Protection of nonsmokers


 

The Parliament adopted the toughening up of the Act on the protection of non-smokers on 26.04.2011.

With this modification, Hungary entered into the group of countries having total smoking ban in all enclosed public places.

According to the legislation in force, smoking is prohibited:

- in rooms of public institutions that are open to the public

- on means of public transport, in means of public transport in local public transport services, on trains in local railway services, on buses/coaches in domestic intercity public transport services based on service schedules as well as on passenger trains in scheduled railway services

in workplaces

- in the following areas qualifying as public area: underpasses open to passenger traffic and in other connection spaces of public passageways with closed air spaces, in playgrounds in public places and within 5 meters of the external borderlines of playgrounds, in the areas of railway operation facilities in place for the provision of public railway services and in the accessories of the railway track that are open to the public, in the stops and stations constructed or designated to passengers boarding or alighting from the means of public transport, in waiting areas or rooms, and within a distance of 5 meters of the external borderlines of outdoor stops or waiting areas

No smoking area may be designated even in open air spaces in public education institutions, in child welfare and child protection institutions, in the premises of health service providers

The smoking ban also applies in case of apartment houses in enclosed rooms of common use unless at least four fifth of the owners decide otherwise

Smoking area may be designated in a closed air space for detainees held in penitentiary institutions and prisons (including those with mental disorders), for psychiatric patients in psychiatric institutions, in workplaces where the corrected effective temperature is over 24C° and -with certain conditions- in workplaces and establishments with increased risk or risk of fire and explosion and risk of fire. (example: oil refinery)

Cigar rooms of hotels which are already operating at the time of the coming into effect of the Act could also apply for derogation.

The Act also provides for the introduction of pictorial health warnings on the packages of tobacco products in January 2013.  The measure aims at the prevention of taking up smoking by indicating its harmful effects and emphasizes the responsibility of the smoker towards other people in connection with passive smoking.

42 pictorials will be rotated.

With this strict law Hungary comes up to the health political, professional expectations of the EU and WHO and substantially decreases the smoking related public health and economic burden as well.

Act XLII of 1999 on the Protection of Non-Smokers and Certain Regulations on the Consumption and Distribution of Tobacco Products (content coming into force on 01.01. 2012)

History: Commissioned by the National Institute for Health Development and under its professional supervision, the Median Opinion and Market-research Ltd. prepared a study on the opinion about the planned toughening up of the Act involving the most affected target groups such as hospitality industry, health care and school education (9). The aim of the research was the exploration of smoking behaviour of the respondents and their environment, and the effects and attitude regarding the planned modifications. Data collection was realized in April 2009.

According to the results, more than half of the employees smoked in hospitality venues  and one fourth of the employees smoked in the health care and school education institutions.

Most of the smokers reported that they mostly smoke in places designated for smoking in their workplace and they know where these designated places are. One fourth of the guests in hospitality venues  claimed that someone always smokes around them. The highest rate of persons exposed to tobacco smoke during the whole work day was in hospitality venues (38%). One tenth of employees in health care and school education sectors never work in smoking environment. For non-smoker employees this rate was higher. Employees tolerated less if someone smokes around them in their workplace than guests and patients. Smoking disturbed more than half of them. They would have strengthened smoking prohibition mostly in the health care sector. Smoking ban (beside the one plus day off for non-smokers) in enclosed places in hospitality venues was less supported. However (beside the plus day off) the majority absolutely supported all the elements of the stricter law. Most of the smokers thought that their smoking behaviour would not have changed because of the stricter smoking restrictions. 3-7 % of them reported that they would have quitted owing to the new Act. One third - one fifth of them suggested that they would have smoked less after the enforcement of the modification.

