Europe’s health progress is stagnating, and in some areas, even reversing, according to a new World Health Organization (WHO) report published in late February assessing everything from infections and chronic diseases to life expectancy.
While the report notes a decline in non-communicable diseases (NCDs) like cardiovascular diseases (CVD) and cancer, these conditions still pose a significant threat, responsible for one in six deaths among people under 70 in Europe, as well as 90% of all deaths. As WHO Europe regional director, Dr. Hans Kluge, has warned, the region must address chronic disease’s root causes, citing tobacco as a major risk factor. Indeed, the WHO reports cautions that the continent’s smoking rates stubbornly high at 25%, with Europe set to miss this year’s 30% reduction target.
Despite the gravity of the situation, the European Commission remains curiously silent on the tobacco industry, whose noxious lobbying influence has long shielded cigarettes from stricter oversight despite their widely-known cancer and CVD links – particularly concerning regulation to tackle the bloc’s rising illicit tobacco trade. In advancing its public health agenda, the EU executive must implement WHO-aligned policies that reflect the uniquely dire public health and social menace that tobacco represents.
Europe’s avoidable health crisis
Published every three years, the WHO report has crucially reminded that CVD and cancer are the twin pillars of Europe’s public health crisis, together accounting for roughly two-thirds of the continent’s premature deaths. In Eastern Europe, the early death risk from CVD is nearly five times higher than in Western Europe, with cancer presenting a similarly stark contrast. While wealthier Western nations see more cancer cases but improving survival rates, the lower incidence in the East masks a harsher reality, where patients face significantly higher mortality.
In the EU, a citizen faces a cancer diagnosis every nine seconds, representing 2.7 million people in 2022 alone. That same year, the disease claimed 1.3 million lives, making cancer Europe’s second cause of death after CVD. Tobacco remains the most lethal risk factor – accounting for over a quarter of all cancer-related deaths, with lung cancer at the forefront. The numbers are staggering, and yet, largely preventable. Tobacco consumption claims nearly 700,000 lives annually across Europe, costing the EU an estimated €97.7 billion – a near-even split between direct healthcare expenses and indirect costs such as lost productivity.
Four years after the launch of Europe’s Beating Cancer Plan, progress has been tangible but uneven. While notable strides have been made to alleviate the continent’s disease burden, many commitments vital to dealing a meaningful blow to cancer in Europe have gone unmet. With the European Commission’s Country Cancer 2025 reports revealing a 24% spike in cancer prevalence and persistent cancer inequalities across the bloc, Brussels needs to deliver decisive action to turn the tide.
Big Tobacco lobbyists obstructing progress
As Dr Wendy Yared of the European Cancer Leagues (ECL) recently noted, revising the EU tobacco legislation framework represents a vital measure within Brussels’ policy arsenal to tackle cancer, rightly stressing that these efforts must “not be delayed any further.” Indeed, the Big Tobacco lobby has successfully watered down or stalled key policy initiatives in recent years.
Last year, a coalition of MEPs, public health experts, and tobacco control advocates – including the University of Bath’s Tobacco Control Research Group and the Smoke-Free Partnership (SFP) – released a White Paper exposing the EU’s ongoing failure to shield its health policies from Big Tobacco’s influence. As the White Paper’s contributors, such as SFP Director Lilia Olefir, have long warned, the EU tobacco lobby has spent years obstructing the Tobacco Products Directive (TPD) and Tobacco Taxation Directive (TTD) revisions.
Delayed for over two years now, the Commission has yet to explain its failure to turn policy ambition into concrete public health legislation that protects its citizens from tobacco. Meanwhile, Big Tobacco has intensified its stalling tactics, investing millions in lobbying to undermine the TPD-TTD revision process, which would likely impose higher taxes and an independent tobacco traceability system – measures vital for public health but harmful to the industry’s profit margins.
EU tobacco traceability reflecting systemic failures
This latest lobbying offensive echoes Big Tobacco’s successful efforts to weaken the last TPD update in 2014, when the industry successfully pushed for the removal of an independent, WHO FCTC Protocol-compliant track-and-trace system initially proposed to combat Europe’s illicit tobacco trade. In the ensuing decade, Big Tobacco has benefitted from a far weaker framework operated by longstanding industry-linked entities, with Swiss firms Inexto and Dentsu Tracking, as well as France’s Atos and its four subsidiaries representing nearly half of all primary repositories, and former sister company, Worldline, also involved.
Inexto’s and Dentsu’s connections to the tobacco industry are especially troubling, as the ‘descendants,’ via respective acquisitions, of Codentify – the Philip Morris International-developed traceability system long derided by leading health experts as a blatant industry attempt to control traceability efforts and ensure regulation plays to its commercial advantage. In addition to the technology, Inexto equally inherited former Philip Morris International executives – including Codentify’s creators.
Beyond Inexto’s WHO-violating financial ties to the tobacco industry, Dentsu’s involvement has drawn particular scrutiny from MEPs and NGOs, especially after revelations that Jan Hoffman, a former European Commission official, now holds an executive role at Dentsu, raising serious conflict-of-interest concerns regarding what MEPs identified as the opaque tender process that awarded the company the contract. (Dentsu insists that Hoffman did not have any improper influence over the tender award).
Mirroring its EU controversies, Dentsu Tracking’s recently exposed scandal in Brazil represents the final nail in the coffin of its tobacco industry independence, with the company’s General Manager – a former Philip Morris International executive – recorded promoting the Big Tobacco giant’s interests concerning Brazil’s traceability system.
Time to take a stand
With industry allies like Inexto and Dentsu at the helm of the EU system, illicit tobacco trade in Europe continues to rise, padding Big Tobacco’s pockets while draining billions in EU excise tax revenue – funds that could support essential preventative healthcare initiatives.
This tobacco traceability scandal is symptomatic of a deeper flaw within the EU’s institutions: lofty promises repeatedly undermined by failure to enact concrete, protective measures. With the long-delayed TPD revision in sight, the new Commission has the once-in-a-generation opportunity to redress the wrongs of the past and implement an independent, WHO-aligned tobacco traceability system.
The WHO’s concerning findings in its latest Europe report offer a timely reminder that the continent cannot afford complacency amid an escalating public health crisis. Moving forward, the EU executive must not allow lobbyists pressure to further delay and dilute its public health agenda. The choice is clear: act decisively to safeguard millions of EU citizens or allow commercial interests to undermine the continent’s anti-cancer agenda – the time for half-measures has passed.
