Smoking Is a Dying Habit. Not in Germany

Germany—public health officials in Germany are raising the alarm over an unexpected uptick in cigarette smoking—including among the young—that started in the wake of the Covid-19 lockdowns. The overall smoking rate in Germany was just over 34% in July, according to the most recent findings from Debra, a bimonthly survey funded by the German Health Ministry. In March 2020, the rate was 26.5%. The percentage of Germans between 14 and 17 years old who said they smoked cigarettes jumped to 15.9% in 2022, from 8.7% in 2021, according to Debra. This makes Germany an outlier among other developed nations. Other European countries, including Sweden, Ireland and the Netherlands, have seen steady decreases in smoking rates, said Rüdiger Krech, director of health promotion for the World Health Organization. “We’re so baffled around this,” he said. “In so many areas of public health and health systems, Germany is performing very well. Here, it is an outlier.”

Among a number of possible factors, Krech and other experts said pandemic-related disruptions to work and social rhythms might be leading people to spend more time at home, where smoking isn’t restricted. In the U.S., cigarette sales resumed a yearslong decline after a brief halt during the pandemic. A survey found 4% of 12th-grade U.S. students smoked cigarettes in 2022, roughly the same as in 2021 and below prepandemic levels. The smoking rate for U.S. adults in 2021 dropped to 11.5%, according to the U.S. Centers for Disease Control and Prevention. The French Health Ministry reported in May that 24.5% of surveyed adults were daily smokers in 2022, which is roughly even with 2019 levels. An European Union-sponsored survey in 2019 found that more Germans were daily smokers than their European neighbors. Alexander Dumser, 16, from the south German state of Bavaria, said he began smoking at the end of last year. For him it is a social activity, usually in combination with drinking alcohol. “I think it is just part of the age. Now is the time to experience things,” he said. There isn’t much of a stigma on smoking in his peer group in the Munich suburbs, he said, and it is usually possible to buy cigarettes from a store without anyone checking if he is over 18, the minimum age to purchase tobacco products in Germany. The country’s public-health experts are now urging the government to increase cigarette taxes to drive up prices.

The average cost for a pack of cigarettes in Germany was around €6.65 in 2022, according to industry data, equivalent to about $7.26. The price in Germany is less than France and the U.K. but more than twice as expensive as nearby Poland. In some parts of the U.S., a pack of cigarettes costs as much as $15. Daniel Kotz, an epidemiologist based in Düsseldorf and director of the Debra study, said he believed relatively low prices and lax antismoking policies set the context for the postpandemic uptick. One reason for the increase might be the restoration of freedom after many social activities were restricted during Covid shutdowns.

More data will be available at the end of the year, but Kotz suspects the level will remain above its prepandemic baseline. “It is of high concern, because we will have another generation of nicotine and tobacco-addicted people coming up,” he said. Part of what keeps people from smoking are social controls that broke down during the pandemic when people started working from home, said Heino Stöver, an addiction specialist at the Frankfurt University of Applied Sciences. “I saw in many Zoom conferences that people were smoking who I never thought were smokers,” he said. Cigarettes in Germany are still available in automatic vending machines, at grocery stores and drugstores. Required labels warn users that smoking is deadly, but brands are often displayed at checkout counters. There are lower smoking rates in countries where it is harder to buy and advertise tobacco products, Stöver said. A spokeswoman for the federal health ministry said reducing tobacco consumption and protecting the young are urgent policy goals. The government in 2020 banned outdoor advertising of tobacco products. In 2021, lawmakers approved a multiyear cigarette-tax increase totaling about 50 cents a pack and levied fresh taxes on new products, including heated tobacco and e-cigarette refill containers. Krech and Laura Graen, an associate at the German Cancer Research Center, said the tax rate increase didn’t keep pace with inflation, which is running higher in Germany than in many of its neighbors in Europe. They urged Berlin to further increase prices and to push states to ban smoking in more public places.

Smoking has been prohibited on public transportation and in federal office buildings since 2007 and restricted in workplaces since 2004. Individual states have latitude in implementing restrictions on bars, clubs and restaurants. Jan Mücke, chief executive of BVTE, a tobacco lobbying association, has said additional restrictions are patronizing and warned that increasing cigarette taxes would drive people into illicit markets. Mücke also questioned the quality of Debra’s data, whose survey of 2,000 people he said doesn’t include a large number of adolescents. He pointed to a separate 2021 government survey that found that 6.1% of 12 to 17-year-olds smoked. Federal tax data for 2022 showed the number of cigarettes sold declined by 8.3% in that year from 2021 levels. The same tax report showed a 0.9% increase in the amount of fine-cut tobacco, which is used for roll-your-own cigarettes. The report didn’t capture data for cigarettes sold in other countries. Kilian Grewminger, a 24-year-old sociology student, said he started smoking when he got to the university and increased the number of cigarettes each day during the lockdowns because he could attend seminars from home. His rate has stayed at the higher level, and he recently started rolling his own cigarettes when the cost of buying packs became prohibitive. “It becomes too expensive for young people,” he said.

Source : Mint