Is it too soon to hope for a tobacco free Romania?

This article was exclusively written for the The European Sting by Alexandru-Constantin Sîrbu, Horea Chirilă and Teodor Blidaru, three 5th year medical students from Romania, currently leading the Romanian Federation of Medical Students’ Associations (FASMR), a national member organization of IFMSA. They are affiliated to the International Federation of Medical Students Associations (IFMSA). However, the opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one. Romania has seen major changes regarding tobacco cessation policies in recent years, including a ban on smoking in public places, but are those even working? To actually understand the phenomenon we need some context. On June 6, 2002 the law No. 349 was adopted, being the primary piece of legislation regulating smoking in public places. Even though the law was amended several times, the most important change came in March 2016, through the form of Law No. 15/2016, when the ban on smoking in public places was extended to fit the norms of most of the EU countries. The year 2016 was a major victory for tobacco control also because Law No. 201 forced the producers to replace the packaging and labeling of tobacco products. (1) Since 2016 smoking is prohibited on public transport and in all indoor public places and workplaces. Before this year of change, smoking was allowed in public places like cafes, restaurants, pubs and clubs. The Romanian law prohibits most forms of direct advertising. This includes TV, radio, print media, and outdoor advertising, but the law allows advertising at the point of sale, including special offers for the buyers. The price of tobacco products have increased regularly, now the price of one pack of 20 cigarettes being 4 euros. Also the price increases seems the be the the most efficient anti-tobacco policy for the romanian population, accounting for almost half of the smoking cessation in Romania. (2) And yet, there is a constant problem. According to a WHO report on the global tobacco epidemic published in 2008 smoking prevalence in young adults is 18.9% and in adults it reaches 30%. (3) But the 2017 report from the WHO shows even more troubling data. The young males smoking rates are 20% and female are 17% with a mean (not shown in the report) of 18.5%. Regarding adults, 26.7% of them are still smokers. (4) This actually shows that after extensive legislation changes, including public space ban, the smoking rate barely dropped in Romania. Furthermore, there have been extensive media campaigns to cease smoking and also many health centers provide smoking cessation support that is covered by the government. So has the new legislation and anti-tobacco changed anything? Well, technically we can’t say. Even though we have new laws, they have been adopted quite recently (2016) and regarding the chronic use of tobacco things never changed overnight. Furthermore the data in the 2017 WHO reports was gathered in December 2016, so the time passed between the changes and the survey was short. We have hope though, because the laws set in place are actually properly followed and not abiding to them has more than often ended up with financial sanctions. Public space ban was a strong step and with more NGOs and medical professionals advocating for even more strict tobacco control measures, we are paving the way for a cigarette free Romania in the near future. References:

1. Romanian laws: 15/2016, 348/2002
2. Health impact of tobacco control policies in line with the WHO Framework Convention on Tobacco Control (WHO FCTC)(Fact Sheet)
3. WHO report on the global tobacco epidemic, 2008
4. WHO report on the global tobacco epidemic, 2017
5. http://2035faratutun.ro/
6. Romanian Multiannual Plan for Education and Health
7. Romanian National Health Strategy

About the authors Alexandru-Constantin Sîrbu, Horea Chirilă and Teodor Blidaru are three 5th year medical students from Romania, currently leading the Romanian Federation of Medical Students’ Associations (FASMR), a national member organization of IFMSA. Since 2016, FASMR has represented medical students in high level national forums and has stated the importance of a more comprehensive tobacco control policy. Alexandru, Horea and Teodor are No Tobacco Ambassadors and have been part of the NGO network that advocated for changing the tobacco law.