EN    EN EN 
 
EN    EN  COMMISSION OF THE E UROPEAN COMMUNITIES 
Brussels, 30.6.2009 
SEC(2009) 895 
  
COMMISSION STAFF WORKING DOCUMENT 
Accompanying document to the proposal for a Council Recommendation on smoke-free 
environments 
  
SUMMARY OF THE IMPACT ASSESSMENT 
  
{COM(2008) 328 final} 
{SEC(2008) 894} {SEC(2008) 896} 
 
EN 2   EN 1. I NTRODUCTION  
In its Environment and Health Action Plan  (2004-2010), the Commission committed itself to 
improving indoor air quality, in particular by en couraging the restriction of smoking in all 
workplaces. The consultation launched by the Co mmission's Green Paper "Towards a Europe 
free from tobacco smoke: policy options at EU  level" revealed significant support for 
comprehensive smoke-free policies and for fu rther EU action to promote smoke-free 
environments. The Community strategy on heal th and safety at work (2007-2012) proposed 
greater efforts to improve health  and safety protection for workers. At international level, the 
WHO Framework Convention on Tobacco Control (FCTC) commits its Parties to tackle 
exposure to tobacco smoke in indoor workplaces and public places. 
2. C ONTEXT AND PROBLEM DEFINITION  
2.1. Context 
2.1.1. Health burden of ETS exposure Exposure to environmental tobacco smoke (ETS) – also referred to as second-hand smoke or 
passive smoke – is a source of widespread mort ality, morbidity and disability in the EU. ETS 
is linked to lung cancer, coronary heart dise ase, stroke, asthma and chronic obstructive 
pulmonary disease in adults. It is also ha rmful to children, causi ng sudden infant death 
syndrome, acute respiratory infections, mi ddle ear disease and more severe asthma. 
According to earlier estimates, 7 300 adults, in cluding 2 800 non-smokers, di ed as a result of 
ETS exposure at their workplace in the EU-25 in 2002. The deaths of a further 72 000 people, 
including 16 400 non-smokers, were lin ked to ETS exposure at home.
1 This Impact 
Assessment estimates the total number of deaths attributable to passive smoking in offices and 
bars/restaurants at 6 000 in the EU-27 in 2008, which includes 2 500 non-smoking staff. The 
exposure among non-staff members such as the cu stomers of bars and restaurants could be 
expected to account for a substan tial additional health burden.  
                                                 
1 The Smoke Free Partnership (2006). Lifting the smokescreen: 10 reasons for a smoke-free Europe 
Brussels, Belgium, European Respiratory Society: 146 . 
 
EN 3   EN Estimated EU-wide mortality due to ETS exposur e among smoking and non-smoking staff in 2008 
 Non-smokers Smokers Smokers and 
Non-Smokers 
 Offices Bars and 
restaurants Total Offices Bars and 
restaurants Total Total 
Lung cancer 387   156   542   600   161   761  1303 
Stroke  378  160  538   601   197   798  1336 
Heart disease  384   138   522  612   159   771  1293 
Chronic lower  
respiratory disease  565  332  897  881   296   1,176  2073 
Total  1,714   786   2,500  2,694   813   3,507  6,007  
Comparison with fatalities from other health hazards - both specific to the workplace and 
occurring in the general populat ion - shows the significant hea lth burden of ETS exposure. 
2.1.2. Economic burden of ETS exposure 
Exposure to ETS poses a significant financial burden. The macroeconomic cost of workplace 
exposure to ETS across the EU-27 has been estimated at 2.46 billion euro per year. This consists of over 1.3 billion euro constituting medical expenditure on tobacco-related diseases (including €560 million accounted for by non-sm oking staff) and over 1.1 billion euro 
constituting non-medical costs linked to  productivity losses (including €480 million 
accounted for by non-smoking staff). The micro economic burden of ETS exposure includes 
lower workers' productivity, fire damage cau sed by smoking materials as well as additional 
cleaning and redecoration costs related to smoking. 
2.2. Problem definition 
2.2.1. Incomplete compliance with interna tional obligations resulting from FCTC 
The WHO Framework Convention on Tobacco C ontrol (FCTC) – ratified by the Community 
and 26 Member States – creates a legal obliga tion for its Parties to protect people from 
second-hand smoke in all indoor workplaces, public transport and indoor public places. The 
second Conference of the Parties to the Convent ion in July 2007 adopted guidelines setting a 
"gold standard" that every Party should aim to achieve.  
However, as things stand, only slightly over a th ird of Member States ha ve adopted policies to 
comply with their FCTC commitment. A numb er of countries have encountered serious 
difficulties in introducing and/ or enforcing comprehensiv e smoke-free laws. Bars and 
restaurants have proved to be a particularly difficult area of regulation. At the moment, it 
seems unlikely that all Member States will be able to meet their FCTC obligation unless there 
is a political stimulus and a mon itoring mechanism at EU level.  
So far, only partial action to promote smok e-free environments has been taken by the 
Community. This issue has been  addressed in non-binding re solutions and recommendations, 
but they do not provid e detailed guidance on how to achieve fully smoke-free environments. 
In addition, a number of occupational health and safety directives address the issue, in some 
cases indirectly only while in others the level of protection is not comprehensive.  
 
