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Speech by Commissioner Vytenis Andriukaitis on the occasion of the World Cancer Day

Met dank overgenomen van V.P. (Vytenis) Andriukaitis, gepubliceerd op maandag 4 februari 2019.

Axiotime kyrie Proedre,

Kirie Ipourge,

Kiries kai kirioi,

Chéromai idiétera pou vriskomai stin Athina simera mazi sas, prokeiménou na sizitisoume ta thémata igias pou prokiptoun apo to kápnisma.

To kápnisma katastréfei tis zoés mas, ti zoi ton paidión mas kai ton eggonón mas, eno episis ripéni to perivállon. To kápnisma mas skotóni sigá sigá.*[i]

In 2016, scientists discovered evidence of cancer in a 1.7-million-year-old bone belonging to a human relative in South Africa.

It seems that cancer is as old as time itself. In fact, it has accompanied us through the ages.

Around 2600 BC, an Egyptian physician wrote about a “bulging mass in the breast” that was resistant to treatment. It is believed to be one of the first documented cases of breast cancer.

More than 2000 years later, Hippocrates argued that cancer was caused by an imbalance of fluids in the body. He used “carcinos”, the Greek word for crab, to describe a growth of cancerous cells.

In the Second Century, Galen began calling benign tumours “oncos”, from the Greek term for swelling. The Greek physician also wrote about the importance of early detection and the potential for surgical cures.

And in the seventeen hundreds, an English surgeon described an occupational cancer in chimney sweeps caused by chimney soot.

Cancer is clearly part of our history.

Unfortunately, it is very much part of our present too - there are few among us who have not been touched in some way by this disease.

According to the recent State of Health in the EU report, cancer is Europe's second leading cause of death -- it claimed more than 1.3 million lives last year.

Almost 4 million new cases are expected this year in the EU alone.

World Cancer Day is a crucial part of our response to this disease. It empowers citizens and amplifies their collective voice. And I am delighted to be part of that effort.

So, I want to thank the Hellenic Cancer Society and President Pavlopoulos and Minister Xanthos for hosting this event. And thank you for giving me the opportunity to speak with you today.

We have made a lot of progress in cancer research and treatment in recent years.

But cancer is fought on several fronts - and not just in the research lab or the hospital. It is tackled in schools, doctors' surgeries and workplaces.

Crucially, both the public and private sector need to be involved, including a wide range of government departments.

This is no longer just the responsibility of the health sector.

The more we understand about the causes of cancer, the more we realise that we need to get ahead of this disease. And that means tackling cancer at its source and talking about obesity, alcohol abuse and healthy diets.

But today, I want to focus on tobacco consumption - which continues to be the single largest avoidable health risk.

The numbers are stark:

  • Tobacco is the most significant cause of premature death in the European Union.
  • Half of all smokers die prematurely, on average 14 years earlier.
  • And tobacco is responsible for a staggering number of deaths every year - nearly 700,000.

We should think not only about those who smoke but also about those who are affected by the environment full of smoke. Here I speak about passive or secondary smoking.

Exposure to passive smoking is still a problem in many European countries; Greece is one of them. According to Eurobarometer, Greece has an exposure rate in eating establishment of 78%, the worst in the EU and 87% exposure rate in drinking establishments, such as bars.

While the majority of these premature deaths are due to lung cancer, we must not forget that tobacco is also a major risk factor in many other forms of cancer, as well as other major diseases such as cardiovascular diseases.

Every one of these avoidable deaths is unacceptable to me - which is why I'm especially worried by the current trends in the EU:

  • The smoking rate in the EU has stayed at 26 percent since 2014.
  • I know that Greece has made great efforts and come a long way, but Greece still has the highest cigarette smoking rates in the EU, at 37 percent.
  • Amongst young people, the rate of smoking has increased EU-wide from 25 percent in 2014 to 29 percent in 2017.
  • At the same time, the mortality rate from lung cancer increased by almost 20% in the EU over the past decade.

Ladies and gentlemen,

As the European Commissioner for Health and Food Safety, as a doctor, as a father and grandfather, I am determined to protect citizens, particularly children, adolescents and young people.

Allow me to take a few moments to discuss exactly what the EU is doing to promote tobacco control.

The Tobacco Products Directive became fully applicable in the EU in 2016 and is a key piece of legislation in this area.

One of its core aims is to make tobacco products less attractive to young people.

For example, picture and text warnings now cover 65 percent of the front and back of cigarette packs.

Some EU countries are going even further - France, the United Kingdom, Ireland and Hungary are implementing plain packaging measures and others are moving in this direction too.

As well as larger health warnings, key provisions include bans on promotional and misleading elements on tobacco products, stronger regulation on ingredients and the introduction of the new tracking and tracing system.

The Tobacco Products Directive is also the first comprehensive legislation regulating e-cigarettes.

This is important, because I am concerned by the numbers of young people taking up vaping and various new tobacco products.

I want to assure you that we will monitor these products carefully and regulate them appropriately.

Almost three-years since the Tobacco Products Directive has come into force, the implementation is now in full swing in the Member States. The Commission continues to track its application and I encourage you all to do your utmost to ensure that it is implemented and enforced correctly.

I must also say that the growing popularity of new tobacco products among young people especially worries me. We cannot deny the reality. We cannot go on pretending that e-cigarettes are for smoking cessation when we see so many young people starting to smoke them.

