Support for Population Level Tobacco Control Policies in Hungary

By Paulik, Edit; Maróti-Nagy, Ágnes et al. | Central European Journal of Public Health, March 2012 | Go to article overview

Support for Population Level Tobacco Control Policies in Hungary


Paulik, Edit, Maróti-Nagy, Ágnes, Nagymajtényi, László, Rogers, Todd, Easterling, Doug, Central European Journal of Public Health


SUMMARY

Background: Smoking is the leading, preventable risk factor for premature death and disability in Hungary. The objective of this paper was to assess the social acceptability of and the predictors of holding favourable attitudes toward tobacco control policies among the Hungarian population.

Methods: A self-administered questionnaire-based study was carried out among individuals aged 16-70 years. Logistic regression analysis was used to assess whether support for the ten tobacco control policies varies as a function of age, sex, educational level, and smoking status.

Results: The majority of the respondents supported the studied tobacco control measures. Over 90 percent of the sample supported: fines for retailers selling tobacco products to minors (92.3%), stricter enforcement of restrictions on selling tobacco products to minors (90.5%), and a ban on smoking in health care institutions (91.4%). The lowest levels of support were for bans on sponsorship by the tobacco industry (52.8%) and price increases on tobacco products (54.9%). For each measure, support was significantly lower among smokers than non-smokers. Age and education were significantly related to support for some but not all measures.

Conclusions: Strong majorities of Hungarians support the enactment and enforcement of a wide range of tobacco control measures, a fact that was acknowledged by Parliament's passage of the 2011 Anti-Smoking Law. Advocacy efforts to encourage the acceptance of tobacco control policies should focus not only on smokers, but also on younger and less educated non-smokers.

Key words: smoking, tobacco control, public policy

INTRODUCTION

Hungary has one of the highest rates of smoking among European countries (1), and leads the world in the rate of male lung cancer deaths and in the rate of coronary heart disease in men and women under the age of 65 years (2). It is well established that taxes on tobacco, smoking bans, advertising restrictions, and other tobacco-control policies have a dramatic impact on smoking prevalence and health-related outcomes (3, 4). Beginning in the early 1 990s, the Hungarian government enacted a series of important tobacco control policy measures. The Labour Safety Act of 1993 stipulated that specific smoking areas must be designated in all workplaces, or other organizational measures taken to provide for elimination of the harmful effects of environmental tobacco smoke (5). The Act on Advertising in 1997 (amended in 2001, 2005, 2008) banned direct and indirect advertising for tobacco products (6-8). The Anti-Smoking Law in 1999 made it illegal to sell tobacco products to anyone under 18, banned smoking in public buildings and on public transport, and prescribed separate smoking areas in restaurants (9, 10).

In 2004, Hungary ratified the WHO Framework Convention on Tobacco Control (FCTC) and committed to implementing policies in support of FCTC such as prohibiting smoking in offices, public buildings, restaurants, bars, company vehicles, and even in playgrounds (11). Following up on this commitment, the Hungarian Parliament amended the 1 999 Anti-Smoking Law in April 2011 to more strictly regulate smoking in public places. The new law, which takes full effect in 2012, bans smoking completely in restaurants, workplaces, health care institutions, and closed public places as well as in specific outdoor public places including bus stops and playgrounds (12).

In addition to these laws restricting tobacco use, the Hungarian government has also increased taxes as means of discouraging smoking. Tobacco excise taxes were enacted several times during the last decades (e.g., in 1 998, 2003, 2004 and 2006). Despite these tax increases, Hungary continues to maintain comparatively low prices for tobacco products in relation to average income (13,14).

Tobacco control policy in Hungary has been enacted not only at the national level. More progressive "settlements" (generally mid-sized and larger cities) were out in front of the national government with regard to banning smoking in restaurants, public spaces, and playgrounds. …

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