By Kathryn Kranhold and Jason McLure of The Examination and Rory O’Neill and Antonia Zimmermann of POLITICO. This article was reported in collaboration with The Examination, a nonprofit newsroom that investigates global health threats. BRUSSELS — When the world’s largest tobacco company needed help lifting international restrictions on its products, it enlisted an unlikely ally: the European Union, a leader in tobacco control.  EU officials met with Philip Morris International representatives at least six times from September 2022 through 2024, according to documents released through public records requests. The tobacco giant’s agenda: Enlist EU officials’ help in loosening restrictions or setting favorable tax rates on its products — including IQOS, a heated tobacco device key to the company’s future — in 10 countries outside the EU. Officials with the European Commission, the EU’s executive arm, took action at least three times that would have benefitted the company, The Examination and POLITICO found. They published a notice saying Mexico’s ban on new nicotine products was a possible barrier to free trade. They asked Turkish officials whether they planned to maintain the country’s requirement that cigarettes contain a minimum amount of local tobacco. And in a high-level report for EU officials, they flagged that rule and Turkey’s cigarette tax rate as issues that could affect ties between it and the EU.  The Commission’s actions regarding Turkey were “of great help for us,” a PMI representative wrote to staffers at the Commission. “We would like to express our gratitude in regard of (sic) the actions that you took.”  A Philip Morris International representative thanked European Commission trade officials for flagging Turkey’s cigarette tax and a rule on domestic tobacco as possible trade issues. (Redactions by the European Commission. Highlighting by The Examination) The revelations, contained in documents released through public information requests by the French anti-tobacco group Contre-Feu, raise questions about whether the EU breached its commitment to a global treaty to combat smoking signed by the EU and member countries. Guidelines to implement that treaty — the Framework Convention on Tobacco Control (FCTC) — say that when setting and implementing public health policies, governments should restrict their dealings with the tobacco industry and disclose any meetings whenever possible. None of the meetings with PMI or other industry groups cited in the documents were disclosed, according to The Examination and POLITICO’s review of the EU’s disclosure websites. The “fact that EU officials acted upon PMI’s requests signals a troubling willingness to give the tobacco industry privileged access. That is precisely what the FCTC was designed to prevent,” said Tilly Metz, a member of the European Parliament with the Greens. “It undermines both public trust and the EU’s credibility as a global leader in tobacco control.” A spokesperson for the European Commission told The Examination and POLITICO  that it “strictly follows” the treaty guidelines. But tobacco products are covered by EU trade policy, and the Commission can negotiate tariffs and trade rules, the spokesperson said.  “The Commission does not shape, influence or lobby for specific health policies in third countries on behalf of any industry,” the spokesperson said.  While industry associations and companies can share concerns on market access in non-EU countries with the Commission, and the Commission may meet with complainants to get more information, the spokesperson said such meetings are “strictly related to trade facilitation and market access.” European parliamentarians appeared divided over whether the dealings were improper.  Vytenis Andriukaitis with the Socialists and Democrats and a former EU health commissioner said the European Commission “cannot represent the interests of tobacco companies,” nor “press other countries to weaken” their tobacco controls. Barry Andrews, a member of the centrist Renew Europe Group, said: “These regular meetings with big tobacco lobbyists and the flurry of emails should not have happened.” By contrast, Stine Bosse, a member of the same political group, said: “The tobacco industry has every right to employ lobbyists.” However, Bosse added: “Morally, I stand in a very different place. While they constantly try to reinvent new products to get people hooked on nicotine and tobacco, I am fighting for precisely the opposite.”  