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}
Date: 2009-06-30
Institutions: European Commission
Subjects: EU action, EU programme, health policy, health risk, impact study, report, smoking, tobacco, tobacco industry

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COMMISSION OF THE EUROPEAN 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} 

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1. 

INTRODUCTION 

In its Environment and Health Action Plan (2004-2010), the Commission committed itself to 
improving  indoor  air  quality,  in  particular  by  encouraging  the  restriction  of  smoking  in  all 
workplaces. The consultation launched by the Commission'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  further  EU  action  to  promote  smoke-free 
environments.  The  Community  strategy  on  health  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. 

CONTEXT 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 mortality, morbidity and disability in the EU. ETS 
is  linked  to  lung  cancer,  coronary  heart  disease,  stroke,  asthma  and  chronic  obstructive 
pulmonary  disease  in  adults.  It  is  also  harmful  to  children,  causing  sudden  infant  death 
syndrome, acute respiratory infections, middle ear disease and more severe asthma. 

According to earlier estimates, 7 300 adults, including 2 800 non-smokers, died 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  linked  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  customers  of  bars  and  restaurants  could  be 
expected to account for a substantial 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. 

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Estimated EU-wide mortality due to ETS exposure among smoking and non-smoking staff in 2008 

Non-smokers 

Offices 

Bars and 
restaurants 

Total 

Offices 

Smokers 

Bars and 
restaurants 

Smokers and 
Non-Smokers 

Total 

Total 

Lung cancer 

Stroke 

Heart disease 

Chronic lower  
respiratory disease 

387  

 378 

 384  

 565 

 156  

 160  

 138  

 332  

 542  

538  

 522  

897  

 600  

 601  

612  

881  

 161  

 197  

 159  

 296  

 761  

 798  

 771  

 1,176  

Total 

 1,714  

 786  

 2,500 

 2,694  

 813  

 3,507  

1303 

1336 

1293 

2073 

6,007  

Comparison  with  fatalities  from  other  health  hazards  -  both  specific  to  the  workplace  and 
occurring in the general population - shows the significant health 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 microeconomic burden of  ETS exposure includes 
lower  workers'  productivity,  fire  damage  caused  by  smoking  materials  as  well  as  additional 
cleaning and redecoration costs related to smoking. 

2.2. 

Problem definition 

2.2.1. 

Incomplete compliance with international obligations resulting from FCTC 

The WHO Framework Convention on Tobacco Control (FCTC) – ratified by the Community 
and  26  Member  States  –  creates  a  legal  obligation  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 Convention in July 2007 adopted guidelines setting a 
"gold standard" that every Party should aim to achieve.  

However, as things stand, only slightly over a third of Member States have adopted policies to 
comply  with  their  FCTC  commitment.  A  number  of  countries  have  encountered  serious 
difficulties  in  introducing  and/or  enforcing  comprehensive  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 monitoring mechanism at EU level.  

So  far,  only  partial  action  to  promote  smoke-free  environments  has  been  taken  by  the 
Community. This issue has been addressed in non-binding resolutions and recommendations, 
but they do not provide 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.  

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2.2.2.  High and uneven ETS prevalence across the EU-27 

In countries with no comprehensive 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  offices,  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 exposure to ETS and the related health hazards.  

There  are  huge  differences  in  the  prevalence  of  ETS  exposure  between  Member  States, 
ranging from 3% in Ireland to 85% in Greece. The 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 existing inequalities in health. 

2.2.3. 

Inadequate protection of children and young people from tobacco smoke 

Children's and adolescents' exposure to tobacco smoke is a particular health concern. Children 
have  little  or  no  control  over  their  exposure  to  ETS  from  adult  smokers.  Children  are  also 
particularly  vulnerable  to  the  health  effects  of  ETS.  In  addition  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 smoking 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  Youth  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  exposed to adult role models smoking in  outdoor places  such as 
public  playgrounds,  outdoor  areas  of  schools,  hospitals  and  other  institutions  providing 
services to children as well as during outdoor sports or cultural events.  

3. 

