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An Evaluation of the Effectiveness of Tobacco-Control Legislative Policies in European Community Countries

Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece

A. J. Sasco

Unit of Analytical Epidemiology, International Agency for Research on Cancer, Lyon, France

Y. Skalkidis

Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece

K. Katsouyanni

Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece

D. Trichopoulos

D. Trichopoulos, Department of Epidemiology, Harvard School of Public Health, Boston, Mass., U.S.A., Address for reprints: D. Trichopoulos Harvard School of Public Health Department of Epidemiology 677 Huntington Avenue Boston, MA 02115, U.S.A.

The purpose of this paper was to assess the effectiveness of anti-tobacco smoking legislation from 1948 onwards in reducing actual per capita tobacco consumption in the twelve countries of the European Economic Community (EEC). In order to undertake these assessments a score was assigned to every legislative measure, indicating the a priori likely impact of this measure on tobacco consumption. Two approaches were then utilized. In the first, it was found that the cumulative anti-tobacco legislative score correlates well in time with a reduction of tobacco consumption. In the second, cross-sectional data from the EEC countries and multiple regression modelling were used to estimate the elasticities of tobacco price, per capita income and cumulative anti-tobacco legislation score; it was found that legislation has an impact on tobacco consumption which, although considerably smaller than the corresponding impact of tobacco price levels, is nominally significant and potentially important. The evaluative approaches utilized in this paper are based on observational data of ecologic nature and can provide only weak evidence about the causal nature of the reported associations. Nevertheless, this limited evidence suggests that legislative measures may be effective both by affecting price levels and through other mechanisms, including health education and the formation of a more general anti-smoking ethos.

Key Words: smoking • legislation • effectiveness • economics • evaluation • EEC countries

Scandinavian Journal of Public Health, Vol. 18, No. 2, 81-89 (1990)
DOI: 10.1177/140349489001800201


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