EN 4   EN 2.2.2. High and uneven ETS prevalence across the EU-27 
In countries with no comprehens ive smoke-free regulations, tobacco  is present in the majority 
of public places, most of which are also somebody's workplace. Based on the Eurobarometer data from the end of 2006, it is estimated that 28% of EU employees are exposed to ETS on a 
daily basis in indoor workplaces and offi ces, and the corresponding figure for bars and 
restaurants is 39% as of end-2008. In addition, the customers of drinking and eating venues 
are at risk of particularly high levels of e xposure to ETS and the related health hazards.  
There are huge differences in the prevalen ce of ETS exposure between Member States, 
ranging from 3% in Ireland to 85% in Greece. Th e scope and strength of national smoke-free 
legislation is a crucial factor responsible for the differences in ETS exposure across the EU.  
In addition, the risk of being exposed to ETS  is significantly higher for the lower socio-
economic groups, exacerbating the ex isting inequalities in health. 
2.2.3. Inadequate protection of children and young people from tobacco smoke 
Children's and adolescents' exposur e to tobacco smoke is a partic ular health concern. Children 
have little or no control over their exposure to ETS from adult smokers. Children are also 
particularly vulnerable to the h ealth effects of ETS. In additi on to the health risks of ETS, 
exposure to tobacco smoke makes children more  likely to perceive smoking as common adult 
behaviour and thus to take up smoki ng themselves in adolescence.  
Most of children’s exposure to ETS comes from parents, and occurs in the home. In the last 
Eurobarometer, over a third of smokers said  that they smoke inside their home in the 
company of children. The WHO Global Y outh Tobacco Study found that 40-90% of 
teenagers were exposed to ETS in their homes across twelve EU Member  States. In addition 
to homes, parental smoking in cars is a source of exposure to particularly high levels of ETS.  
Children are also routinely expo sed to adult role models smoki ng in outdoor places such as 
public playgrounds, outdoor areas of schools, hos pitals and other institutions providing 
services to children as well as during outdoor sports or cultural events.  
3. R
ATIONALE FOR EU ACTION  
Articles 137 and 152 of the EC Tr eaty provide a clear legal basi s for an EU measure in the 
area of protection from tobacco smoke. Such s upport at EU level would help the timely and 
coherent implementation of the FCTC provisions in  line with the Member States' and the EU's 
international commitments. It would also contri bute to reducing the di fferences in protection 
from ETS exposure both between and within Member States and the resulting health 
inequities and negative cross- border implications. Community action would bring clear added 
value to national efforts by se tting out the evidence base, facilitating the exchange of 
experience and best practice among Member Stat es, providing Member St ates that have not 
yet implemented comprehensive smoke-free legi slation with guidance for doing so (possibly 
accompanied by minimum EU standards for work er protection), and monitoring progress 
throughout the EU.  
 
EN 5   EN 4.
 O BJECTIVES
Improve the health of citizens and workers in 
line with Art. 152 and 137 EC Treaty through reductions in tobacco–related illness and 
mortality
Assist MS to eliminate ETS 
exposure in workplaces/public places and to promote smoke-free homes
Translate FCTC provisions into EU context Monitor progress towards smoke-free environments Comply with EU and MS obligations under FCTC General objective
Specific objectives 
Specific objectives 
 
5. P OLICY OPTIONS  
1) No change from status quo 
This option would mean no new ac tivity on the part of the EU , while continuing the current 
work on ETS under the different Community programmes, information and education 
campaigns and networking initiatives. 
2) Open method of coordination  (OMC)   
Under this option Member States would be  encouraged to cooperate on smoke-free 
environments with a view to exchanging info rmation, agreeing common targets and indicators 
and periodic review. A coordina ting body bringing together Member  States and the European 
Commission would need to be set up. The content of this option would depend on agreements between Member States but theoretically coul d be comprehensive in scope and could go 
beyond the FCTC guidelines (focused on protec tion from ETS in indoor public places and 
workplaces). 
3)
 / 4) Commission or Council Recommendation   
A Recommendation from the Co mmission or the Council based on Art. 152would encourage 
and assist Member States in introducing compre hensive smoke-free policies in line with their 
FCTC requirement by introducing a uniform EU  deadline for implementation and a clear 
reporting and monitoring mechanism. On top of  the provisions of the FCTC guidelines, such 
Recommendation should include measures to  tackle ETS exposure among children and 
adolescents as well as flanking measures su ch as awareness raising and smoking cessation 
support. 
3+ / 4+ Combination of Commission or Co uncil Recommendation and Open Method of 
Coordination 
 
