parliament and state ministers want to achieve more smoke-free public places, associations are taking legal action against breaches of the law, private initiatives are acting against littering with cigarette butts, opposition parties are introducing bills, petitions are being submitted…

Vieles wäre hierzulande möglich und durch steigende Zustimmung in der Bevölkerung gedeckt, wie z.B. ein Rauchverbot in Fahrzeugen, das aber nicht einmal die Drogenbeauftragte der Bundesregierung unterstützt. Oder mehr Prävention, besserer Zugang zu Entwöhnung, weniger Werbung, weniger Abfall. Nichts davon wird umgesetzt, da der Wille dazu einfach nicht vorhanden ist. Die Tabaklobby behält auch 2020 über einen einflussreichen Kern in der Union die Fäden der Tabakpolitik in der Hand. Fortschrittliche Gesundheitsprävention kommt nicht aus Deutschland.

Link: Grafiken zur Tobacco Control Scale.