Philip Morris International did not answer questions from The Examination and POLITICO about its dealing with EU officials. On its website, the company said it shares its perspectives with policymakers and it is “particularly active with respect to policies regarding less harmful alternatives to cigarettes, trade and fiscal matters, and intellectual property.” (The company is separate from Philip Morris USA, which is part of Altria Group.) The Examination and POLITICO have not found evidence that any of the 10 countries targeted by PMI altered their tobacco taxes or regulations following meetings with EU officials, including where the EU took action with regard to Mexico and Turkey. Most of PMI’s entreaties focused on IQOS, which it says is better than cigarettes because heating tobacco releases fewer toxins than burning it. Public health experts say the long-term risks of heated tobacco are unknown and products like IQOS could increase tobacco use. IQOS devices with heated tobacco sticks. Philip Morris International says IQOS is better than cigarettes because heating tobacco releases fewer toxins than burning it. Public health experts say the long-term risks of heated tobacco are unknown. | Roberto Pfeil/picture alliance via Getty Images Public health advocates said Commission officials’ actions were especially surprising because the EU has been one of the strongest supporters of the FCTC.  This year, the Commission proposed hiking EU-wide taxes on most tobacco products and setting minimum taxes for vapes and heated tobacco for the first time. Health Commissioner Olivér Várhelyi has pledged to drive e-cigarette taxes even higher; his tax counterpart, Wopke Hoekstra, has called vapes the “revenge of the tobacco industry.” The countries that PMI sought help with were outside the EU. Nearly all of them — Argentina, Brazil, India, Mexico, Singapore, Thailand, Turkey and Vietnam — had banned heated tobacco. Taiwan had what PMI described as a burdensome approval process. Japanese leaders were in discussions to raise taxes on heated tobacco to the same rate as cigarettes. Philip Morris International asked for the EU’s help in loosening restrictions or setting favorable tax rates on its IQOS product in 10 countries outside the EU. (Redactions by the European Commission. Highlighting by The Examination) PMI officials wanted people in those countries to be able to buy IQOS as easily as cigarettes. The company calls IQOS part of its “dream team” of alternative nicotine products, including e-cigarettes and nicotine pouches, that are meant to offset declining cigarette consumption.  So the company sought help in the EU’s distinctive 15-story glass trade building, the Charlemagne, in Brussels. PMI SEEKS HELP IN MEXICO Mexico was the first country that PMI sought help with, according to the documents. That country was a key market for IQOS, but a ban on vapes and heated tobacco was set to go into effect in December 2022.  In an investor meeting on Sept. 6, 2022, an analyst asked about IQOS’ “lack of success” in the Americas. Emmanuel Babeau, the company’s chief financial officer, blamed “some restrictions” in Mexico but said, “it’s going to be a very successful market for IQOS once we can really sell the device really without any issue.” That same day, company staff had an online meeting with EU officials to discuss the ban. It was one of several discussions about Mexico. After the ban went into effect, PMI sought more help from EU officials. In an April 3, 2023, email, an executive at the company’s Swiss office asked for another meeting, explaining that Mexico’s “business environment is still marked by uncertainty, judicial processes, interpretations, and doubtful, temporary and unclear administrative acts.”    After a ban on vapes and heated tobacco went into effect in Mexico, Philip Morris International sought more help from EU officials. (Redactions by the European Commission. Highlighting by The Examination) Soon after the email, European trade officials issued what is known as a barrier to trade notice, reporting Mexico’s IQOS ban as a potential trade treaty violation. PMI representatives and trade officials met later that month, when the company contended similar bans in Argentina, Brazil and Vietnam were trade barriers, according to a Commission report summarizing the meeting. The Commission spokesperson said it had acted in response to a formal complaint that “involved discriminatory treatment of like products” and that it did not undertake any further action regarding Mexico. Mexico’s Supreme Court struck down the ban in November 2024, allowing PMI to continue selling IQOS there.  The correspondence shows how PMI leveraged its status as a major European employer and exporter. The company employed more than 21,500 people in Europe as of 2023 and had 20 manufacturing sites there. In one email, a PMI representative told a European trade official that a meeting would be a “good opportunity to update you [on] the most recent data on EU exports in the tobacco sector and PMI’s investments in the EU.” OFFICIALS QUESTION TURKEY’S TAXES, RULES ON LOCAL TOBACCO EU officials also assisted PMI in trying to change rules on cigarettes.  In July 2023, a company representative complained to EU officials about Turkey’s cigarette tax, saying in an email that Turkey had “one of the highest ad valorem duty levels in the world.” The representative also flagged Turkey’s “local content” rule, which required that cigarettes made and sold in the country contain a certain amount of domestic tobacco. The PMI representative wrote that the company had “prepared a few suggestions” for the Commission’s upcoming report on Turkey’s economic and diplomatic relationships with the EU.  