GSB 7.1 Standardlösung

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Diabetes in Germany - children and adolescents

Tobacco control

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Smoking cigarettes and other tobacco products is one of the most important risk factors for developing noncommunicable diseases, such as lung cancer, chronic obstructive pulmonary disease, cardiovascular diseases and type 2 diabetes (National Center for Chronic Disease Prevention and Health Promotion Office on Smoking Health, 2014; Wannamethee et al., 2001; Zeiher et al., 2017; Zeiher et al., 2018). Measures for lowering the proportion of smokers within the population can make a significant contribution to reducing the burden of disease (Gredner et al., 2020; Levy et al., 2013; Tönnies et al., 2021). Smoking is also a risk factor for secondary diseases of diabetes, such as retinopathy and cardiovascular diseases. The tobacco control scale (Tobacco Control Scale, 2021) evaluates the measures for curbing tobacco consumption and passive smoking of a country, and thus makes it possible to make statements about the so-called tobacco control policy compared to other European countries (WHO, 2003).

Key messages

  • Compared to other European countries, in 2021 Germany is among the five countries with the lowest tobacco control.
  • The tobacco control policy in Germany has hardly changed in the last 20 years; improvements exist only in the area of public place bans and advertising bans.

Tobacco control scale 2021

Tobacco control scale 2021 in points
Country Total (100) Price (30) Public place bans (22) Budget (10) Ad bans (13) Health warning (10) Treatment (10) Illicit trade (3) Influence tobacco industry (2)
United Kingdom822722-129921
Ireland8227221139811
France7121183119621
Netherlands6715213109621
Hungary651621011962-
Norway6320171138310
Finland6217182135610
Iceland6115178134400
Romania611821085810
Belgium5914161109720
Spain581221195820
Turkey5815160810720
Denmark561311-139811
Israel5516150106800
Greece551322-75620
Malta551616011552-
Slovenia54916-139610
Italy521318095610
Russian Federation52919013461-
Lithuania5214151105520
Czechia491315085620
Estonia491315-115320
Poland4914110115710
Sweden491115095720
Croatia491411012552-
Latvia481213-115520
Austria481118075520
Cypus471212011552-
Luxembourg47916095620
Portugal461411-105420
Slovakia461113-95620
Ukraine461215-114400
Bulgaria441311-95510
Germany431411065520
Serbia381311091310
Switzerland a)351211125500
Bosnia & Herzegovina25144050200
a) Switzerland is the only country in this survey which has not ratified the WHO Framework Convention on Tobacco Control (FCTC): minus one point

Results

Compared internationally, Germany has dropped back steadily from 22nd place (out of 30 countries) in 2005 and is in 34th place (out of 37 countries) in 2021. The total number of points for Germany rose from 36 points in 2005 to 43 points in 2021 (of 100 possible points each). However, a strengthening of the measures and thus an increase from 2 points to 11 points (out of 22 possible points) and from 2 points to 6 points respectively, can be observed in this time period only for the components ‘public place bans’ and ‘advertising bans’. In contrast, there are hardly any changes in the components ‘treatment and smoking cessation’, and ‘health warnings’ between 2005 and 2021. The component ‘price’ decreased from 20 points to 14 points (out of 30 possible points). Currently, there are no noteworthy ‘public info campaign spending’ in Germany to control tobacco (0 of 15 possible points since 2013 or 10 possible points since 2019, respectively). While steps for ‘combatting illicit trade’ were taken in Germany (2 of 3 possible points), no measures for ‘limiting the influence of the tobacco industry’ are currently reported (0 of 2 possible points). Interactive graphics are available under the following link.


Conclusion

In 2021, in the tobacco control, Germany is in one of the last places in Europe and has implemented only few measures in the last 20 years. There is need for improvement in Germany in all areas of the tobacco control. To lower the risk factor smoking and thus the risk for type 2 diabetes and other noncommunicable diseases, the strengthening of political measures for the tobacco control appears to be expedient as these can reduce the proportion of smokers ( Levy et al., 2013; Levy et al., 2004).

Show more information on methodology and data sources

The indicator tobacco control is defined by the tobacco control scale, that means as the total amount of points (maximally 100 points are possible) of the points of various, defined components for the tobacco control according to Joossens et al. 2006. The components include ‘price’, ‘public place bans’, ‘public info campaign spending’, ‘advertising bans’, ‘health warnings’, and ‘treatment and smoking cessation’ and, since 2019, ‘combatting illicittrade’, and ‘limiting the influence of the tobacco industry’.

Data source

Reports of the tobacco control scale, regularly published under https://www.tobaccocontrolscale.org/ and promoted by health programs of the European Union under the auspices of the Association of European Cancer Leagues (ECL) and of the Institut Catala d’Oncologia (ICO).

Calculation

  • Description: Total number of points of the evaluation of the six components (2003 to 2016) or eight components (since 2019), respectively, of the tobacco control scale according to Joossens et al. 2006 with different weighting of the individual components resulting from the maximum number of points that can be reached for each component. The maximum number of points is 100 points. It is important to note that the weighting of the components has changed slightly since 2019 because the components ‘combatting illicit trade’ and ‘limiting the influence of the tobacco industry’ were newly added in 2019 (Joossens et al., 2020).

Data quality

The tobacco control scale is an evaluation tool for the tobacco control policies of European countries, which was developed with the help of an international committee. The components of the tobacco control scale are evaluated at regular intervals (every 2 to 3 years) by experts from the participating European countries. Due to the fact that relatively little evidence on the effectiveness of political measures relating to the tobacco control is currently available, the weighting of the components is still the subject of discussions (Tobacco Control Scale, 2021). The quantitative evaluation of the implemented political measures relating to the tobacco control is possible only to a limited extent. The tobacco control scale currently does not show all relevant areas of the tobacco control, so that the instrument is further developed on an ongoing basis, for example by adding two components in 2019 (Joossens et al., 2006).

Data download

References & external links

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