Keynote speech van Directeur-Generaal Volksgezondheid bij 10th Conference of the Parties (COP10) to the WHO Framework Convention on Tobacco Control, the WHO FCTC.

Toespraak | 07-02-2024

Perspective from a Party, towards a smoke free generation in the Netherlands

Your excellencies, dear colleagues, distinguished participants, members of civil society, ladies, and gentlemen,

Thank you, Panama for hosting COP 10 in your beautiful country. Yesterday I visited lake Gatun and the canal and really enjoyed the beautiful scenery. Muchas gracias.

I am delighted to be here with you today and speak at this COP of the Framework Convention for Tobacco Control.
 
I would like to address two things today. First, the Dutch approach to tobacco control and second, our concern regarding emerging tobacco and nicotine products and how they affect our youth. These two issues contain some interesting lessons I’d like to share with you. 

I do not need to tell you that tobacco is a significant public health threat – killing 8,7 million people worldwide each year. In the Netherlands that number is about 19.000 per year on a population of 17,5 million people. Nearly 10% of the burden of disease in the Netherlands is caused by smoking. This makes smoking the main preventable cause of death and disease in the Netherlands. 
The WHO Framework Convention on Tobacco Control is our powerful tool to combat this global health threat through evidence-based measures that effectively protect children and adults from initiation and tobacco-related harm. Implementing this treaty is key to a successful tobacco control policy. The treaty instruments together with the MPOWER interventions, such as raising taxes, introducing smoke-free legislation and banning all tobacco advertising and promotion are at the base of our national approach to tobacco control.
For the Netherlands it is an honor that the WHO has acknowledged in July of last year that our country is now one of the four countries in the world that implemented all MPOWER measures at the highest level of achievement. Next to Brasil, Mauritius, and Turkey.
This also creates obligations, at least in the sense that we should actively promote the MPOWER principles and the Convention instruments and share our experiences. Something I gladly do today.   
To start, I would like to emphasize two important success factors in strengthening tobacco control policy: political will and a good cooperation with civil society or the whole of society approach as Mr Krech just mentioned it.

In the Netherlands tobacco control policy has changed over the last 20 years. In 2002/2003 political decisiveness made it possible to implement a comprehensive ban on the marketing and promotion of tobacco products. Especially the last 5 years we were able to make great progress, as in 2017, the government decided to adopt the clear ambition of achieving a smoke free generation and sign a National Prevention Agreement. This allowed us for instance to raise taxes, introduce plain packaging, a display ban and reduce the number of points of sale. 

In our National Prevention Agreement the government has a fruitful cooperation with an active civil society. It was the Dutch Alliance for a Smoke-free Society that created the smokefree generation movement which increased the acceptance among the Dutch population for tobacco control measures. This led to the government adopting the goal of a smoke free generation in 2040. This means a maximum of 5% adult smokers, no youth smoking and no smoking amongst pregnant women in 2040. Next to the Alliance for a Smoke-free Society there is the bottom up initiative of the Dutch Cancer Agenda; A co-creation of over 100 health organizations, health institutes, patient organizations and many health professionals. Also within this Agenda the protection of children and adults from tobacco initiation and tobacco-related harm is one of the main goals. 

An important lesson would therefore be to cooperate with civil society in order to create social and political support for stricter tobacco control. And secondly, exploit political opportunities when they present themselves and make sure policy making is prepared for these opportunities. 

Where are we now? In 2010 we noted a smoking prevalence of almost 27%, dropping to 19 % in 2022. This is a reduction close to the voluntary global target of a 30% reduction in tobacco use, but it is not enough. We are pleased that the European Union has set a similar target for 2040 in the EU Beating Cancer Plan and we are looking forward to working together within the EU to strengthen the EU instruments to reach this important ambition. EU regulation has been very important as a base line for tobacco control helping us to gradually move forward. And I already stressed the importance of the FCTC and the work of WHO to combat smoking. 

So, a third lesson would be to cooperate internationally, because we face a global industry, we live in a highly globalised world and one country can only do so much. A clear example is the raise of taxes, one of the most important tools to bring tobacco use down and which could be more effective when that is done with all countries together.

Another lesson I would like to share with you is that we must look ahead. The tobacco industry always finds new ways to circumvent legislation. This is illustrated by the introduction of alternative nicotine products. As many of you have witnessed, new tobacco and nicotine products are becoming more and more popular among young people. These products are supposedly designed to help existing smokers to quit, but in practice these products mainly attract young people. In the Netherlands we are very concerned. These colorful and fancy products with attractive flavors have become very popular among Dutch school youth. Nicotine is especially addictive and harmful in young people: young people are more sensitive to nicotine and the brain keeps developing up to 25 years of age.
Recent figures on the use of tobacco and of the use of e-cigarettes amongst young people between 12 and 25 years of age in the Netherlands show a worrying picture:
One out of ten used an e-cigarette in the last month and of these young e-cigarettes users, 70% smoked classic cigarettes as well!
This shows us that e-cigarette use and tobacco use go hand in hand. It illustrates that we should not only focus on tobacco but also on nicotine products, when our goal is to reach a smokefree generation. We should strive to prevent the uptake of emerging tobacco and nicotine and products, especially among the youth. Recently we took measures that will also help in this respect such as a ban on internet sales for all tobacco and nicotine products, a significant tax raise on tobacco products and a flavor ban on e-cigarettes. We are also working on a ban on oral nicotine products We hope to learn from experiences from other parties how they address youth uptake. Taking measures together makes us more effective in protecting our youth.
This COP 10 brings us together to face common challenges which require a global answer, for instance the emergence of new tobacco and nicotine products that are attractive in design and flavor. And we are all faced with innovative marketing strategies using social media platforms with their cross border challenges. 
It is important we further develop the Framework and we should not be afraid to be too ambitious, because the outcome of this week in Panama will certainly make a difference in real life and will help us to better protect the health of our youth. 

Muchas gracias.