EN 6   EN A Commission or Council Recommendation coul d be an incentive for strengthened 
cooperation between Member States. In this s cenario, the text of the Recommendation would 
serve as a basis and point of reference while Member States would exchange information and 
best practice on its implementation, adopt co mmon targets and benchmarks for reaching and 
possibly going beyond its requirements, and devel op common indicators to monitor progress.  
5) Binding legislation   
The adoption of binding legislative measures coul d consist in revision of the existing health 
and safety directives (in particular Dire ctive 89/654/EEC on minimum health and safety 
requirements for workplaces and/or the Carcin ogens and Mutagens Directive 2004/37) or 
enactment of a separate directive on workpl ace smoking based on Art. 137. This option would 
be restricted in scope to the workplace envir onment and would not cover either public places 
that are not workplaces or self-employed workers.  
6. A SSESSING THE OPTIONS  
The identified policy options have  been analysed across five  main parameters: the added 
value of EU involvement, the expected speedines s of adoption of the given policy instrument, 
the likely content of the policy option, the level of political or legal obligation to comply on 
the part of the Member States and possi ble unintended consequences. Based on this 
qualitative analysis and the forecasted develo pments in the Member States, the following 
assumptions have been made about the relative effectiveness of each of  the policy options in 
reducing ETS prevalence by 2013 (i.e. the last year of the current Health Strategy):  
Policy 1 (status quo) would bring the least reduc tion in ETS prevalence ratios that would be 
largely consistent with a situation in which countries with advanced or fairly advanced 
smoke-free legislation proposals have implem ented their proposed policies by 2013. The 
existing trend towards smoke-free could be expe cted to continue, but at a slower pace.  
The effects of the five non-regulatory options ar e likely to be somehow similar in the sense 
that they would offer support for policy develo pment but could not oblige Member States to 
adopt and enforce smoke-free laws . They are expected to have the potential to bring about a 
two- to fourfold reduction in ETS prevalence ra tios as compared to the status quo. Policy 2 
(OMC) and Policy 3 (Commission Recommendation) ar e likely to be the least effective out of 
the non-regulatory options. The implementation of  OMC would be relatively lengthy and it 
does not seem well suited to tackling a "mat ure" problem like ETS. The impact of a 
Commission Recommendati on, on the other hand, would be limited by the fact that it would 
not create a sense of commitment among Member States. Policy 4 (Council 
Recommendation) is potentially more effective, primarily due to the ownership effect. Similar 
effects could be assumed for Policy 3+ (Com mission Recommendation with OMC). Policy 4+ 
(Council Recommendation with OMC) is expected  to be most effective out of the non-
regulatory options. It would give  the strongest sense of owne rship to Member States, who 
would be involved both in adopting the text of the Recommendation and in developing 
benchmarks and indicators for its implementation. 
Policy 5 (binding legislation) is likely to bri ng the greatest reductions in ETS prevalence. In 
the best-case scenario, it could be expected to virtually eliminate ETS exposure in workplaces 
throughout the EU. However, it would be narrowe r in scope than the non-regulatory options 
since self-employed workers as well as flan king measures would not be covered by the 
legislation. In addition, the time frame for real ising the benefits stemming from a new legal 
instrument is likely to be relatively lengthy.  
 