That report, which came out in November 2023, flagged Turkey’s taxes and the local content rule. That elicited the email from PMI thanking EU officials for their help. Meanwhile, the company was pushing European Commission officials to raise the local content rule again, but in a different forum: an upcoming World Trade Organization (WTO) review of Turkey’s trade policies. PMI provided EU trade officials with questions to ask Turkey. EU officials then submitted a question prior to the review, asking whether the local content requirement for tobacco and other industries would continue, according to meeting minutes. The Commission spokesperson did not directly answer questions from The Examination and POLITICO about its actions regarding Turkey. Turkey has not changed its requirements on local tobacco or its tax rate.  MEETINGS PART OF A MULTIMILLION-DOLLAR LOBBYING EFFORT The meetings are part of an industry lobby that spends $16.2 million (14 million euros) a year in the EU, according to a report by Contre-Feu and STOP, another anti-tobacco group, released Wednesday. Contre-Feu mapped a network of 49 organizations and companies, including Philip Morris International and British American Tobacco, that lobbied the European Commission and Parliament to weaken tobacco regulations and set lower taxes on new nicotine products, both within and outside the EU. (British American Tobacco did not respond to requests for comment.) The interactions between the tobacco industry and EU officials appear to be extensive, according to the documents. They include several dozen email exchanges and refer to at least nine meetings between EU officials and tobacco companies or industry-supported groups.  In addition to the six meetings with PMI, there were three other meetings with tobacco representatives. Trade staff met with three other companies and a tobacco trade group in March 2024 to hear their requests for more favorable tariff rules for new nicotine products. In a separate video conference, British American Tobacco asked trade staff to intervene at a WTO hearing over Saudi Arabia’s proposed tax hike on e-cigarette cartridges. (The EU did not take action, according to the documents.) And in a third meeting, the EU’s former agriculture commissioner, a Polish member of the EU parliament and two tobacco farming lobby groups discussed tobacco subsidies and the Commission’s position on the global tobacco treaty. Nathalie Darge, secretary general of Tobacco Europe, the trade group included in one of those meetings, said its input focused on technical requirements and that it wanted to “ensure legal certainty for operators and customs authorities.” One European Commission report recapping a meeting with PMI was sent to 32 trade department officials and staff, including EU representatives assigned to Mexico, Brazil, Argentina and Vietnam and division directors. Contre-Feu wrote that the dealings between government officials and tobacco representatives showed that “current rules to limit industry influence are falling short and European policymakers continue to be heavily lobbied by the tobacco industry and those working on its behalf.” PMI’s efforts are part of a long history of the tobacco industry using trade and investment pacts to expand markets and undermine health policies, said Suzanne Zhou, who works for the World Health Organization FCTC Knowledge Hub on Legal Challenges and a senior fellow at the Melbourne Law School in Australia. “Tobacco companies have lost the argument from a health perspective,” Zhou said. “So they are reframing the issue as a trade issue in the hopes that they can advance their interests in that forum instead.”  In the 1980s, the U.S. Trade Representative threatened sanctions if Japan, Taiwan, South Korea and Thailand didn’t open their markets to U.S. cigarette companies. A study later concluded that cigarette consumption in those four markets was nearly 10 percent higher than it would have been if they had remained closed to U.S. companies.  More recently, Australia and Uruguay faced trade litigation from the industry or industry-aligned governments over their tobacco control policies.  COMMISSION CRITICIZED FOR UNDISCLOSED MEETINGS Contre-Feu contended that the documents also show that EU officials didn’t disclose meetings with the industry when they should have. To aid countries in implementing the tobacco treaty, delegates wrote a set of guidelines. They state that when setting and implementing public health policies, interactions with the tobacco industry should be limited to what is strictly necessary for effective regulation. Interactions should be conducted in public and disclosed whenever possible. And the guidelines emphasize that “all branches of government” should be made aware of industry efforts to interfere with policies. The Commission spokesperson said that’s exactly what it does: “Meetings with the tobacco industry are avoided, unless they are strictly necessary. If the applicable conditions are met, meetings are held in a fully transparent manner and are appropriately documented.” But EU trade officials did not disclose any of these meetings on the website where the trade department reports such contacts. One batch of documents was released through a request for access; another batch was obtained by Contre-Feu. One of the meetings not disclosed by trade officials occurred in July 2023. Global health leaders were scheduled to meet that November to update the FCTC. The European Commission was considering supporting strict limitations on heated tobacco products.  