RATIONALE FOR EU ACTION 

Articles 137 and 152 of the EC Treaty provide a clear legal basis for an EU measure in the 
area of protection from tobacco smoke. Such support 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 contribute to reducing the differences 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  setting  out  the  evidence  base,  facilitating  the  exchange  of 
experience and best practice among Member States, providing Member States that have not 
yet implemented comprehensive smoke-free legislation with guidance for doing so (possibly 
accompanied  by  minimum  EU  standards  for  worker  protection),  and  monitoring  progress 
throughout the EU.  

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4.

OBJECTIVES

General objective

Improve  the  health  of  citizens  and  workers  in 
line  with  Art.  152  and  137  EC  Treaty  through 
illness  and 
tobacco–related 
reductions 
mortality

in 

Specific objectives 

Specific objectives 

Comply  with  EU  and 
MS  obligations  under 
FCTC 

Assist MS to eliminate ETS 
exposure in workplaces/public 
places and to promote smoke-
free homes

Translate 
provisions 
context

FCTC 
into EU 

Monitor  progress 
smoke-free environments 

towards 

5. 

POLICY OPTIONS 

1) No change from status quo 

This option would mean no new activity 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 information, agreeing common targets and indicators 
and periodic review. A coordinating 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  could  be  comprehensive  in  scope  and  could  go 
beyond  the  FCTC  guidelines  (focused  on  protection  from  ETS  in  indoor  public  places  and 
workplaces). 

3) / 4) Commission or Council Recommendation  

A Recommendation from the Commission or the Council based on Art. 152would encourage 
and assist Member States in introducing comprehensive 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  such  as  awareness  raising  and  smoking  cessation 
support. 

3+ / 4+ Combination of Commission or Council Recommendation and Open Method of 
Coordination 

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A  Commission  or  Council  Recommendation  could  be  an  incentive  for  strengthened 
cooperation between Member States. In this scenario, 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 common targets and benchmarks for reaching and 
possibly going beyond its requirements, and develop common indicators to monitor progress.  

5) Binding legislation  

The adoption of binding legislative measures could consist in revision of the existing health 
and  safety  directives  (in  particular  Directive  89/654/EEC  on  minimum  health  and  safety 
requirements  for  workplaces  and/or  the  Carcinogens  and  Mutagens  Directive  2004/37)  or 
enactment of a separate directive on workplace smoking based on Art. 137. This option would 
be restricted in scope to the workplace environment and would not cover either public places 
that are not workplaces or self-employed workers.  

6. 

ASSESSING THE OPTIONS 

The  identified  policy  options  have  been  analysed  across  five  main  parameters:  the  added 
value of EU involvement, the expected speediness 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  possible  unintended  consequences.  Based  on  this 
qualitative  analysis  and  the  forecasted  developments  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 reduction 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  implemented  their  proposed  policies  by  2013.  The 
existing trend towards smoke-free could be expected to continue, but at a slower pace.  

The effects of the five non-regulatory options are likely to be somehow similar in the sense 
that they would offer support for policy development 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 ratios as compared to the status quo. Policy 2 
(OMC) and Policy 3 (Commission Recommendation) are 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  "mature"  problem  like  ETS.  The  impact  of  a 
Commission Recommendation, 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+ (Commission 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  ownership  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 bring 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 narrower in scope than the non-regulatory options 
since  self-employed  workers  as  well  as  flanking  measures  would  not  be  covered  by  the 
legislation. In addition, the time frame for realising the benefits stemming from a new legal 
instrument is likely to be relatively lengthy.  

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6.1. 

