BRUSSELS — Buying a pack of cigarettes in Belgium these days can be enough to scare you to death.
Since November, smokers in this rain-swept country of 10 million people have been confronted with graphic warnings on their cigarette packs, and they are not for the fainthearted.
One shows a man with a swollen red tumor protruding from his neck. “Smoking can lead to a slow and painful death,” reads a note underneath. Other pictures the Belgian government plans to rotate over the next three years show toothless gums, blackened lungs and open heart surgery.
So far, Belgium is the only European country to force manufacturers to slap gross pictures onto cigarette packs. But Britain, Latvia, Portugal and Romania intend to follow Brussels’ example, according to the European Commission, the European Union’s executive body.
EU Health Commissioner Markos Kyprianou, who hopes to see the spread of such graphic warnings, argues they not only provide relevant health information “but also are likely to reduce tobacco use in the population.”
Evidence from Canada, which became the first country to put graphic pictures on cigarette packs in 2001, suggests he is right. Almost a third of former smokers in Canada say the images encouraged them to quit, and 7 out of 10 adults say the warnings were an effective way of informing them about the health effects of smoking.
Heavily taxed by governments, barred from smoking in offices, bars, restaurants and other public spaces, and now forced to carry around small anti-smoking billboards, European smokers are not happy.
“There is a general trend to take away the rights of smokers, who still make up one in four of the population in Europe,” says Catherine Armstrong, press officer for British American Tobacco, makers of the Lucky Strike and Kent brands and the world’s second-largest cigarette manufacturer. “Smokers are increasingly finding themselves marginalized.”
European smokers are used to being stung by tax authorities, who have made a pack of cigarettes almost twice as expensive in Britain as in the United States. Smokers in other European countries pay less, but for the first time are facing restrictions on lighting up outside their homes.
Ireland, a country famed for its smoke-filled pubs, was the first EU state to ban puffing in enclosed public spaces in 2004. Since then, almost a dozen European countries have followed suit to varying degrees.
Scotland will outlaw smoking in workplaces and enclosed public spaces in March, and the rest of Britain will follow by the summer. Italy, Malta and Sweden allow smoking only in sealed-off, ventilated areas. And France, where film directors still consider smoking sexy and cafe debates are fueled by nicotine and coffee, introduced similar measures on Feb. 1 — although bars and restaurants have until the end of the year to fall into line.
Other countries that have banned smoking in all public spaces except bars and restaurants include Cyprus, Estonia, Finland, the Netherlands, Slovenia, Spain and — as of Jan. 1, Belgium.
The measures have been given wide support, especially in countries where smoking bans have been introduced. More than 80 percent of Europeans are in favor of outlawing smoking in indoor public spaces such as offices, shops and airports. The figure drops to 75 percent for restaurants and 61 percent for bars and pubs, according to a poll sponsored by the European Commission.
Some cigarette makers, such as British American Tobacco, may dispute the effects of tobacco on nonsmokers — “clinical studies have not shown a massive increase in risk,” says Mrs. Armstrong — but the European Commission is in no doubt about the hazards of second-hand smoke.
According to studies quoted in its policy paper, almost 80,000 adults die each year in the EU as a result of passive smoking — at a massive cost for countries where health care is publicly financed.
The 27-member commission, which drafts all European Union laws, is also convinced that smoking bans work. It quotes studies showing an 8 percent drop in tobacco sales in Italy and a 14 percent fall in Norway following recent public smoking bans. In Ireland, 80 percent of former smokers say the new law had encouraged them to drop the habit.