A Commission report summarizing a July 19, 2023, meeting with PMI said that the company had “alerted” the Commission about language “calling on WHO members to adopt import bans on heated tobacco products.” The company asserted that EU tobacco policy should take into account WTO agreements, which the company has contended would preclude countries from banning IQOS.  Philip Morris International met with European Commission trade officials in July 2023 to discuss a proposed change to a global tobacco control treaty that would have banned heated tobacco. Though such meetings are supposed to be disclosed, this one wasn’t. (Redactions by the European Commission. Highlighting by The Examination) The documents don’t say anything about whether the Commission took action, and tobacco-friendly countries in the EU such as Italy and Greece pushed back against restrictive guidelines. But in the end, the Commission took no position on heated tobacco— a victory for the industry.  During the period covered by the documents, the EU required only high-ranking Commission officials to report meetings with companies or special-interest groups. In December 2024, the Commission tightened rules to require disclosure by additional staff. It’s unclear whether those rules would’ve required disclosure of these meetings.  Former EU ombudsman, Emily O’Reilly, found other instances in which the Commission didn’t disclose meetings with the tobacco industry, which she concluded failed to meet transparency rules required under international law.  Contre-Feu has urged the EU to tighten transparency guidelines even further by extending disclosure requirements to all staff, among other things. The group said in its report that the extensive lobbying and lack of disclosure “reveal either a repeated violation of the FCTC by the European Commission or, at the very least, an insufficient implementation of the treaty’s measures.” Mathieu Tourliere of Proceso contributed reporting. STOP has received support from Bloomberg Philanthropies, which also provides financial support to The Examination. The Examination operates independently and is solely responsible for its content. Correction: This story has been corrected to say that the report on tobacco industry lobbying was jointly published by Contre-Feu and STOP, and that STOP has received support from Bloomberg Philanthropies.

The World Health Organization has recommended the use of novel weight-loss drugs to curb soaring obesity rates, and urged pharma companies to lower their prices and expand production so that lower-income countries can also benefit. The WHO’s new treatment guideline includes a conditional recommendation to use the so-called GLP-1s — such as Wegovy, Ozempic and Mounjaro — as part of a wider approach that includes healthy diet, exercise and support from doctors. The WHO described its recommendation as “conditional” due to limited data on the long-term efficacy and safety of GLP-1s. The recommendation excludes pregnant women. While GLP-1s are a now well-established treatment in high-income countries, the WHO warns they could reach fewer than 10 percent of people who could benefit by 2030. Among the countries with the highest rates of obesity are those in the Middle East, Latin America and Pacific islands. Meanwhile, Wegovy was only available in around 15 countries as of the start of this year. The WHO wants pharma companies to consider tiered pricing (lower prices in lower-income countries) and voluntary licensing of patents and technology to allow other producers around the word to manufacture GLP-1s, to help expand access to these drugs. Jeremy Farrar, an assistant director general at the WHO, told POLITICO the guidelines would also give an “amber and green light” to generic drugmakers to produce cheaper versions of GLP-1s when the patents expire. Francesca Celletti, a senior adviser on obesity at the WHO, told POLITICO “decisive action” was needed to expand access to GLP-1s, citing the example of antiretroviral HIV drugs earlier this century. “We all thought it was impossible … and then the price went down,” she said.  Key patents on semaglutide, the ingredient in Novo Nordisk’s diabetes and weight-loss drugs Ozempic and Wegovy, will lift in some countries next year, including India, Brazil and China. Indian generics giant Dr. Reddy’s plans to launch a generic semaglutide-based weight-loss drug in 87 countries in 2026, its CEO Erez Israeli said earlier this year, reported Reuters. “U.S. and Europe will open later … (and) all the other Western markets will be open between 2029 to 2033,” Israeli told reporters after the release of quarterly earnings in July. Prices should fall once generics are on the market, but that isn’t the only barrier. Injectable drugs, for example, need cold chain storage. And health systems need to be equipped to roll out the drug once it’s affordable, Celletti said. 