The collaborators of the Air Hygiene Unit of the National Environmental Health Institution, the Focal Point for Tobacco Control in the National Institute for Health Development, the Public Health Services of the VI. VII., VIII, IX. districts of Budapest elaborated and conducted a survey in 2012 on the interior air quality of hospitality venues. The fractions under 2,5 μm of the floating dust (PM2,5) were selected as an indicator material, because this dust fraction is very sensitive to indoor smoking. The diameter of particles of cigarette smoke is between the fine and ultrafine particle domain (0,02 - 2 μm).The results of the survey clearly proved that there is a relevant improvement in the indoor air quality. The mass concentration of the particles under 2,5μm was significantly higher (p<0,001) in all of the units that were controlled if there were smoking in the given unit. There was a decrease of around 90% in the average PM2,5 concentration in all of the enclosed places that were controlled after the amendment of the law. The measuring in front of hospitality venues (outdoor), the results on PM2,5 characterizing outdoor areas proved that the main source of high aerosol concentration under 2.5 μm was cigarette smoke in the indoor places controlled.

 

International and Hungarian data

In 1993, the U.S. Environmental Protection Agency and the International Agency for Research on Cancer of the WHO reported second hand smoke a carcinogenic substance.

As an amendment, in 2000 the Finish Government, in 2011 the German Government defined second hand smoke as a carcinogen substance in workplaces. The Californian Environmental Protection Agency defined it as a toxic and air pollutant substance.

There is no minimal safety level of tobacco smoke in the inhaled air! According to laboratory tests (1) ventilation technical devices could ensure the required pollutant low level in indoor places to improve indoor air quality if the air flow was “wind tunnel”-like rate. Scientific evidences underlines that technical approaches don’t protect from tobacco smoke exposition.

Everyone has the right for smoke-free environment, which follows from the right for the highest available level of physical and mental health as a basic human right (2).

According to the World Health Organization the epidemiology of smoking means a global problem with serious public health consequences, which makes essential the best international cooperation and participation of all countries in an effective, direct and comprehensive international reaction. As a consequence of the study the FCTC was realised by the direction of WHO, which is ratified by 172 countries till today (2010.12.29) such as Hungary and the EU.

One of the most important parts of the FCTC is the protection of non smokers from second hand smoking. The Conference of the Parties adopted the Guideline about the protection from tobacco smoke exposition specifying the introduction and implementation of such an effective administrative or other methods, which provide suitable protection from tobacco smoke in workplaces, public transport and other public places. Article 8. of FCTC is legally obliges the Parties to adopt and implement such an effective measures, which are against the second hand smoke exposition in all enclosed work places, public transports, indoor public places or other public places. In other jurisdiction areas they have to support actively the adoption and implementation of these measures.

All the Parties should stand for the implementation of the Guidelines in five years from the enforcement of the convention.

The Council of the EU (3) drew its resolution regarding smoking in public places in 1989, and in 2002 this reported (4) a recommendation motivating member states to take legal steps in favour of the protection of non smokers concerning workplaces, enclosed public places, public transport.

The current Hungarian law in force allows smoking just in designated areas (enclosed parts of public places open for service users) in places with smoking restriction. In favour of people with special need for protection owing to their age, health state or the characteristics of used services total smoking ban is implemented in some places (e.g. kindergartens) by the prohibited designation of smoking areas. (5)

Although since the enforcement of the FCTC some aggravations have been realized in the “Act XLII of 1999 on the Protection of Non-Smokers and Certain Regulations on the Consumption and Distribution of Tobacco Products” the Hungarian regulation is still not suitable. There is a serious need for aggravation, and total smoking ban. Since the enforcement of the FCTC the following steps are realized to modify the Act for the protection of non-smokers:

-      designation of smoking area is prohibited in buildings of health care services providing inpatient care for children, and in the whole area of kindergartens. (Act for the protection of non-smokers 2.§ (2))

-      widening of possibilities of employers in the development of smoke-free workplaces.  (Act for the protection of non-smokers 4/A. §)

-      leadership of schools, colleges, institutions and general activity centers can declare the institution smoke free. (Act for the protection of non-smokers 4. § (7))

-      ban of cigarette sale from vending machine (Act for the protection of non-smokers 6.§ (6))

-      rise of the amount of health care penalty (Act for the protection of non-smokers 7. § (4):

o   in case of breaking the smoking related bans penalty raised from maximum 30 000 to minimum 20 000 and maximum 50 000 Ft in 01.09 2006.

o   in case of inadequate or lack of designation of smoking areas or failure in monitoring the cooperation with the bans, regulations regarding smoking and sale of tobacco products penalty was raised from minimum 50 000 Ft and maximum 100 000 Ft to minimum 100 000 Ft and maximum 250 000 Ft for the persons in charge for compliance in 01.09.2006 and minimum 1 000 000 Ft and maximum 2 500 000 Ft for institutions, organizations or commercial companies.

