RENDEZ-VOUS 27
Friday, April 30 , 1999
Tibor Szilàgyi is Scientific Coordinator of the Hungarian
Tobacco and Alcohol Policy Development Project
Thank you Tibor for accepting our « rendez-vous ». May I ask you to introduce yourself ?
My name is Tibor Szilagyi, and I am 33 years old.
I have a medical doctor degree and a second degree
in internal medicine.
I worked for 6 years in the country's biggest hospital
for infectious diseases.
My speciality was (is) hepatology and gastroenterology.
Two years ago I shifted to health promotion
and disease prevention becoming the
scientific coordinator of the Hungarian
Tobacco and Alcohol Policy Development Project
funded with a World Bank loan.
During the past 2 years I've gathered
a lot of experience and information on Hungarian
tobacco control activities.
At present I'm involved in the process of coordination
of Hungarian tobacco control activities, in the elaboration
of short, medium and long term tobacco control
Action Plans of the Ministry of Health, as well as
in the planning of financing tobacco
control by the National Insurance Company.
1. Can you tell us about the situation
of the Tobacco epidemic in Hungary and how do
you compare with other Eastern European countries?
The human toll imposed by tobacco use and related
mortality in Hungary is among the highest in the world.
According to the survey data about 37% of Hungarians
are current smokers, smoking rates are increasing
among women and children.
About 35% of Hungarian secondary school pupils
were smokers in 1995.
The average cigarette consumption in Hungary is
among the highest in the world, being about 3200/adult
over 15 years old in the years 1990-92.
About 34,000 Hungarian die every year in diseases
directly related to smoking.
Editor's note: Hungary 's population is about 10 million people.
2. On April 13 you announced on Globalink the
Creation of the Hungarian Alliance for Tobacco Control.
You said 12 organizations have decided to cooperate within
the Alliance.
Can you give us some more details about how the Alliance
is going to operate, what your first objectives are?
Does the Alliance have a specific budget , permanent staff?
Is it more like a commitment to share initiatives but
without specific funding?
12 Hungarian organizations (governmental and and NGOs)
declared their willingness to unify their forces
under the umbrella of a Hungarian Alliance
for Tobacco Control.
To start the common work within the frame of a new
organization it should be registered by the Court.
A lawyer is now working on proposals for the most suitable
organisational structure will be the most suitable to achieve our
objectives.
After debating these proposals, the foundation documents
will be drafted and submitted to the Court.
It is very important to mention that the Ministry of Health and the
Parliamentary Committee on Health and Social Affairs
are actively participating in the process.
The member organizations outlined at the same time
the main objectives of the Alliance, as follows:
1. to create forums for information change,
sharing of initiatives between organisations
involved in the planning and implementation
of tobacco control activities,
2. to strengthen the collaboration between organisations
in the fields of programme planning,
implementation, monitoring and evaluation,
3. to make suggestions and advise the development
of tobacco control Action Plans within the
Ministry of Health,
4. to create new partnerships in tobacco control and
to ensure intersectoral cooperation in tobacco control,
5. to support the Ministry's endeavours to introduce
healthy public policies aiming to decrease tobacco
consumption in Hungary and creating forums for the
social debate of such policy options,
6. to form an active lobby to influence decision makers,
7. to activate media aiming to decrease the social
acceptance of smoking,
8. to create new partnerships with international
organisations involved in tobacco control.
We have been promised that the Alliance will have a
regular budget from the Ministry's Health Promotion
Fund in 2000.
In 1999, the membership will ensure a priority in
the decisions on funding tobacco control activities.
3. You also announced on April 14 that the Hungarian
Parliament had just passed a new tobacco control act.
Can you first tell us about the political context of this
law?
Who pushed for it? Why a new law now?
Here is a short history of the new tobacco act:
The bill was first submitted to the Parliament in 1996,
together with the Act on Advertisements.
While the Parliament passed the later in
1997 (and allowed tobacco advertising on billboards,
magazines and newspapers), it "forgot" the tobacco law,
which was withdrawn by the former socialist government
when it lost the parliamentary elections in May, 1998.