LONDON — Milkshakes and lattes will be subject to a sugar tax for the first time, U.K. Health Secretary Wes Streeting said Tuesday. Speaking ahead of the budget, Streeting said the government would remove the exemption that milk-based products currently have from the Soft Drinks Industry Levy in January 2028. The threshold at which the levy is imposed will also be lowered from 5 grams to 4.5 grams (g) per 100 milliliters (ml). Commonly dubbed the “sugar tax,” the levy, which was introduced in 2018 under the previous Conservative government, aims to reduce obesity and improve child health.  “Obesity robs children of the best possible start in life,” Streeting told MPs Tuesday. “It hits the poorest hardest — sets them up for a lifetime of problems.” Bottles and cartons of milkshakes, flavored milk,  sweetened yoghurt drinks, chocolate milk drinks, ready-to-drink coffees and milk substitute drinks will now be eligible for the levy. Drinks prepared in cafes and bars remain out of scope. The levy requires companies producing drinks that contain between 5g and 8g of sugar per 100ml to pay 19.4 pence per liter while drinks with 8g or more of sugar must pay 25.9 pence per liter. A government document published Tuesday said ministers expect the Treasury to raise between £40 million and £45 million a year as a result of the changes. The average sugar content in drinks has fallen by almost 50 percent since the levy’s introduction. It is associated with a fall in rotten tooth extractions in kids and an estimated 8 percent relative reduction in obesity levels among young girls. Sarah Woolnough, chief executive of the King’s Fund health think tank, said the measure was “not only common sense but also a quick win for government and, most importantly, for children and young people.”

A non-alcoholic beverage may not be sold as gin, the Court of Justice of the EU ruled today in a case that could have wide-ranging consequences for a growing sector catering to health-conscious consumers. The case involved a drink being sold as Virgin Gin Alkolholfrei. The Luxembourg court ruled that wording violated an EU law that says gin should be produced with ethyl alcohol and juniper berries, with a minimum alcoholic strength by volume of 37.5 percent.  The law is meant to protect gin producers from competition and consumers against confusion, the court said in a statement. The gin judgment comes as plant-based meat products gear up for a potential labeling fight, depending on whether a controversial “veggie burger ban” makes it through inter-institutional negotiations. A German association for combating unfair competition brought the case against PB Vi Goods, which manufactures the gin copycat. A German court referred the case to the Court of Justice, which found a “clear prohibition in EU law” because the beverage does not contain alcohol. The product can be sold, but not as “gin,” regardless of whether or not it uses terms like “non-alcoholic” or “virgin.” The top EU court has upended consumer trends in the past: it ruled against calling plant-based products “milk,” “cream,” “butter,” “cheese” or “yogurt”’” in 2017.

The European Commission is set to unveil the Biotech Act I, an EU cardiovascular health plan and a simplification of the bloc’s medical devices and in vitro diagnostics rules on Dec. 16, according to the latest Commission agenda published Monday. The first part of the Biotech Act will focus on the pharmaceutical industry and is being produced without a dedicated impact assessment. The second part — covering other biotech sectors — is expected in the third quarter of 2026. The upcoming cardiovascular health plan — inspired by the bloc’s Beating Cancer Plan — will cover prevention, early detection and screening, treatment and management, and rehabilitation. Meanwhile, simplification of the bloc’s medical devices and in vitro diagnostics rules comes after the regulations drove up assessment costs, caused certification delays, and led to product withdrawals from the market. Europe’s Health Commissioner Olivér Várhelyi has previously said the sector needs a “major overhaul.” Additionally, the Commission’s agenda includes a “drugs package” comprising new rules on drug precursors and an EU Drugs Strategy and European action plan against drug trafficking — both scheduled for Dec. 3.

Mortality rates for young adults have increased in Eastern Europe over the past decade, despite global death rates falling. Drug-use, suicide and war are among the causes of death that are rising in Eastern Europe, while earthquakes and climate-related disasters have also pushed up death rates in the region. The Global Burden of Disease report — published in The Lancet on Sunday and presented at the World Health Summit in Berlin — analyzed data from more than 200 countries and territories to estimate the leading causes of illness, mortality and early death worldwide from 1990 to 2023. Between 2000 and 2023, there was a notable rise in deaths among younger adults in Eastern Europe caused by HIV, self-harm and personal violence. In Central Europe, deaths from mental disorders and eating disorders have also risen sharply among teens over the decade. This reflects a global trend — a rise in mental health disorders, with worldwide rates of anxiety increasing by 63 percent and of depression by 26 percent. “The rise of depression and anxiety is very concerning,” coauthor Chris Murray, director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, told POLITICO. “We hear a lot of debate as to what the root causes are … but we certainly need to pay attention to try to figure out what’s driving the rise. “ The report shows some overall positive trends: Global mortality rates dropped by 67 percent between 1950 and 2023 and global life expectancy in 2023 was more