A ROMANIAN PERSPECTIVE ON TOBACCO AND ALCOHOL
by Dr. DANIELA BARTOS,
Minister of Health and Family
at the Ministerial Round Table “Risks to Health”
on the 55th World Health Assembly
(Geneva, May 14, 2002)
In Romania, after the political, social and economic reforms that took place since 1989, death rate and morbidity patterns, which relate to tobacco products consumption have considerably changed. New issues became manifest in the tobacco market, through the tobacco products import. Opening of the borders meant the finding of a new, empty market for the multinational companies, thus appropriate for placing their products.
Recent data are offered by a survey of the National Institute for Statistics reveal that one of five romanians aged over 15 are daily smokers. Men smoke three times more then women. The most frequent daily smokers are aged between 25-54. Half of the smokers started this practice at the age of 15 to 19 years.
Restrictions on the advertising and promotion of tobacco products have been imposed in 2001 (the Law regarding the ban on publicity for tobacco products in entertainment halls and the sale of tobacco products to minors). Legal regulations were issued in the latest years, which refer to the publicity for and sale of tobacco products to the minors, or the labelling of tobacco products. Examples thereof are Law on advertising, or Minister’s Order regarding labelling for tobacco products.
On the other side, Minister’s Order regarding the banning of smoking in all health institutions is still effective. The Romanian legislation has explicitly defined the meaning of such phrases as tobacco product, or tobacco product consumption, stamping, labelling, and selling. Nevertheless smoking and its related effects are only informally approached in these regulations.
In the context of the European integration process, through its National Plan for Accession into the European Union (NPAR) Romania has engaged to approve the Tobacco Bill by the end of 2002, a complex set of norms integrating this regulatory act with the effective European legislation. We are speaking here about the Draft Law for approving the technical and hygiene norms in the producing, storing, transporting, and selling of tobacco products.
The Ministry of Health and Family (MHF) has also issued a Draft Law for the prevention of tobacco products consumption, regulating such issues as the ban on smoking in closed public spaces. As of now, both of the law projects are to be adopted by the Parliament until December 2002.
It is therefore imperative for MHF to co-operate, in an integrated framework, with the other state authorities. A crucial role within reducing tobacco product consumption goes to the civil society, which is the ultimate beneficiary of these endeavours, the citizens after all.
To this end, Government institutions jointly with NGOs have all engaged, since 2000, in an Anti-Tobacco Partnership Program, under MHF co-ordination. This year, one of the major Anti-Tobacco actions has been one initiative for signing of the Statement of the Romanian non-smoking pupils by thousands of pupils from education institutions all over the country.
The Statement was then submitted, on May 31, at the same hour in all counties, to various authorities (City halls, prefecture halls, environmental protection agencies, consumers’ protection offices, etc.). In reply, several prefecture and mayor halls, and even disco clubs put a ban on smoking, even in the absence of any law that would ban smoking in work places, or closed public spaces.
Romania has also greeted and supported the WHO initiative – the Framework Convention on Tobacco Control - and participated in the inter-governmental negotiations.
Those ones have represented for us the starting point in order to establish an inter-ministerial body for elaborating of our national position into the international negotiations. This inter-ministerial group has also among its tasks to establish the National Action Plan on Tobacco Control.
According to the Loan Agreement that Romania concluded with the World Bank, a three years’ project on smoking prevention should be mentioned. This project will include wide information, education, and communication campaigns, as well as the setting up of five pilot counselling centres for quit smoking and also a network of quitlines.
Romania has been granted within the European Community Public Health Programme, alongside with the Member States, to develop one project that has focused to smoke-free workplaces under the co-ordination of the European Network for Smoking Prevention (ENSP). The Report of the Berlin Conference regarding smoking in the workplaces will be available in Romanian language, too, on the web-site of the project and also in Romanian books for population.
Ladies and gentlemen,
It is well known that alcohol is one of the factors to determine both individual and community health status. This fact is proved by the increasing statistical data referring to the number of the car accidents, number of the persons who need medical services for digestive disorders (e.g. liver cirrhosis), neurological, behavioural and mental disorders due to alcohol consumption, temporary incapacity of work, work accidents, etc.
The use of alcohol among adolescents is another problem related to alcohol consumption. Some studies show that the age of the first use is decreasing. The European Survey Programme for Alcohol and Drugs (ESPAD) was carried out in Romania in 1999 – 2000 among pupils below 16 years of age. The results of the study shown that 83% of the pupils had drunk alcoholic beverages and 43% of them had been drunk. From this point of view, Romania ranks position 20 among the 29 countries wherethe study had been carried out.
In spite of the data that shows a decreasing of the yearly average consumption, per inhabitant, for the distilled beverages (2,1 litres pure alcohol in 1999), exist an important increasing of the low and medium alcoholic beverages, per inhabitant, especially for beer (49,6 litres in 1999). That data are provided by the official statistics but Romania is a country with tradition for home made alcoholic beverages.
For this reason, an important part of the production and consumption of alcohol is still unknown and difficult, even impossible to estimate.
Additional to these problems is the phenomenon of the domestic and public violence with many human and material implications. In this context, it is obvious that alcohol consumption is an important problem of public health, which needs multiple approaches and involves huge social costs.
Unfortunately, in Romania a national consensus about the importance of reducing and controlling alcohol consumption isn’t established yet. The State has not a monopoly on the alcohol trade and this fact contributes to the development of the “black market” and to selling some unregistered products.
Legislative acts that limit the trading and the advertising of the alcohol products in some conditions have been issued in the last years. They provide measures regarding banning of the selling and advertising of the alcohol products inside of the educational and medical units. Also, in Romania alcohol consumption when driving is forbidden.
Centres for preventing and counselling on drugs, including alcohol were established in each county. The centres provide information for preventing the use of alcohol and drugs also refer the persons that already use drugs and alcohol to specific assistance.
At present, our Ministry funds several public health programs including the ‘Health Promotion and Education for Health’ National Program. The 42 health promotion services within the county public health departments run annual information, education, and communication campaigns on the prevention of tobacco and alcohol products consumption. We, also, intend to extend the Network of Health Promotion Schools, by first starting a training program for the teachers in the field of education-for-health, and the tobacco- alcohol addiction issues will be part of the curriculum.
MHF is opened to partners and allies in its anti-tobacco and alcohol fight, supporting also all civil society initiatives on this major public health issues.
Thank you for your attention.
Back to statements