Cigarette Advertisements in Albania

Adopting stricter tobacco control laws, but inadequately enforcing them, does not curb Wont smoking prevalence, according to research from Albania. Despite the adoption of strong anti-smoking policies and restrictions on cigarette adverting in 2007, the smoking rate in Albania has risen. The increase in cigarette smoking has been driven by higher smoking rates among women and young adults.

Albania's anti-smoking laws have, however, contributed to reductions in exposure to secondhand smoke and tobacco advertising.

"The impacts of smoke-free policies and an advertising ban have been limited due to lack of enforcement and failure to adopt a comprehensive set of tobacco control measures," said the researchers of a study that appears in the December 2010 issue of the journal Tobacco Control.

Tobacco Control Policies in Albania

Albania implemented a smoke-free law in 2000, which consisted of a ban on cigarette advertising on television, radio, print media and billboards; public information campaigns on the dangers of tobacco use; health warnings and the disclosure of tobacco product ingredients; and restrictions on smoking in public places.

The government ratified in 2006 the Framework Convention for Tobacco Control (FCTC)—which provides an internationally coordinated response to addressing the global tobacco epidemic—and increased cigarette taxes. However, advertising on billboards and at the point of sale and other promotional activities were still allowed.

In May 2007, Albania banned all outdoor tobacco advertisements including billboards, prohibited smoking in all public places including restaurant and bars, and banned sales of tobacco products to those under age 18 years. At that time, the smoke-free regulations were among the strongest in Europe.

Albanians Are Smoking More Despite Smoking Restrictions
Between 2007 and 2009, the percentage of women in Albania who smoke cigarettes rose from 18.9 percent to 29.3 percent. Smoking prevalence among young adults increased from 23.2 percent to 38.5 percent in the same period. Cigarette smoking among men went up slightly from 64.4 percent to 65.6 percent.

The increases were particularly pronounced in rural areas (from 16.4 percent to 50.9 percent among young male daily smokers and from 0.2 percent to 12.8 percent for occasional female smokers.

Factors Affecting Cigarette Smoking in Albania

With economic liberalization and the freedom to travel after the fall of communism, the ability of Albanians to explore outside world dramatically increased the demand for Western-type products including cigarettes. Foreign products symbolized prestige and a promise of future economic prosperity. Cigarette smoking among women, considered socially unacceptable during the communist regime, became a sign of emancipation and a modern lifestyle, especially among the younger generations.

Exposure to Secondhand Smoke and Tobacco Ads Declined
Exposure to secondhand smoke at home, work and in public places decreased significantly since smoke-free legislation was enacted in 2007. The largest impact was recorded in medical facilities, where exposure declined from 35 percent in 2007 to eight percent in 2009. Exposure also declined markedly in government offices (from 59 percent to 26 percent) and educational institutions (from 38 percent to 20 percent).

Exposure to secondhand smoke remained high in private workplaces, restaurants and cafes/bars/night clubs (64 percent, 66 percent and 84 percent, respectively).

Study respondents also reported a decline in exposure to cigarette advertising. The percentage who said they were exposed to outdoor cigarette ads (on posters, billboards or public transportation vehicles) went down from 75 percent in 2007 to 52 percent in 2009. This decline was more dramatic in urban areas (from 85.6 percent to 45.8 percent).

Additional Measures to Curb Smoking are Needed in Albania
The introduction of cessation services, which are not currently available in Albania, could help increase the number of former smokers, especially among women, whose quit rates remain low. In addition, quit rates might be increased through better enforcement of advertising bans and smoke-free laws, as well as increasing the tax on cigarettes.

The average price for a pack of 20 cigarettes in Albania in 2009 was 137 Lek (US$1.40). That same year the government increased the cigarette tax from 40 Lek to 50 Lek per pack. The study researchers highlighted the importance of taking inflation and income growth into account when increasing the cigarette tax. While cigarette prices increased by 3.4 percent between 2007 and 2009, the GDP increased by 12 percent in the same period. Plus, unemployment declined from 13.7 percent to 12.7 percent. “Economic growth and lower unemployment increase purchasing power and thereby the affordability of cigarettes,” the researchers said.

To lower smoking prevalence and improve public health, the government of Albania should enforce existing tobacco control policies, and adopt further policies, according to the study. “Experience from other countries indicates that a comprehensive set of tobacco control policies that are simultaneously implemented can achieve large reductions in smoking prevalence."