11 96
smoke.
A
few
countries,
including
Bahrain,
Cyprus,
Mauritius,
South Africa,
and United Arab Emirates,
as well
as
several
states or provinces
in Australia, Canada, and
the
United
States,
have
banned
smoking
in
vehicles
carrying
children,
and
several
other
countries
are
considering
similar
bans
[77–79].
3.6.1.3.
Offering
help
to
quit
tobacco
use.
Personalized
advice
from
health
professionals
[80]and
access
to
affordable
nicotine
replacement
therapies
[81]help
patients
quit
smoking.
In
many
successful
tobacco
control
strategies,
cessation
support
by health
care
providers
is
accompanied
by quit
lines and other communication
technologies such as
appropriate
text messaging,
social
networking,
and
phone
applications
[82–84] .These
policies
are
best
implemented
in
the wealthiest
nations.
Of
55
high-income
countries
in
2012, 47
countries
fully
covered
at
least
one of
the policies
(cessation
service
or
nicotine
replacement
therapy),
and
14
countries
covered
both
policies
[6] .3.6.1.4. Warning about
the dangers of
tobacco.
A
large
share of
the
world’s population
still
is not
fully aware of
the health
risks
associated with tobacco use:
<
40% of adults
in China believe
that
smoking
causes
heart
attacks,
and
<
50%
of
adults
in
India
believe
that
smoking
causes
strokes
[5].
Harms
of
tobacco
can
be
communicated
through
antitobacco
cam-
paigns
and
health warnings
on
tobacco
product
packages.
Media
campaigns
can
quickly
reach
large
populations
of
both
smokers
and
nonsmokers.
Health warning
labels
are most
effective
in
the
form
of
large
pictures
[85]located
on
the
upper
part
of
both
the
front
and
rear
panels
of
each
cigarette
package. Middle-
income
countries
are
the
highest-achieving
country
group
in
implementing
large pictorial warning
labels. The new EU
Tobacco
Products
Directive
makes
using
such
labels
mandatory
in
all
EU member
states
by May
2016
[86].
It
has
been
shown
that
tobacco
warning
labels
work
best
when
they
elicit
disgust,
fear,
or
sadness
[87] .3.6.1.5.
Enforcing
bans
on
tobacco
advertising,
promotion,
and
sponsorship.
Marketing
bans
protect
people
from
alluring
industry messages
aimed
at discouraging
existing
smokers
from quitting and attracting new
smokers, especially youth
[88].
There
are now 127
countries
(with 74% of
the world’s
population)
that
ban
all
or
almost
all
forms
of
direct
and
indirect
tobacco
advertising
[6] .Low-income
countries
are
the
best
group
in
implementing
these
policies.
To
limit
the
effect
of
appealing
tobacco
packages,
an
innovative
plain
packaging
law was
introduced
in Decem-
ber
2012
in Australia
to
standardize
the
size,
labeling,
and
shape of packages. For example,
this
law requires
that brand
and
company names on all
retail
tobacco packs
in Australia
must
be
printed
in
a
uniform,
small-sized
font,
and
packs
must have a drab dark brown color
[89] .Preliminary studies
have
reported
a
boost
in
the
number
of
quit
line
calls
following
the
introduction
of
this
law
[90]and no
increase
in
the
availability
of
illicit
tobacco, which
contrasted
the
tobacco
industry’s
claims
and
arguments
[91] .In
2015,
Ireland
and
the United Kingdom
also
passed
plain
packag-
ing
legislations
[92].
3.6.1.6.
Raising
tobacco
taxes.
Tobacco excise
tax
increases
that
result
in higher
tobacco product prices are among
the most
effective
tobacco control measures available, particularly
to
reduce
smoking
rates
in
youth
and
lower
socioeconomic
groups
[93,94].
Tax
rates
need
to
be
regularly
revised
to
increase
the
price
of
tobacco
products
at
a
rate
above
inflation and
income growth, making
tobacco products
less
affordable
over
time
[95] .With
a
successful
cigarette
tax
harmonization
and
integration
regimen
in
the
European
Union,
the member
states
have
the
highest
tobacco
excise
taxes
in
the world
[96] .In
the United States, where
tobacco
taxes
are partly
set
by
states,
the
tobacco
tax
in northeast-
ern
states
is
higher
and
in
southern
states
is
lower
than
in
the
rest
of
the
country;
higher
taxes
are
associated
with
lower
smoking
prevalence
in
states
[97] .In
addition
to
decreasing
tobacco
use
prevalence
and
intensity,
tobacco
tax
increases
generate
sizable
revenues,
which
can be used
to
fund
tobacco
control and other public
health
initiatives.
For
example,
Costa
Rica
and
the
Philippines
use
a
major
portion
of
their
revenues
from
recent
cigarette
tax
increases
in
health
care,
including
the
diagnosis,
treatment,
and
prevention
of
tobacco-related
diseases
[6,98]Table
3
–
Percentage
of
countries
covered
by
tobacco
control
policies
at World Health Organization–recommended
levels,
2012.
Geographical
region
M Monitoring
P
Smoke-free
policies
O
Cessation
programs
W Warnings
E
Advertising
bans
R
Taxation
Health warnings
Mass media
By
continent,
%
Africa
7
11
0
11
15
20
4
Americas
20
38
17
34
17
9
6
Asia
27
24
17
19
27
13
13
Europe
64
20
12
2
19
5
54
Oceania
19
25
13
13
25
13
0
By
income
group,
%
High
income
62
22
25
13
25
5
41
Upper-middle
income
22
36
11
24
22
19
15
Lower-middle
income
12
17
2
14
18
8
2
Low
income
3
9
0
9
12
21
3
Source: World Health Organization Global
Tobacco
Control
Report
[6] .E U R O P E A N
U R O L O G Y
F O C U S
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