Tobacco use is the leading preventable cause of death, both globally and in the WHO European Region. But these deaths do not affect smokers only. Second-hand tobacco smoke is estimated to cause about 600 000 premature deaths per year worldwide, with 31% occurring among children and 64% among women. In the European Union, 19 000 non-smokers die each year due to the impact of second-hand smoke. 

When it doesn't kill, second-hand smoke causes serious illness, such as coronary heart disease and lung cancer. Children exposed to second-hand tobacco smoke have a 50-100% higher risk of developing acute respiratory illness, and exposure also increases the incidence of ear infections and the likelihood of developmental disabilities and behavioural problems. 

Moreover, second-hand smoke contributes to inequality and imposes a large economic burden on both the individual and society. 

Smoke-free legislation works

Research clearly and unequivocally shows that there is no safe level of exposure to second-hand smoke. Therefore, comprehensive smoke-free laws offer the only effective means of eliminating the risks associated with second-hand tobacco smoke. The primary purpose of such laws, which establish smoke-free public places, is to protect workers and the public from the serious risks posed by tobacco smoke. Article 8 of the WHO Framework Convention on Tobacco Control (WHO FCTC) provides the basis for international action to protect people from exposure to tobacco smoke.

Smoke-free public places protect non-smokers, in particular, from the harmful effects of second-hand smoke. But they also have many other benefits, such as providing smokers with a strong incentive to cut down or quit, as well as discouraging people – especially youth – from starting to smoke. They also benefit businesses, as families with children, most non-smokers and even smokers, themselves, often prefer smoke-free establishments. Smoke-free public places provide a low-cost method for reducing exposure to tobacco smoke.

Momentum building for smoke-free public places

Out of all tobacco control measures, Article 8 has one of the highest implementation rates globally. The WHO European Region has made progress over the past few years in legislating to create more smoke-free public places. Within the Region, 21% of countries have passed complete smoke-free legislation. Educational and healthcare facilities are the most common places where smoking has been prohibited. Some countries, however, do not yet prohibit smoking in healthcare facilities but do prohibit it in restaurants, pubs and bars, where the highest exposure of second-hand smoke in the Region occurs.

The general public, including both non-smokers and smokers, strongly supports smoke-free policies. Momentum is building in the WHO European Region and elsewhere, and an increasing number of countries are implementing measures to protect their populations from the harm of tobacco smoke. As smoke-free policies proliferate, it is vital for countries to document their successes and share experiences, in order to inform and assist the efforts of other countries.