That is why I am very happy that the 8th Conference of the Parties to the World Health Organisation's Framework Convention on Tobacco Control was a milestone for tobacco control work: at the initiative of the EU, it adopted a decision to acknowledge that novel and emerging tobacco products fall under the remit of the Convention and should be comprehensively regulated.

In addition, as part of the Tobacco Products Directive, the EU is currently rolling out the first regional track and trace system for tobacco products. To ensure functionality of the system by 20 May 2019, it is now crucial that Member States deliver on their obligation to appoint an ID issuer.

Despite all the important progress made, I am still frustrated at how easy it is for young people to obtain tobacco products.

I am also disturbed by how much they are exposed to tobacco marketing and images projected in film and social media.

Illicit trade multiplies these dangers. For example, illicit sale makes it easier to buy tobacco products that are often cheaper and less likely to carry health warnings.

The track and trace system, which is being rolled out this year, was designed to minimise these risks.

Initially starting with cigarettes and roll-your-own tobacco, the cross-border track and trace system is due to be functional this May.

I am determined to curb illicit tobacco trade and I urge each Member State to do their part. I am looking forward to seeing the system up and running on time in all Member States.

Ladies and gentlemen,

Together, we are much greater than the sum of our parts. This is certainly true when it comes to issues like tobacco.

The Joint Action on Tobacco Control, which we launched here in Athens one year ago, is an excellent example of the potential for collaboration.

And I want to take this opportunity to thank President Pavlopoulos and Minister Xanthos, who were present that day, for their continued support.

Coordinated by the Hellenic Cancer Society, this three-year collaborative action brings together dozens of partners from 31 countries, including 25 Member States.

As you can see, this is a pan-European initiative.

So, what exactly does the Joint Action contain?

Well, core work packages include the assessment of data on tobacco products and e-cigarettes; laboratory collaboration and evaluation of priority additives.

With a budget of EUR 2.5 million, 80 percent of which is financed by the EU Health Programme, this will deliver tangible benefits to citizens.

Ladies and gentlemen,

There are more than 7 million tobacco associated deaths around the world each year. Clearly, a global approach is needed.

This is the very reason for which the EU and its Member States are strong supporters of the World Health Organisation Framework Convention on Tobacco Control (FCTC).

It is the first global public health treaty and something that the EU is proud to have helped shape.

While the FCTC includes traditional public health work, it also addresses broader tobacco control issues, such as alternatives to tobacco farming, illicit trade and taxation. The treaty also clarifies how policy-makers are to engage with the industry.

Public health policies shall be free from - I quote - ‘commercial and other vested interests of the tobacco industry'.

In 2013 Greece signed a Protocol to eliminate illicit trade in tobacco products. The signing is not enough, please ratify the Protocol as soon as possible!

The FCTC has a long-term vision, touching on major global ambitions such as the Sustainable Development Goals, which include environmental protection, climate change and human rights.

Let me turn your attention to the Sustainable Development Goals, which recognise the current smoking epidemic and underline the importance of reducing tobacco consumption in order to reach the goal of "good health and well-being for all".

Promisingly, the 2018 edition of the report monitoring progress in Sustainable Development in the EU shows that smoking prevalence has reduced considerably in the past ten years: from 32% in 2007 to 26% in 2017. However, it highlights again that there are large disparities between different Member States. The reasons for this are complex but an important component is differences in the strength of tobacco control policies.

So, although we are definitely moving in the right direction with tobacco consumption in the SDGs, the movement is slow and we still have far to go. Strengthening tobacco control policies is integral to this.

Crucially, the treaty applies to all of government, not just health ministers, and I am pleased to see partnerships across different government sectors.

Our recent action against cigarette butts is evidence of this collaborative approach.

Cigarette butts litter our streets and are often listed as the number one item in marine litter surveys. Last year, the European Commission proposed legislation as part of the European Strategy for Plastics.

The draft legislation foresees a range of activities for plastics and specifically for cigarette butts.

It involves Member States setting up extended producer responsibility schemes, so that cigarette producers will have to pay for the clean-up of littered cigarettes butts and for awareness-raising campaigns.

Ladies and Gentlemen,

I can clearly remember seeing lung cancers and other tobacco-associated cancers in my early days as a surgeon. I remember many of the patients and their families and the trauma they faced.

Too much precious time is stolen from us by this terrible disease.

But I want to finish by looking forwards, not back.

Twenty percent of respondents to the last Eurobarometer study said that people were smoking tobacco products inside when they last visited a bar.

This figure is much higher in some Member States. I am saddened to learn that citizens are using Facebook groups to identify bars in Greece where there is no indoor smoking.

So, in the immediate future, we must do more to enforce our existing smoke-free laws.

I also believe it is important to include e-cigarettes and novel tobacco products under smoke-free legislation. So, I encourage governments to be ambitious in drafting and enforcing new smoke-free laws.

At the same time, I will continue to work with my fellow Commissioners to address wider tobacco-related issues.

Cancer is certainly part of our history. And it is sadly part of our present too. It is relentless, but so are we.

So, let us do everything in our power to eliminate it from our future.

Sas efharistó thermá, kai pistévo óti enónontas tis prospáthies mas, tha xeperásoume to kakó pou légetai kápnisma.[ii]

[i] Dear President Pavlopoulos, Minister Xanthos, Ladies and Gentlemen, I am delighted to be here today in Athens together with you and to discuss tobacco control issues. Tobacco destroys our, our children's and grandchildren's' lives, it also pollutes our environment. Tobacco kills us slowly.

[ii] Let me thank you, I believe that by joining our efforts we will overcome this evil, which is called tobacco.



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