This World Health Organization (WHO) report has many conclusions that are valuable here in the
US and around the world. They stress the importance of legislation and the fact that (contrary to tobacco industry assertions)
ventilation is not a solution.
Click here to download a PDF copy of the complete report
Conclusions and recommendations
1. Public health policy and action should aim at the elimination of ETS
pollution by creating smoke-free environments for everyone.
2. This goal should be achieved through a combined programme of legislation
and education. Legislation is necessary to create smoke-free workplaces and public places,
including restaurants, educational institutions, day care centres and hospitals.
Educational and promotional campaigns should be implemented to facilitate compliance with this
legislation and also to encourage smoke-free homes.
3. An integrated multisectoral response should be developed involving,
among others, the health, environment and education ministries as well as appropriate NGOs.
4. Laws and regulations are essential to provide protection against
involuntary smoking. Voluntary arrangements are not sufficient. For such legal instruments to be
effective, they should have viable means of enforcement, be supported through educational and
promotional programmes, and be equipped with appropriate sanctions for
5. Since there is no evidence for a safe exposure level, legislation
limited to ventilation design and standards cannot achieve smoke-free workplaces and public places.
6. The enforcement instruments should be created and administered by the
health, occupational health and safety, and environment agencies.
7. Action at both national and sub-national levels to develop and enforce
legislation or regulations is important and mutually reinforcing. The model of local or
grass-roots legislation (e.g. city by-laws) has proved very effective and should be
encouraged in countries where this is possible. In countries where action cannot be taken
locally, the focus should be on national legislation.
8. The tobacco industry should be required to disclose the names of people
and organizations to which it provides both direct and indirect funding and support.
9. Legal action should be taken using existing laws to protect nonsmokers
and to require smoke-free environments. This action should be encouraged to use existing
laws and legal systems to protect the rights of nonsmokers most effectively.
10. The American litigation has proved very effective in bringing the truth
to the public, and has acted as a catalyst for political action. The British and Irish
parliamentary enquiries and the USA Congressional hearings have also contributed to this. Such
enquiries are most effective when parliaments have the legal authority to compel witnesses to
testify and documents to be produced. Countries are encouraged to take appropriate
action to hold the tobacco industry accountable for damage caused by second-hand smoke.
Education and the promotion of smoke-free environments
11. Governments should educate their populations regarding the right to
smoke-free air, existing laws and the dangers of involuntary smoking, including the fact
that there is no safe level of exposure.
12. Educational efforts on the particular dangers of second-hand smoke to
children should be used as a critical part of educational campaigns designed to achieve
smoke-free homes. These educational programmes should address parents, children, child health
professionals and family doctors.
13. Employers, health professionals, teachers, occupational health and
safety professionals, union leaders, policy-makers, the media, the hospitality industry and other
opinion-formers should be informed of the benefits of and need for smoke-free environments.
14. Legislators, policy-makers and the public (including employers and
members of the hospitality industry) should be educated about disinformation campaigns by
the tobacco industry.
15. No educational institution should accept any "educational" programme
prepared, distributed or financed by the tobacco industry.
16. WHO/EURO should provide a clearing-house to support legislation and
other action to create and support smoke-free environments. This support should include a
comprehensive database of existing legislation, individuals and organizations working to
create smoke-free environments, current data on the health effects of involuntary smoking, and
information on the tobacco industry's activities to prevent the creation of
17. WHO/EURO should disseminate the Air quality guidelines chapter on
environmental tobacco smoke as a separate document. It should also encourage occupational
agencies to promote smoke-free workplaces and advise Member States' environmental
health agencies to promote smoke-free environments.
18. There is a need for a well supported, structured European network to
share experience related to ETS on a continuing basis and to develop and operate
standardized analytical tools.
19. WHO's activities need to recognize and address the distinct needs of
different regions, which have different cultures and perspectives.
20. There is a need for uniform reporting of the indicators on both active
and passive smoking across the WHO European Region to assess progress towards meeting the
stated goals. Readily accessible data, which quantify the exposure of the population
(both adults and children) and the efficacy of specific interventions, should be a part of
this information. WHO should include these data in its information system.
World Health Organization
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