Each year, tobacco causes some 4 million premature deaths, with 1 million of these occurring in countries that can least afford the health care burden. By the year 2030, tobacco is likely to be the world's leading cause of death and disability, killing more than 10 million people annually.

Effective tobacco control requires a diverse array of strategies including research, policy and programmatic components. Strategies must be comprehensive, developed and coordinated to work together and compliment those implemented at the local, national and international levels.

To achieve the individual behavior change that supports the non-use of tobacco, communities must change the way tobacco is promoted, sold and used while changing the knowledge, attitudes and practices of young people, tobacco users, and non-users.

The fact that one billion Euros are spent every year subsidizing tobacco production needs to be addressed. A calling for the phasing out of tobacco subsidies in this region is a key element in developing a comprehensive and coherent European tobacco control strategy.

In the primary care system, GPs should play a central role in preventing tobacco use. In order to do that effectively they need appropriate knowledge and communication skills. Their practice should be based on medical evidence. GPs also have to foster a positive attitude towards the task. Adequate resources and time are important factors in succeeding in this preventive activity.

The UEMO, as the political organization of European GPs, is committed to working side by side with other medical organisations on a European and international level to create a coordinated effort to curb the global epidemic of tobacco related disease.

The main objective is to:

• Prevent the initiation of tobacco use among young people
• Promote quitting tobacco use among young people and adults
• Identify the disparities related to tobacco use and its effects among different population groups. This could help finding strategies that meet different needs and background of the patients

Given the burden that tobacco inflicts on the European Community, and given the evidence of the effectiveness of clinical tobacco interventions, the UEMO is of the opinion that:

• There is a leadership role for primary care health professionals in smoking cessation and prevention, and in protection of the public from the harmful effects of tobacco smoke.
• Helping smokers stop smoking is one of the most important services a primary health care provider can offer.
• A comprehensive approach to smoking cessation is important (e.g.

assessment, counselling, pharmacotherapy, ongoing support, relapse

prevention strategies).

• A collaborative multidisciplinary approach to tobacco control is important.

Each health profession brings its own unique knowledge and expertise to

advance an overall strategy.

• GPs should ask their patients/clients about their smoking

status when appropriate and document it.

• The patient/client is an active partner in the smoking cessation process.
• GPs and their primary health care teams require specific education and tools to facilitate their roles in tobacco control.
• The health care system should support GPs and the primary health care workers with appropriate resources and incentives to reduce tobacco use in the population.
• Clinical tobacco interventions by GPs and other health professionals should be part of a comprehensive national tobacco control strategy which also includes prevention and protection measures such as legislation, tax increases, restrictions on tobacco advertising and promotion, restrictions on smoking in public places, and public education campaigns.

The UEMO should use its efforts to influence governments, health care and social systems in the European Society to put into practice comprehensive and co-ordinated tobacco control programs. The goal is to reduce disease, disability, and death related to tobacco use.

The UEMO calls for:

• The enactment of legislation to prohibit both indirect and direct advertising of tobacco
• The phasing out of tobacco subsidies
• High taxation of tobacco products
• Exclusion of tobacco from national price indices
• Effective health warnings on all tobacco products
• Elimination of non-smokers´ exposure to environmental tobacco smoke by ensuring smoke-free public places
• Improvement of educational opportunities and resources to tobacco prevention