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Objectives: To quantify the implementation of tobacco control policies at country level using a new Tobacco Control Scale and to report initial results using the scale.Method: A questionnaire sent to correspondents in 30 European countries, using a scoring system designed with the help of a panel of international tobacco control experts.Results: the 30 countries are ranked by their total score on the scale out of a maximum possible score of 100. Only four countries (Ireland, United Kingdom, Norway, Iceland) scored 70 or more, with an eight point gap (most differences in scores are small) to the fifth country, Malta, on 62. Only 13 countries scored above 50, 11 of them from the European Union (EU), and the second largest points gap occurs between Denmark on 45 and Portugal on 39, splitting the table into three groups: 70 and above, 45 to 62, 39 and below. Ireland had the highest overall score, 74 out of 100, and Luxembourg was bottom with 26 points. However even Ireland, much praised for their ban on smoking in public places, did not increase tobacco taxes in 2005, for the first time since 1995.Conclusions: Although the Tobacco Control Scale has limitations, this is the first time such a scale has been developed and applied to so many countries. We hope it will be useful in encouraging countries to strengthen currently weak areas of their tobacco control policy. ; Assoc European Canc Leagues, Belgian Fdn Canc, B-1030 Brussels, Belgium ; Univ London, Guys Kings & St Thomas Med Sch, London, England ; Universidade Federal de São Paulo, São Paulo Med Sch, São Paulo, Brazil ; Universidade Federal de São Paulo, São Paulo Med Sch, São Paulo, Brazil ; Web of Science

Cigarette smuggling, now on the increase, is so widespread and well organised that it poses a serious threat to public health. This threat comes from two principal directions. First, smuggling makes cigarettes available cheaply, thereby increasing consumption. A third of annual global exports go to the contraband market, representing an enormous impact on consumption, and thus causing an increase in the burden of disease, especially in poorer countries. It is also costing government treasuries thousands of millions of dollars in lost tax revenue. Second, the tobacco industry uses smuggling politically, lobbying governments to lower tax, arguing that smuggling is caused by price differences. This paper shows that the claimed correlation between high prices and high levels of smuggling does not exist in western Europe. In fact, countries such as Norway and Sweden, with expensive cigarettes, do not have a large smuggling problem, whereas countries in the south of Europe do. Cigarette smuggling is not caused principally by "market forces". It is mainly caused by fraud, by the illegal evasion of import duty. The cigarettes involved are not the cheap brands from southern European countries, for which there is no international market. It is the well-known international brands such as Marlboro and Winston. We propose much tighter regulation of cigarette trade, including an international transport convention, and a total ban on transit trade—sale by the manufacturers to dealers, who sell on to smugglers.

The European Union spends about 1000m ecu (800m pounds, $1240m) a year subsidizing tobacco production but only about 1.55m ecu (1.2m pounds, $1.85m) on smoking prevention. The subsidies, part of the common agricultural policy, were originally intended to encourage farmers to grow commercially valued varieties of tobacco and thus reduce imports. But they also aimed to guarantee farmers' income, a goal in direct conflict with the first. The policy has failed to adapt production to demand or reduce imports, since most tobacco grown in the union has little commercial value. Reforms introduced in 1992 have had limited impact on expenditure, and data produced as a result of the reforms show that it would be much cheaper to give farmers direct income support than to subsidize them growing tobacco. Tobacco subsidies should be abolished and more should be spent on smoking prevention.

Governments have recently become concerned about cross border shopping and smuggling because it can decrease tax revenue. The tobacco industry predicted that, with the removal of border controls in the European Union, price differences between neighbouring countries would lead to a diversion of tobacco trade, legally and illegally, to countries with cheaper cigarettes. According to them this diversion would be through increased cross border shopping for personal consumption or through increased smuggling of cheap cigarettes from countries with low tax to countries with high tax, where cigarettes are more expensive. These arguments have been used to urge governments not to increase tax on tobacco products. The evidence suggests, however, that cross border shopping is not yet a problem in Europe and that smuggling is not of cheap cigarettes to expensive countries. Instead, more expensive "international" brands are smuggled into northern Europe and sold illegally on the streets of the cheaper countries of southern Europe.