Greece: A Case Study

17 September 2024

CHAPTER 6 . THR: A GLOBAL TRANSFORMATION

Greece's Progressive Strategy on Communicating Risk-Related Messages to Adult Smokers
A Case Study: Greece

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At a glance

31.6%

In 2024, an estimated 31.6% of adults in Greece smoked daily,^[9] reflecting an approximate 10% decline in smoking prevalence since 2020^[7,9]

10%

Greece is Europe’s fourth largest Heated Tobacco market by value, with an adult (18+) usage rate of 10%. The number of Heated Product users has almost doubled since 2020^[10]

Traditionally known for having one of the highest smoking rates in Europe,^[1] Greece has increasingly adopted smokeless tobacco and nicotine products as part of its broader strategy to reduce smoking rates and accelerate Tobacco Harm Reduction.

According to the Institute for Health Metrics and Evaluation, in 2021, tobacco use was the leading risk factor for deaths and disability in the country,^[2] contributing to 19,900 deaths, which accounted for 27.8% of total deaths.^[3]

To reduce smoking rates and drive Tobacco Harm Reduction, the Greek Government implemented a progressive regulatory framework that goes beyond traditional tobacco control measures such as high taxation, public place smoking and advertising bans, smoking cessation support, and public health awareness campaigns.^[4] Notably, it has established a law that enables manufacturers to submit applications, and upon approval, communicate risk-related messages about their products, empowering adult smokers with even more information to make the decision about transitioning towards smokeless alternatives.^[5]

Greece's Journey

2019

Greece launches the National Action Plan Against Smoking, introducing Tobacco Harm Reduction as the fourth pillar of its strategy, alongside prevention, elimination of second-hand smoke exposure, and providing cessation support.^[6]

2020

The Greek Government enacts Law 4715/2020,^[5] recognising citizens' rights to access accurate information about the properties of regulated Smokeless Products. The law allows scientifically substantiated claims to be communicated at points of sale, subject to prior approval.

2020

The Greek Ministry of Health approves a risk-related message for BAT’s heated tobacco product, glo™ neo classic tobacco.

2023

The Greek Ministry of Health authorises reduced toxicity claim, in comparison to cigarette smoke, for IQOS HEETS AMBER, a heated tobacco product marketed by Philip Morris International.

The National Action Plan Against Smoking

A National Action Plan Against Smoking was launched in 2019.^[6] This plan strengthened the enforcement of the existing anti-smoking laws and introduced "the protection of the health of citizens through the correct and objective evaluation of new tobacco products and the regulation of their circulation on the market", i.e., Tobacco Harm Reduction as the fourth pillar of the national tobacco control action plan, alongside prevention, elimination of second-hand smoke exposure, and providing cessation support.^[6] The introduction of the Tobacco Harm Reduction approach was based on a Public Health commitment to all citizens, including smokers.

Legislation Supporting Tobacco Harm Reduction

In furtherance of its Tobacco Harm Reduction objective, the Greek Government established Law 4715/2020, in July 2020.^[5] Through this law, the government recognised the citizens' rights to access accurate information about the properties of regulated Smokeless Products in Greece, by allowing the communication of relevant messages, subject to prior approval. To ensure scientific integrity, such claims are subject to rigorous scientific assessment by an independent scientific committee, overseen by the Greek Ministry of Health.^[5] The scientific committee includes representatives from various technical and scientific bodies, such as the General Chemical State Laboratory, the National Organization for Medicines, the Hellenic Thoracic Society and the Hellenic Society of Toxicology.

The introduction of Law 4715/2020 marked a significant milestone, making Greece the first country outside the United States to implement a regulatory framework allowing for the communication of risk-related messages to consumers, approved by a competent government authority.

Advancing Through Validation of Our Science from a European Regulator

In 2022, the Greek Ministry of Health authorised the following claim for BAT’s Heated Tobacco Product glo™ neo classic tobacco: “The concentration of chemical substances with known toxicity that are produced with the use of glo™ neo classic tobacco is less compared to conventional cigarette smoking.”* The claim was approved following a comprehensive review process of the supporting scientific evidence. The Greek Ministry of Health is the first European regulator to approve such a claim, allowing smokers to be notified of this claim at points of sale. In 2023, the Greek Ministry of Health also approved a reduced toxicity claim (in comparison to cigarette smoke) for Heated Tobacco Product IQOS HEETS AMBER marketed by Philip Morris International.

The process aligns with BAT’s commitment to transparent communication, actively seeking regulatory scientific evaluation to maximise the potential of Smokeless Products in advancing Tobacco Harm Reduction.

A Model for Tobacco Harm Reduction

Greece’s proactive approach to integrating Tobacco Harm Reduction into its tobacco control framework serves as a strong example for other nations. Early data indicate a significant decline in smoking rates since 2020, with figures from Eurobarometer showing a drop from 42% in 2020 to 36% in 2023.^[7,8] A further decrease was achieved in 2024, with the percentage of adults who smoke daily estimated to be to 31.6%.^[9] The reduction is associated with an almost doubling of the number of users of Heated Tobacco Products over the same period.^[10]

Greece’s success story illustrates how the communication of accurate risk-related claims, when approved by a regulatory authority, can enhance the potential of Smokeless Products in contributing to Tobacco Harm Reduction.

* The following disclaimers must be displayed along with the claim: glo™ neo classic tobacco contains nicotine and other hazardous chemical substances. This tobacco product damages health and is addictive.

Sources

[1] OECD, Tobacco Consumption, Measure: share of population who are daily smokers. Available at: https://data-explorer.oecd.org/vis?tm=daily%20smokers&pg=0&hc[Unit%20of%20measure]=&snb=2&vw=tb&df[ds]=dsDisseminateFinalDMZ&df[id]=DSD_HEALTH_LVNG%40DF_HEALTH_LVNG_TC&df[ag]=OECD.ELS.HD&df[vs]=1.0&dq=.A.....&pd=2010%2C&to[TIME_PERIOD]=false (Accessed: 19 March 2025)

[2] Institute for Health Metrics and Evaluation (IHME), Health by location, Greece. Available at: https://www.healthdata.org/research-analysis/health-by-location/profiles/greece (Accessed: 11 July 2025)

[3] Global Action to End Smoking, State of Smoking and Health in Greece. Available at: https://globalactiontoendsmoking.org/research/tobaccoaround-the-world/greece/ (Accessed: 11 July 2025)

[4] Smoke Free Greece. Available at: https://smokefreegreece.gr/en/smoke-free-greece/ (Accessed: 19 March 2025)

[5] Greek Law 4715/2020 (Article 36), Available at: https://www.kodiko.gr/nomothesia/document/634794/nomos-4715-2020

[6] Greek Government, National Action Plan Against Smoking. 2019. Available at: https://www.government.gov.gr/ethniko-schedio-drasis-kata-toukapnismatos-i-igia-mas-enoni/ (Accessed: 11 July 2025)

[7] Eurobarometer, Attitudes of Europeans towards tobacco and related products. European Commission, 2021. https://europa.eu/eurobarometer/surveys/detail/2240

[8] Eurobarometer, Attitudes of Europeans towards tobacco and related products. European Commission, 2024. Available at: https://europa.eu/eurobarometer/surveys/detail/2995

[9] Statista, Health Indicators Greece report 2024. Available at: https://www.statista.com/study/173878/health-indicators-greece-report/

[10] TobaccoIntelligence, Greece: Heated tobacco market snapshot, November 2024