Comparing the options 

The  expected  social,  economic  and  environmental  impacts  under  each  of  the  policy  options 
are based on the assumptions about their potential to reduce the prevalence of ETS exposure. 
Policy  option  5  (binding  legislation)  is  therefore  expected  to  have  the  strongest  effect, 
followed by option 4+ (Council Recommendation + 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-associated  diseases  (lung  cancer,  stroke,  heart  disease  and 
chronic lower respiratory diseases). It is also expected 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 society. It could also help increase support for smoke-
free policies, including at home. A possible unintended consequence 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  

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 
inequalities 

in 

socio-economic 

Increased  support 
policies 

for  smoke-free 

6.1.2.  Economic impacts 

6,007  

-386 

-774 

+ 

+ 

+ 

+ 

+ 

+ 

++ 

++ 

++ 

++ 

++ 

++ 

-774 
1,550 

+++ 

+++ 

+++ 

++ 

++ 

++ 

to  -

-1,550 

-4,884 

++++ 

+++++ 

++++ 

+++++ 

++++ 

+++++ 

++ 

++ 

++ 

+++ 

++++ 

++++ 

At  macro-level,  the  health  improvement  resulting  from  an  EU  initiative  is  expected  to 
substantially  reduce  medical  and  non-medical  costs  connected  with  major  ETS-associated 
diseases.  The  anticipated  reduction  in  the  levels  of  active  smoking  is  unlikely  to  have  a 
significant  impact  on  the  Member  States'  revenues  from  tobacco  taxation.  The  economic 
impacts at the micro-level include reduced cleaning, maintenance and redecorating costs and 
reduced costs related to fire damage.  

The  main  sectors  concerned  are  the  hospitality  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  increases.  Overall,  no  major  economic  impact  is 
expected. There may be a loss of profit to the tobacco industry and, consequently, reductions 
in tobacco-related employment.  

Baseline 

Policy 1 

Policy 2/ 
Policy 3 

Policy 3+ 
/Policy 4 

Policy 4+ 

Policy 5 

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Economic impacts 

Reduction  in  annual  medical 
costs  due 
to  reduced  ETS 
exposure among staff  

Reduction 
in  annual  non-
medical  costs  due  to  reduced 
ETS exposure among staff  

Reduced 
tobacco taxes 

revenues 

from 

Workers'  productivity  related  to 
smoking breaks  

Reduced 
cleaning and redecoration 

costs 

of 

fires, 

Annual  change  in  revenues  in 
hospitality sector  

€1336 

mn 

€1124 

mn 

-€ 85 mn 

-€172 mn 

-73 mn 

-144 mn 

-€172 mn to 
-€344 mn 

-144 mn to -
290 mn 

-€344 mn 

-€1073 mn 

-290 mn 

-893 mn 

- 

+/- 

+ 

-- 

--- 

---- 

----- 

++/-- 

+++/--- 

++++/---- 

++++/----- 

++ 

+++ 

++++ 

+++++ 

€965 mn 

€114 bn 

+/- 

++/-- 

+++/--- 

++++/---- 

+++++/------ 

-€11bn 
+€10 bn 

to 

Change 
hospitality sector 

in  employment 

in 

6,887,912   +/- 

++/-- 

+++/--- 

++++/---- 

+++++/------ 

Annual 
tobacco industry 

lost 

revenues 

in 

€67 bn 

- 

-- 

--- 

---- 

Lost jobs in tobacco industry 

53,521 

Implementation 
enforcement costs 

and 

6.1.3.  Environmental impacts 

- 

- 

-- 

--- 

---- 

--- 

-- 

--- 

-- 

--- 

-265,000 
+271,000  

to 

----- 

-€3.3 bn 

----- 

-2,609 

--- 

The main environmental impact would be a significant improvement in indoor air quality. The 
potential negative impacts include an increase in the use of patio heaters and increased litter 
from cigarette butts in the streets. 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  biggest  reductions  in  ETS  prevalence  and  the 
related  health  and  economic  benefits,  its  implementation  would  take  longer  and  the  scope 
would  be  narrower  than  would  be  the  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  fastest  and  most  comprehensive  means  of  helping 
Member  States  to  implement  strict  smoke-free  laws  in  line  with  their  FCTC  commitment 
while providing a proportionate approach to the problem. 

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7. 

MONITORING AND EVALUATION 

The  indicators  used  to  monitor  the  effects  of  the  chosen  policy  option  need  to  include  the 
prevalence and quality of national policies, exposure to tobacco smoke in different settings, 
tobacco use, knowledge and attitudes 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.  

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