We imagine in the background pressures from the
financial lobby supported by the tobacco industry.
The new Ministry of Health submitted again
the bill in the Autumn, 1998, with only very few
modifications.
More than 100 bill amendments were forwarded.
Most of them called for stricter regulations.
Only a couple survived the Parliamentary debate
and the law was passed in April 1999
to enter in force in November 1999.
The law can be considered a success
for the new Ministry and Government
suggesting that tobacco control is a priority
in the Hungarian social and health policy
(but a success born under the pression of the
forthcoming accession to EU and recommendations
of the WHO).
4. You criticized the way the law was discussed
and you mentioned heavy pressure from the industry.
Could you elaborate on that and tell us about
the tobacco industry tactics in Hungary?
What are the main multinationals?
The main multinational tobacco companies are
BAT, Philip Morris, and Reemtsma.
They attacked the new Hungarian market after
the transition to the market economy in 1989.
The State welcomed their investments and
"sees big tobacco as a savior"
(The Wall Street Journal, November 2, 1998).
They started a very intensive marketing activity,
including direct and indirect advertising as well
as sponsorship of a wide range of social,
cultural and sport activities in Hungary,
including financial support given to hospitals,
youth organizations, donations to the Hungarian
Red Cross, etc.
They unified they forces under the umbrella
of the Hungarian Association of Tobacco
Manufacturers and are intensively lobbying for
their interests.
The tobacco industry is steadily present in all fields
of social life in Hungary.
5. What are the main points of the new law?
What is missing and how do you intend
to push for new measures?
The new law has 8 paragraphs.
The main provisions are:
- regulation of consumption of tobacco products
1. smoking is forbidden, except in designed areas, in:
public places (including restaurants), public transport
facilities, meetings in closed premises and workplaces
2. smoking is totally forbidden in:
primary health care premises, schools and
other educational institutions, public transport
facilities involved only in local transport,
indoor sport establishments.
3. smoking is allowed in premises of entertainment
and catering establishments if warm food is not
distributed for local consumption.
4. smoking areas in restaurants must be designed
if total separation (separate rooms) from
the non-smoking areas is possible or adequate air
changing devices are in function.
5. well designed labeling must be used at the
entrance of catering establishments to inform
public about the local smoking policy.
6. children under 18 shouldn't smoke anywhere,
nor in places where otherwise smoking is allowed.
The design of smoking areas must be made
taking into consideration the fire prevention
regulations.
The adequacy of smoking areas is supervised
by the national Public Health and Medical Officer Service.
The owners of catering establishments or those
operating public transport facilities
(only trains not operating in longer distance as
100 kilometers) have the possibility to declare
their facilities totally smoke-free.
- regulations of distribution and sale of tobacco
products
1. the sale of tobacco products is forbidden
in educational and social
establishments and health care units.
2. tobacco products cannot be sold to children
under 18
3. tobacco products cannot be distributed
as free samples
4. tobacco products can only be distributed
if a general warning, a rotating warning
and the nicotine and tar content in printed
on the package, occupying 4% of the front,
back and one of the sides
- fines related to those violating the regulations
1. penalties of 30,000-100,000 HUF
(100-300 USD) can be imposed in the
case of violation of regulations concerning
the use, sale and distribution of tobacco products.
The so called "health promotion fine" must be paid
to a separate bank account of the Ministry of Health and
can be used only for financial support of tobacco control
activities.
The importance of the new law lies in the fact
that it will give a background and spiritual
(and financial) support for tobacco control
activities.
What is missing?
Stricter regulation on tobacco ads
and the introduction of an earmarked
tax on tobacco products.
In addition, Hungary called for a derogation on
the nicotine and tar content of the cigarettes
to reach EU levels only in 2006.
I hope that in such a much better environment
we will be able to improve the health of all
Hungarians, including active and passive
smokers.
Thank you Tibor for taking the time to be with us today.
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