Programme national tabac 2008–2012

Objectives

The National Tobacco Programme 2008–2012 is Switzerland’s strategic framework for reducing tobacco consumption and the illness and deaths it causes. It succeeds the 2001–2008 programme, incorporates its 2006 evaluation, and treats tobacco prevention as a combination of behavioural change, health protection and market regulation.[1][2][3]

• Reduce smoking prevalence in the resident population from 29% in 2007 to approximately 23% by the end of 2012.[4][5]
• Reduce smoking prevalence among 14–19-year-olds from 24% in 2007 to below 20% by the end of 2012.[4][5]
• Reduce exposure to second-hand smoke for at least seven hours weekly from 27% in 2006 to approximately 5% by the end of 2012.[4][5]
• Inform and raise public awareness of the harms of smoking, tobacco dependence and passive smoking, improving public and political acceptance of prevention measures.[6][7]
• Protect health and regulate the market through stronger protection from passive smoking, tobacco-tax measures, restrictions on advertising and sponsorship, product information and health warnings, and action on young people’s access to tobacco.[6][8][9]
• Prevent smoking initiation, particularly among young people, while encouraging and supporting smokers to quit.[4][10]
• Coordinate and mobilise federal, cantonal and municipal authorities, non-governmental organisations and other prevention actors around shared objectives.[4][11]

The programme responds to persistent health and social harms. Tobacco use is associated with approximately 8,300 deaths and 16,000 reported disability cases annually in Switzerland, while tobacco-related costs to the Swiss economy were estimated at about 10 billion Swiss francs per year.[12][13][14]It also addresses the substantial burden of passive smoking, which affected 27% of people aged 14–65 for at least seven hours a week in 2006 and disproportionately affected young people.[15]

The strategy is organised around four mutually reinforcing areas of action: public information and awareness; health protection and market regulation; behavioural prevention; and coordination and collaboration.[4][16]This reflects the finding that isolated appeals are insufficient for lasting behavioural change and that prevention requires simultaneous interventions at several levels.[3][16]The broader policy direction prioritises structural prevention, including legal, fiscal and environmental measures, alongside individual information and cessation support.[17][18]

Implementation

Implementation uses a multisectoral, staged and partnership-based model led federally by the Federal Office of Public Health, while recognising the central delivery roles of cantons, municipalities, specialist bodies, non-governmental organisations and private actors.[19][20][21]The programme combines national campaigns and targeted projects with legislative and fiscal measures, local prevention activity, cessation services and protection in settings such as workplaces, schools, sport, public transport and hospitality venues.[22][23][24]

• Coordinate national implementation through the Federal Office of Public Health, which creates conditions for applying strategic objectives, convenes stakeholders and chairs the strategic steering body.[19]
• Govern through a strategic body comprising the Federal Office of Public Health, the Federal Commission for Tobacco Prevention, the Swiss Conference of Cantonal Health Directors and Directors, and a delegation of tobacco-prevention non-governmental organisations.[19]
• Align federal action through an interdepartmental tobacco working group led by the Federal Office of Public Health and including the State Secretariat for Economic Affairs and the Federal Customs Administration.[19]
• Operate practical coordination through a management unit attached to the Federal Office of Public Health’s Alcohol and Tobacco section, responsible for implementation coordination, information exchange and stakeholder contact.[25][20]
• Prioritise measures according to urgency, interdependence, public acceptance and available resources, beginning with programme organisation, communication and monitoring.[20]
• Support cantons to use legislative and service-delivery powers for smoke-free protection, advertising controls, access restrictions, information, specialist counselling and smoking-cessation assistance.[26][8]
• Develop partnerships across addiction policy, education, occupational health, fiscal policy and international cooperation, including work linked to the World Health Organization Framework Convention on Tobacco Control and European Union tobacco policy.[27]

Federal responsibilities include tobacco-product regulation, taxation, occupational protection, national campaigns and nationwide coordination; cantons undertake important behavioural and structural prevention measures.[14][21]Non-governmental organisations, specialist associations and private actors contribute through prevention, cessation advice and treatment, research, public relations and policy interventions.[14][28]The programme seeks to use these complementary roles efficiently, exploit synergies and maintain cooperation across levels of government.[11][16]

Operational action includes media campaigns; smoke-free workplace and sport initiatives; youth-focused and school-based prevention; cessation telephone, online and computer-assisted support; public-transport restrictions; and measures to reduce advertising, sponsorship and youth access to tobacco products.[2][22][23][24][8]Market and legal measures are intended to be updated in response to evidence on harm and dependence, international legal developments and negotiations with the European Union.[3][29]Tobacco-tax increases are to be assessed against health and fiscal objectives, including risks of illicit trade and smuggling, before longer-term policy changes are made.[8]