than 20 years higher compared to 1950. But despite the improvements, the study also highlights “an emerging crisis” of higher death rates in teenagers and young adults in certain regions. In North America and Latin America, for example, deaths among young people increased significantly from 2011 to 2023, mainly due to suicide, drug overdose and high consumption of alcohol. In sub-Saharan Africa, they increased due to infectious diseases and unintentional injuries. In Eastern Europe, the largest increases in mortality were among those aged 15-19 year and 20-24 years, with rates increasing by 54 percent and 40 percent, respectively, between 2011 and 2023. The report also tracks leading causes of mortality worldwide. It found that non-communicable diseases (NCDs) now account for nearly two-thirds of the world’s total mortality and morbidity, led by ischemic heart disease, stroke and diabetes. In particular, in lower-middle and upper-middle income countries there is a “very rapid transition towards non-communicable diseases,” said Murray, driven by factors such as an aging population, slow or no progress on tobacco and air pollution, and rising levels of obesity. In Central Europe and North America, these chronic diseases were primarily driven by an increase in drug use disorders, according to the report. Diabetes and kidney disease also largely contributed to the increase in Central Europe, along with several other regions. “Addressing these trends requires targeted public health interventions, improved health-care access, and socioeconomic policies to mitigate the underlying risk factors,” the report authors urge. The researchers estimate that half of all deaths and disability could be prevented by tackling high levels of blood sugar, overweight and obesity, for example.    The report also points out how conflict has “begun to shift from north Africa and the Middle East to central Europe, eastern Europe, and central Asia,” in recent years due to Russia’s war in Ukraine. This has led to a rise in injury-related deaths. Palestine had the highest mortality rate due to conflict and terrorism of any country in the world. While injury-related deaths caused by specific natural disasters, such as the 2023 earthquake in Turkey and the 2022-23 heatwaves in Europe, are also on the rise. “In central and eastern Europe, heatwaves have been occurring more frequently over the past decade,” the authors said.

Europe has the highest rate of tobacco use in the world, overtaking Southeast Asia, a report from the World Health Organization found Monday. Just under a quarter (24.1 percent) of people aged 15 and over in Europe use tobacco, more than in any other WHO region, according to data from 2024. Women in the broader Europe region also have the highest global prevalence at 17.4 percent, the report found. The study also recorded global vaping rates for the first time; the WHO said the figures were especially “alarming” among young people. The data lands as the European Commission pledges to take a harder line against tobacco and vape products, with the EU health and tax commissioners pushing to hike taxes on both to curb related illnesses such as cancer and heart disease. Tedros Adhanom Ghebreyesus, the WHO director general, said tobacco control efforts prevent millions of people from smoking. But, “the tobacco industry is fighting back with new nicotine products, aggressively targeting young people,” he said, urging governments to act “faster and stronger” in implementing proven tobacco control policies. TAKING THE LEAD Globally, in 2024, there were an estimated 1.2 billion tobacco users aged 15 years and older. Tobacco prevalence is falling worldwide, but at a slower rate in Europe than other regions. The figures for the WHO’s Europe region include 53 countries and stretch as far east as Russia. However, the latest EU data also matches the WHO’s findings — a Eurobarometer survey from June 2024 found that 24 percent of people in the bloc smoked tobacco. Prevalence in Europe fell from almost 35 percent in 2000 to a little over 24 percent in 2020. In Southeast Asia, meanwhile, tobacco consumption has plummeted from around 54 percent to over 23 percent during the same period. Meanwhile, there were over 86 million adults who vape worldwide in 2024, the report found. The Americas and Europe had the highest prevalence rates of people aged 15 and over who use vapes, at 4.8 percent and 4.6 percent respectively. The WHO pointed to “concerning” data among adolescents aged 13 to 15, where around 7.2 percent use e-cigarettes globally, equating to around 14.7 million children. The U.N. organization cautioned, however, that the estimated total number of children using vapes is “almost certainly an undercount,” since only 75 percent of the world’s population are covered by national vaping surveys. The WHO said countries had to crack down on the tobacco industry’s efforts to create new addicts through the marketing of vapes toward young people. “E-cigarettes are fuelling a new wave of nicotine addiction,” said Etienne Krug, head of health determinants, promotion and prevention at the WHO. “They are marketed as harm reduction but, in reality, are hooking kids on nicotine earlier and risk undermining decades of progress.” European leaders have taken an increasingly strong position on vapes as of late. Tax Commissioner Wopke Hoekstra told POLITICO that vapes were “killing our kids” and pledged to follow through with his plan to extend the Tobacco Taxation Directive to new products. The vaping industry denied his claim, saying there have been no deaths caused directly by legal vapes. Meanwhile, Health Commissioner Olivér Várhelyi told a health conference in Austria last week he wanted to eventually raise minimum taxes on vapes in line with tobacco.

