Selected Aspects of Tobacco Control in Bulgaria: Policy Review
Loubeau, Patricia R., Central European Journal of Public Health
This paper seeks to outline the challenges of tobacco consumption control in the transitional economy of Bulgaria. It focuses on issues of taxation, high unemployment, and smuggling while attempting to meet European Union (EU) requirements for tobacco control legislation that reduces smoking consumption. The issue of tobacco control is not a simple one and requires a multi-pronged approach. While Bulgaria has made some progress in adopting legislation, it needs to strengthen its efforts in terms of enforcement, stronger legislation and increased taxation of cigarettes.
Key words: smoking, tobacco control, Bulgaria, public health, economics, tobacco policy
Tobacco Control Legislation
Tobacco control legislation has gained prominence at the European Union (EU) level and the rest of the world due to the serious health impact of smoking. It is well known that smoking harms nearly every organ of the body, causing many diseases, and reduces quality of life and life expectancy. The highest recorded level of smoking was among men and was first recorded in 1948 when surveys started. At that time, 82% of men were smoking (1). It has been estimated that between 1950 and 2000, 60 million people worldwide have died from tobacco-related diseases (2). It is further estimated that by 2030 the worldwide death toll due to smoking will be around ten million annually (3).
The concern about smoking has been heightened as evidence mounts about the cost of smoking and the effects of second-hand smoke. Tobacco is the single largest cause of avoidable death; it accounts for over half a million deaths each year in the EU (4).
A "smoke-free Europe" is one of the priorities of the European Commission's public health, environment, employment and research policy. Substantial steps have already been taken to promote a smoke-free environment in the EU. Progress has been achieved due to legislative efforts and diligent health promotion efforts. In the early nineties, a number of EU health and safety at work directives defined certain restrictions on smoking at work. These were complemented by the Recommendation on Smoking Prevention of 2002 which called on Member States to provide protection from exposure to environmental tobacco in indoor workplaces, enclosed public places, and public transport (5).
National legislation differs widely across Member States. Italy, Malta, Sweden and parts of the United Kingdom have been cited as having excellent examples of effective measures to protect their citizens from the harmful effects of smoking. Other countries are less stringent in their legislation to restrict tobacco use. At present there is, however, a clear trend towards smoke-free environments throughout the EU Member States driven by legal requirements and public support at the EU level. For example, many Member States have regulations banning or restricting smoking in major public places, such as health care, educational and government facilities, and public transport.
In order to become part of the EU, a country is legally obligated to comply with and implement certain legal acts. Tobacco control legislation at the EU level consists of legally binding directives and non-binding resolutions and recommendations regarding tobacco control (6). Since 1991, Bulgaria has been a parliamentary democracy, and since January 2007, the country has been a member of the European Union. As such, the Bulgarian regulatory framework has been enacted somewhat exogenously by the process of joining the EU. Efforts to reduce tobacco consumption are not straightforward in a country with both an evolving economy and a change in the political system. The goal of this paper is to explore the pros and cons of tobacco taxation in the transitional economy of Bulgaria.
RESULTS AND DISCUSSION
Smoking Prevalence in Bulgaria
Tobacco has been grown, consumed, and exported in Bulgaria for centuries. …