Monitoring combines continuous tobacco monitoring of consumption and attitudes with programme communication and periodic adaptation to new evidence and emerging phenomena.[30]An annual report supports self-evaluation and continuous improvement, while an external evaluation was scheduled no later than 2011 to inform tobacco-prevention policy after 2012.[25][30]Financing comes partly from the Federal Office of Public Health prevention credit and project applications to the Tobacco Prevention Fund; the Fund remains organisationally independent of programme implementation and provides approximately 17 million Swiss francs annually for prevention subsidies.[30][20][10]

Monitoring & Evaluation

The National Tobacco Programme 2008–2012 uses measurable population targets, continuous tobacco monitoring, annual self-evaluation and a planned external review to guide implementation and adaptation. Its evaluation approach builds on the 2006 assessment of the preceding 2001–2008 programme and combines outcome trends, implementation information and international policy comparisons.[2][30]

• Track smoking prevalence in the resident population, with a target reduction from 29% in 2007 to approximately 23% by the end of 2012.[4][5]
• Track smoking among 14–19-year-olds, with a target reduction from 24% in 2007 to below 20% by 2012.[4][5]
• Track prolonged exposure to second-hand smoke, with a target reduction from 27% in 2006 to approximately 5% of the population by 2012 among those exposed for at least seven hours weekly.[4][5]
• Maintain tobacco monitoring of consumption patterns and public attitudes, using findings to inform communications, campaigns and adjustments for new knowledge or emerging phenomena.[30]
• Produce an annual report as the basis for self-evaluation and continuous improvement of implementation.[25][30]
• Conduct an external evaluation no later than 2011 and combine its findings with tobacco-monitoring results to formulate recommendations for tobacco prevention after 2012.[25][30]

The 2006 evaluation of the previous programme found progress in public attitudes towards passive smoking and in legislation, but insufficient achievement in creating tobacco-free environments for young people.[2]Smoking prevalence fell from 33% to 29% among people aged 14–65 and from 31% to 24% among 14–19-year-olds between 2001 and 2007, although the decline could not be attributed wholly to the programme because of wider influencing factors.[31][32]

• Use programme management and Federal Office of Public Health coordination to support delivery, stakeholder consultation, communication and information exchange.[19][20]
• Assess policy progress through international comparisons: Switzerland rose from 23rd of about 30 European countries, with 35 points out of 100 in 2005, to 18th with 47 points in 2007.[21]
• Monitor implementation through campaign evaluations and participation data, including workplace, sports-club and school initiatives.[22][23][24]

The extracts do not define a complete indicator dictionary, reporting template, surveillance methodology, routine reporting timetable beyond the annual report, or detailed formal accountability procedures.[25][30]

Costing & Financing

Tobacco use is presented as imposing a substantial economic and social burden, while tobacco taxation and the Tobacco Prevention Fund provide important financing mechanisms for prevention and social-insurance purposes. Programme financing is shared across federal, cantonal, municipal and non-governmental actors, but no consolidated 2008–2012 programme budget or funding-gap assessment is provided.[14][30]

• Recognise an estimated annual economic cost of tobacco use of approximately 10 billion Swiss francs, including 1.2 billion Swiss francs in medical treatment costs, 3.8 billion Swiss francs associated with work absenteeism, disability and related impacts, and an estimated 5 billion Swiss francs loss in quality of life.[14]
• Allocate tobacco-tax revenue to old-age and survivors’ insurance; revenue amounted to 2.16 billion Swiss francs in 2006.[33]
• Finance the Tobacco Prevention Fund through a levy on cigarettes sold in Switzerland, set at 0.13 Swiss centimes per cigarette in the cited material.[10]
• Provide approximately 17 million Swiss francs annually through the Tobacco Prevention Fund for prevention subsidies, campaigns, projects and research.[1][33][20]
• Maintain a similarly sized annual SOTA fund to support domestic tobacco production.[33]

The Federal Office of Public Health may finance prevention through its prevention credit and may apply to the Tobacco Prevention Fund for particular projects, including national campaigns. Cantons, municipalities and non-governmental organisations maintain their own prevention funding and can seek additional Fund support.[30]The Fund is institutionally separate from the programme implementation structure, with Federal Office applications subject to the ordinary funding procedure.[20]

• Use tobacco-tax increases as a prevention instrument, subject to analysis of effectiveness against public-health and fiscal-policy objectives and consideration of illicit trade and smuggling risks.[6][8]
• Prioritise prevention interventions according to evidence of effectiveness and cost-effectiveness.[34]
• Align use of Tobacco Prevention Fund resources with the programme’s strategic objectives.[11]

No source material specifies the size of the Federal Office of Public Health prevention credit, project-level allocations, total expenditure, resource requirements, funding gaps, cost-effectiveness thresholds or detailed economic forecasts for the 2008–2012 programme.[30]