GASTEIN, Austria — European Health Commissioner Olivér Várhelyi said the EU will eventually hike taxes on vapes to match “classic tobacco products” as Europe was already seeing the public health impact of vaping. Várhelyi said the European Commission’s proposed tax hikes on cigarettes and vapes, presented in July, were a “strong signal” of EU policy’s direction of travel. The Commission proposed to raise tobacco taxes across the board and set minimum taxes on vapes and nicotine pouches for the first time.  The proposed tax levels vary by product but are higher for cigarettes and tobacco than e-cigarettes. The new tax on cigarettes would be at least 63 percent of the average retail price, while for vapes it will range from 20 to 40 percent.  “We will raise the excess duties on these new products to the exact same level as it is for classic tobacco products and we will need to continue in that direction,” the commissioner said during a panel at the European Health Forum Gastein in Austria. “For whatever reason, in the public [vaping] is not presented as a danger — yet,” Várhelyi said. But he said Europe was already witnessing the public health impact. In the Czech Republic, more than 25 percent of young people vape. “The health impact is already there,” he said, pointing out this number was higher than the average rate of EU adults who smoke. In 2019, 18.4  percent of people in the EU aged 15 and over smoked daily. Várhelyi didn’t give a timeline for when taxes on new products would rise to match cigarettes. “Of course, it’s very important to have confirmation from the lung experts that we’re doing the right thing,” he added. Várhelyi was speaking at a panel on heart health where he heard pitches from experts on how to maximize the impact of the planned cardiovascular health plan, expected by the end of the year.

Poland wants to ban shop booze sales at night to curb excessive drinking, cut crime and prevent ill health, after Warsaw city tried and failed to outlaw them. Prime Minister Donald Tusk’s coalition partners — The Left and centrist Poland 2050 — have submitted legislative proposals including broad alcohol advertising bans, outlawing off-license sales from at least 10 p.m. to 6 a.m. and curbs on alcohol sales at petrol stations and online. The coalition partners say these measures, consistent with World Health Organization recommendations, are among the most effective tools to prevent alcohol-related poor health, such as cancer and mental health disorders. Latvia enforced similar measures from August. EU health data places Poland among the bloc’s worst performers on alcohol-related mortality: The country ranked second in the EU for alcohol-attributable deaths, behind Slovenia, in 2022, Eurostat said in March. The push for a nationwide ban follows the collapse of plans for a citywide proposal in Warsaw, after the local council threw out the measure over failure to agree. Warsaw’s failed attempt highlights the divergence between political groups on such public health measures, even inside Tusk’s ruling coalition. Councilors rebelled against the proposal tabled by their own mayor, Rafał Trzaskowski, arguing it impinged civil liberties. Trzaskowski pledged to keep trying to institute the ban.   It also comes as global leaders failed to agree to a political declaration to curb chronic diseases, such as those caused by drinking, underscoring the difficulty in agreeing to proven public health measures in a politically divided arena. In Poland, Warsaw city’s policy failure came despite overwhelming support among the local Varsovians when the city hall had tried to gauge the mood among people. Warsaw’s failed attempt highlights the divergence between political groups on such public health measures, even inside Donald Tusk’s ruling coalition. | Jonathan Raa/Getty Images Joanna Wicha, an MP for The Left, told POLITICO many local governments often lack determination and courage to ban nighttime booze sales. “That is why a top-down ban is needed,” she said. She hinted Tusk’s backing could help make the bans reality.  Currently, the proposals are undergoing public consultation and the parliament is expected to begin work on them in late October or early November, she said. SATURATED Poland is awash with booze shops. There were nearly 119,000 shops selling alcohol in Poland at the end of 2023, from small privately owned stores to large grocery chains, to 24-hour gas stations, Poland’s health ministry said in January. By contrast, Sweden has 900 alcohol stores, one per roughly 11,000 people, compared with one for every 320 people in Poland. To date, some 180 Polish municipalities already operate some form of nighttime prohibition, including in Kraków — Poland’s top tourist destination. Warsaw eventually ended up passing trial bans in two of the city’s 18 districts, but critics say it’s nowhere near effective. In locations where bans have been in place, police reports say the effects have been positive — less crime, more security in the streets and fewer patients at emergency wards — according to local media. “I would prefer local governments to follow the example of those that consistently try to counter the effects of what I call ‘liberal alcoholism,’ Especially in big cities, the presence of drunk people late at night near homes or in city centers is anything but pleasant,” Tusk said Sept. 22. The Left’s draft would ban sales at petrol stations and in long-term rehabilitation facilities and impose a 10 p.m.