Tapani Piha

Tuesday, April 6 1999

Thank you Tapani for accepting our " rendez-vous ". May I ask you to introduce yourself ?

I am a specialist in community medicine and have worked for several years with health promotion and international health policy.

Currently I work as Counselor on health issues at the Finnish Representation to the European Union in Brussels.

My main task is to coordinate the Finnish relations with EU in health policy.

This is a continuation of my previous task at the Ministry of Social Affairs and Health in Finland where I also coordinated funding of health promotion.

In 1989-94, I worked at the WHO European Office where I was responsible for the development and implementation of one of the Office's major projects, the Action Plan on Tobacco for a Tobacco-free Europe.

Before that, I took care of the Finnish national tobacco policy.

My scientific background is in the epidemiological research and the prevention of cardiovascular diseases. Health promotion, international health policy, tobacco policy and microcomputers are my special interests.

1. We just learned about the collective resignation of the European Commissioners. What are your first reactions?
Do you see this as a shift of power in favor of the Europarliament? 
Do you think there 'll be implications for tobacco control?

The development of decision making in the European Union is a long process where the democratic elements have been gradually strengthened.

Everyone seems to agree that the role of the European Parliament should be stronger.

This can be seen as well in the Amsterdam Treaty as in the recent events.

I don't think that it has any immediate effects on the tobacco control policy in Europe.

2. Do you think new initiatives are going to take place in tobacco control at the EU level?
     If so, in what directions?

The past Commission promised several initiatives which were much welcomed by member states.

The need for new measures is also obvious.

Therefore I am sure that also the new Commission will propose legislative improvements to the tobacco control in the Union.

However, public health advocates must stay alert to make sure that initiatives are not stopped by counterinterests.

3. You have been in charge of the WHO-Europe tobacco control program, you spent some time with the DGV in Luxembourg (the service in charge of tobacco control for the EU Commission), you are now in Brussels.
      Do you think arenewed/increased cooperation is possible between WHO and the       EU Commission?

Definitely, and there are already good signs of that.

The Commission and WHO are preparing an exchange of letters to boost cooperation in many areas, including the tobacco control.

I know both WHO and EU as well as the national policy making and that has convinced me about the importance of cooperation.

Each player has a vital and complementary role.

WHO can lead the policy development from a purely public health point of view; EU has a mandate to make Community legislation and fund action; and member states can implement all aspects of the tobacco control.

However, more efforts by all partners are needed to promote mutual understanding.

An interesting area for cooperation will be the International Framework Convention for Tobacco Control initiated by WHO.

4. The financial resources for tobacco control have very often been very low and far from the stated objective of 1% of tobacco taxes.
     Do you foresee any progress there?
     At the national as well as at the EU level?
     How many people now staff the tobacco control program at the Commission?
     Could/should a structure similar to the US "Office of Smoking and Health" be created at the EU level?

When I was with the WHO European Office we tried to assess the resources available for tobacco control in member states but it turned out to be a very difficult job.

Resources are shared by many fields of health promotion or are hidden in health systems.

We concluded though that some identifiable tobacco control resources are needed for effective action.

At the same time they are a sign of serious commitment.

But more important is to put tobacco questions for example on the funding agenda of health research, health care system and environmental health.

Experience shows that broad health promotion is the best solution also in promoting nonsmoking.

Health promotion must address all aspects of health behavior and in many ways
- sometimes with integrated campaigns, sometimes with dedicated tobacco projects.

Consistency is also vital. A smoking drug campaigner or a tobacco advocate driving without safety belts is bound to be inefficient.

I don't see a European Office on Tobacco Control as a separate entity in a near future.

The strengthened networking of different national institutes and associations could and should form a virtual European tobacco control office.

5. How do you assess the strength of the tobacco lobby in Brussels?
     Is the Philip Morris Institute for Public Affairs still active?
     What about the "tobacco control lobby"?

I haven't come across tobacco lobbyists here in Brussels.

They probably target agricultural, financial and industrial counselors, not health people.

Tobacco lobbyists dress their claims in employment, economic and other issues as was seen in their battle to maintain the tax-free sales in Europe.

The tobacco control advocates' hardest work is always at home: without the push from national governments there will be no European or national legislation (remember the ad ban directive).

MEPs represent their voters back at home. Brussellois action is needed to influence the Commission but its public health sector has been very sympathetic for tobacco control: it is best assisted by securing the pressure and support from member states.

     Any concluding remarks?

We have succeeded in many aspects of tobacco control in Europe and in some countries although much remains to be done.

The two major challenges are ahead:

to put the known policies into practice at national level and develop new approaches to tobacco control at all levels.

The growing social and economic inequality is a major threat to our success.

At the same time as we continue our present work we need to develop a way to influence those who are less well off or less academic.

It is not impossible but we have to invest much more for example to develop campaigns suitable for occupational schools.

Thank you Tapani for taking the time to be with us today.