EN 7   EN 6.1. Comparing the options 
The expected social, economic and environmen tal impacts under each of the policy options 
are based on the assumptions about their potent ial to reduce the preval ence of ETS exposure. 
Policy option 5 (binding legislati on) is therefore expected to  have the strongest effect, 
followed by option 4+ (Council Recommendati on + OMC), 4/3+ (Council Recommendation / 
Commission Recommendation + OMC) + and 2/3 (OMC / Commission Recommendation), 
while the status quo would bring the least change.  
6.1.1. Social impacts 
By reducing the prevalence of ETS exposure, an  EU initiative is expected to reduce illness 
and mortality from major ETS-a ssociated diseases (lung cancer,  stroke, heart disease and 
chronic lower respiratory diseases). It is also ex pected to have an indirect effect on morbidity 
and mortality associated with active smoking by reducing tobacco consumption and encouraging quit attempts among smokers. An EU  initiative would likely bring particular 
benefits to the most deprived groups in societ y. It could also help increase support for smoke-
free policies, including at hom e. A possible unintended conse quence for smokers could be a 
sense of stigma and alienation. 
 Baseline Policy 1 Policy 2/ 
Policy 3 Policy 3+ 
/Policy 4 Policy 4+ Policy 5 
Social impacts  
Reduction in annual mortality due to 
ETS exposure among staff  6,007  -386 -774 -774 to -
1,550 -1,550 -4,884 
Reduction in morbidity due to ETS 
exposure  + ++ +++ ++++ +++++ 
Reduction in mortality from reduced 
active smoking  + ++ +++ ++++ +++++ 
Reduction in morbidity from reduced 
active smoking  + ++ +++ ++++ +++++ 
Reduction of ETS at home  + ++ ++ ++ +++ 
Reduction in socio-economic 
inequalities  + ++ ++ ++ ++++ 
Increased support for smoke-free 
policies  + ++ ++ ++ ++++ 
6.1.2. Economic impacts 
At macro-level, the health improvement resulting from an EU initiative is expected to 
substantially reduce medical a nd non-medical costs connecte d with major ETS-associated 
diseases. The anticipated reducti on in the levels of active smoking is unlikely to have a 
significant impact on the Member States' re venues from tobacco taxation. The economic 
impacts at the micro-level include reduced cl eaning, maintenance and redecorating costs and 
reduced costs related to fire damage.  
The main sectors concerned are the hospitali ty and the tobacco industries. Based on the 
evidence reported in the literature, the impact on employment and revenue in the hospitality 
sector could range from reductions to increa ses. Overall, no major economic impact is 
expected. There may be a loss of profit to the tobacco industry and, c onsequently, reductions 
in tobacco-related employment.  
 Baseline Policy 1 Policy 2/ 
Policy 3 Policy 3+ 
/Policy 4 Policy 4+ Policy 5 
 
EN 8   EN Economic impacts 
Reduction in annual medical 
costs due to reduced ETS 
exposure among staff  €1336 
mn -€ 85 mn -€172 mn -€172 mn to 
-€344 mn -€344 mn -€1073 mn 
Reduction in annual non-
medical costs due to reduced 
ETS exposure among staff  €1124 
mn -73 mn -144 mn -144 mn to -
290 mn -290 mn -893 mn 
Reduced revenues from 
tobacco taxes  - -- --- ---- ----- 
Workers' productivity related to 
smoking breaks   +/- ++/-- +++/--- ++++/---- ++++/----- 
 
Reduced costs of fires, 
cleaning and redecoration  + ++ +++ ++++ +++++ 
€965 mn 
Annual change in revenues in 
hospitality sector  €114 bn 
 +/- ++/-- +++/--- ++++/---- +++++/------ 
-€11bn to 
+€10 bn 
Change in employment in 
hospitality sector 6,887,912  +/- ++/-- +++/--- ++++/---- +++++/------ 
-265,000 to 
+271,000  
Annual lost revenues in 
tobacco industry 
 €67 bn - -- --- ---- ----- 
-€3.3 bn 
Lost jobs in tobacco industry 
 53,521 - -- --- ---- ----- 
-2,609 
Implementation and 
enforcement costs  - --- -- --- -- --- --- 
6.1.3. Environmental impacts 
The main environmental impact would be a sign ificant improvement in indoor air quality. The 
potential negative impacts include an increase in the use of patio heater s and increased litter 
from cigarette butts in the stre ets. However, these impacts are likely to be relatively small. 
 Baseline Policy 1 Policy 2/ 
Policy 3 Policy 3+ 
/Policy 4 Policy 4+ Policy 5 
Environmental impacts 
Reduction in indoor air pollution  + ++ ++ +++ ++++ 
Increased street litter and use 
of air heaters  - - - -- --- 
6.2. The preferred option 
While binding legislation would bring the bigg est reductions in ETS prevalence and the 
related health and economic benefits, its implementation w ould take longer and the scope 
would be narrower than would be th e case with a Recommendation. A Council 
Recommendation with elements of OMC has been  identified as the preferred option in the 
short term because it appears to be the fast est and most comprehensive means of helping 
Member States to implement strict smoke-fr ee laws in line with th eir FCTC commitment 
while providing a proportionate  approach to the problem. 
 
EN 9   EN 7. M ONITORING AND EVALUATION  
The indicators used to monitor the effects of the chosen policy option need to include the 
prevalence and quality of nationa l policies, exposure to tobacco smoke in different settings, 
tobacco use, knowledge and attit udes related to tobacco (smoke) as well as the incidence of 
and mortality from tobacco-related diseases. It is envisaged to evaluate the overall impact of 
the initiative in a Communication on tobacco  control strategy, planned for 2010 or 2011.