Tobacco and inequities - Guidance for addressing inequities in tobacco-related harm
This policy guidance aims to support European policy-makers to improve the design and implementation of policies to reduce inequities in tobacco-related harm.
Smoking kills more Europeans than any other avoidable factor. Socioeconomic inequities in tobacco consumption in Europe are extensive, and are
widening. The overall reduction in smoking in Europe has been a public health success, but the effects have mainly been seen in middle- and high-income groups, causing a substantial widening of inequities.
Reducing health inequities is a key strategic objective of Health 2020 – the European policy framework for health and well-being endorsed by the 53 Member States of the WHO European Region in 2012. This guide seeks to assist European policy-makers in contributing to achieving the objectives of Health 2020 in a practical way. It draws on key evidence, including from the WHO Regional Office for Europe’s Review of social determinants
and the health divide in the WHO European Region. It sets out options and practical methods to reduce the level and unequal distribution of tobacco use in Europe, through approaches that address the social determinants of tobacco use and the related health, social and economic consequences.
Key messages
- Socioeconomic inequities in tobacco consumption in Europe are large, and are widening.
- Tobacco use is a leading contributor to overall health inequities in Europe.
- Policies that reduce smoking prevalence do not necessarily reduce inequities, and can in fact
make inequities worse. - Impact on inequities needs to be considered for tobacco control measures to be successful.
- Tobacco control policies have different impacts on different social groups.
A fair and effective policy response to tobacco needs to consider:
- inequities in tobacco use between different social groups
- inequities in exposure to tobacco
- inequities in vulnerability to harm from tobacco exposure
- differences in access to, pathway through, and outcome from the health system
- differences in the socioeconomic harms from/consequences of tobacco use.