–6 a.m. national ban, with the option for local councils to widen the restriction to start at 9 p.m. and end at 9 a.m. It would also mandate age checks for every purchase and forbid selling below the combined level of excise and VAT, as is often the case in supermarket promotions. Poland 2050 also wants to let local authorities extend bans to 9 a.m. and to adjust licenses that have not been changed in 23 years. FEW INCENTIVES TO DRINK LESS The country’s National Center for Counteracting Addictions, or KCPU, a government agency coordinating policies on drug and alcohol abuse, estimates the social cost from alcohol in Poland at roughly 93 billion złoty (€21.8 billion) a year, compared with just 14 billion złoty in excise revenues. Poland’s per-capita consumption of pure alcohol stood at 8.8 liters in 2024, dropping steadily from 9.7 liters in 2021 due to lower beer consumption, according to KCPU data. Spirits, meanwhile, have held steady. WHO data shows Poles drink more than the bloc’s average. Cheap booze may be a reason: In 2024, an average monthly wage would buy about 2,103 half-liter bottles of beer — the highest since at least 2002. Affordability of other alcohol types has also been rising. By contrast, Sweden has 900 alcohol stores, one per roughly 11,000 people, compared with one for every 320 people in Poland. | Xavi Lopez/Getty Images The drinks industry has mobilized against sweeping curbs. “The proposed bill is a populist overregulation drafted in a wave of emotion and a chaotic set of changes that do not account for consumption trends or market realities,” Browary Polskie said in a statement. The brewers’ lobby argues beer volumes have been sliding for years: Sales have fallen some 15 percent over six years, and in the first nine months of this year the category declined a further 7-8 percent, while beer prices rose around 45 percent in recent years. Browary Polskie also complained that the draft would sweep in nonalcoholic beer — a product that, they say, helps reduce alcohol intake — and hit domestic brewers disproportionately. “Entrepreneurs are again surprised by legislative initiatives that threaten business stability,” Karol Stec, head of the spirits industry employers’ group, told the national newswire PAP.

BRUSSELS — Climate change was responsible for an estimated 16,500 additional deaths in Europe this summer, according to a study by epidemiologists and climate scientists published Wednesday. This represents 68 percent of the 24,400 estimated heat-related deaths that happened this summer in large European cities, according to researchers from Imperial College London and the London School of Hygiene and Tropical Medicine. “These numbers represent real people who have lost their lives in the last months due to extreme heat. Many of these would not have died if it wasn’t for climate change,” said Friederike Otto, a climate science professor at the Centre for Environmental Policy at Imperial College London, who contributed to the study. Climate change has made Europe’s largest cities, on average, 2.2 degrees Celsius warmer compared to a pre-industrial world. This not only makes them hotter in general, but increases the risk of heat waves, Otto said. This summer was the third hottest on record, according to the EU’s Copernicus Climate Change Service. Extreme heat is also putting older people and those with underlying health conditions, such as heart disease and diabetes, at higher risk. People aged 65 and over accounted for 85 percent of the estimated excess heat-related deaths this summer, according to the study, highlighting how hotter summers are becoming increasingly deadly for Europe’s aging population. “An increasing heat wave temperature of just 2 to 4 degrees [Celsius] can mean the difference between life and death for thousands of people,” said Garyfallos Konstantinoudis, a lecturer at the Grantham Institute for Climate Change, who contributed to the study. “This is why heat waves are known as silent killers.” But this estimated death toll is just a snapshot, according to the researchers, as the study only focused on 854 cities with more than 50,000 people in the EU and the U.K. This represents only about 30 percent of Europe’s population. However, these deaths are “preventable” if countries continue to reduce their emissions and combat climate change, said Malcolm Mistry, assistant professor at the London School of Hygiene and Tropical Medicine, who contributed to the study. Italy and Spain were the most severely affected, with climate change contributing to an estimated 4,597 additional heat-related deaths in Italy and 2,841 in Spain. But the researchers also found that “although the excess mortality rates are lower in northern Europe, mainly because temperatures were lower, the proportion of deaths attributable to climate change is higher.”