In the field of tobacco control Ireland and Scotland are the leaders in the EU, where smoking bans for bars and restaurants are implemented at first, and France, Italy, Lithuania, Latvia, Montenegro, The Netherlands, Slovenia, Finland and Sweden followed them.

 

EU situation (6)

Three groups of regulation:

1. Total ban in all enclosed workplaces and public places

Ireland: March 2004.

Cyprus: January 2010.

Great Britain: March 2006 – July 2007 depending from regions

Spain: January 2011.

2. Comprehensive ban (smoking is allowed only in separated cigar/smoking rooms)

France: January 2008.

Italy: January 2005.

Lithuania: June 2006.

Latvia: May 2004., and then in hospitality venues in January 2007.

Montenegro: October 2005.

The Netherlands: July 2008.

Slovenia: August 2007.

Finland: June 2007.

Sweden: June 2005.

3. Partial ban/protection(Smoking is not prohibited in hospitality venues or only partly prohibited or usage of technical devices are allowed for ventilation).

Belgium: January 2006.

Bulgaria: January 2005.

Czech Republic: January 2006.

Denmark: August 2007.

Germany: August 2007-2009

Estonia: September 2007.

Luxemburg: September 2006.

Hungary: November 1999., with modifications September 2006

Austria: January 2009.

Poland: January 2002.

Portugal: January 2008.

Romania: January 2009.

Slovakia: April 2009.

Detailed review of smoking bans in EU Member States is available in English: here.

Passive smoking related data from Hungary in comparison with the EU average seems worse. (7) Rate of those who are not exposed from passive smoking in the workplace is 76% in EU27, but only 55% in Hungary. In case of bars the average of EU27 is 54%, in Hungary it is just 21%. In restaurants the situation is similar, Hungary has lower rate: 69% (EU27), 57% (HU). There is no big difference in households, the rate of those whose home is smoke free (smoking is not allowed in any rooms) is around 60% in EU countries and Hungary as well.  According to the Gallup Smoking Monitor research the rate of those people who want to prohibit smoking in public places is raised from 53% (2004) to 60% (2007).

 

Consequences

In Hungary most of the smoker and non-smoker citizens agree with the smoking ban in all enclosed workplaces. Accordingly the Act, the local public health authorities are responsible for the monitoring of the compliance and the sanctioning in case of breaking the low. When necessary, relevant support from the police is available. But it could be a problem, if the infringing person leaves the scene, while the help arrives. The administrative background of the monitoring is still not standard and detailed enough, thus it is not suitable for further analysis.

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1. Institute for health and consumer protection. Activity Report, 2003

2.Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) adopted by the United Nations General Assemblyon December 16, 1966

 3. Council Resolution on smoking in public places (1989)

4. Council Recommendation 2003/54/EC of 2 December 2002 on the prevention of smoking and on initiatives to improve tobacco control [Official Journal L 22 of 25.01.2003].

5. Act XLII of 1999 on the Protection of Non-Smokers and Certain Regulations on the Consumption and Distribution of Tobacco Products

6. Chart:
http://ec.europa.eu/health/archive/ph_determinants/life_style/tobacco/documents/tobacco_implementation_en.pdf

7. http://ec.europa.eu/public_opinion/flash/fl_253_en.pdf

8. European Parliament resolution of 26 November 2009 on smoke-free environments

9.”Attitudes and Effects of the Act of the protection on non-smokers” Questionnaire Research for the National Institute for Health Development, Median 2009

10. 2008. Impact assessment: “Monitoring of the possible effects and provisional cost-benefit estimation of the aggravation of the Act for the Protection of Non-smokers by taking account the recommended measures based on international experiences.”.  National Institute for Health Development