Perspectives | Public Health

Implementing Kosovo’s Tobacco Law is a legal and public health priority

By - 06.03.2024

The enforcement that began in January 2024 should be just the start.

Enjoyers of coffee shops in Kosovo know that there is a tradition of smoking while drinking a cup of coffee. But in early 2024, most coffee shops in Prishtina stopped smoking indoors. The government started the year by trying to enforce tobacco laws and sending inspectors throughout Prishtina’s array of cafes. 

In January 2024 alone, 520 fines were issued by sanitary inspectors for non-compliance with the Tobacco Control Law. We could potentially even see new anti-smoking campaigns down the line. Such enforcement is notable. But will it be enough to overcome the factors that have made the tobacco law historically not enforced? 

Tobacco consumption is a pressing health concern in Kosovo. Based on data from Kosovo’s Customs, Kosovars consume over three thousand tons of tobacco per year, worth over 300 million euros. A survey by Democracy Plus in 2019 showed high smoking rates in Kosovo: 36.4 percent of adults. Among men, it’s 48.9 percent and among women, it’s 23.8 percent. Nearly 70 percent of smokers in Kosovo smoke over 20 cigarettes a day. The public health impacts of this high tobacco consumption drives institutions to take measures to limit it. However, anti-smoking laws have faced hurdles in implementation. 

According to the World Health Organization (WHO), tobacco is responsible for over 8 million deaths per year around the world, 20 different subtypes of cancer and many other debilitating health conditions. Tobacco use and production also has a negative environmental impact. The industry consumes vast resources and emits 80 million tons of CO2 annually, the equivalent of adding 17 million gas-powered cars to the earth’s roads and five percent of global deforestation results from cutting down trees to make room for tobacco plants. About 4.5 trillion cigarette butts pollute the globe every year. 

Kosovo’s Law on Tobacco Control regulates various aspects of tobacco controls through a series of stringent measures. The law has been amended twice, once in 2022 and again in 2023. Smoking is now prohibited in almost all indoor public places and workplaces. Moreover, the law strictly prohibits all forms of tobacco advertising, promotion and sponsorship, including any financial support to the government from the tobacco industry. It also mandates prominent text warnings covering a significant portion of tobacco packaging, restricts the sale of tobacco products in certain locations and imposes an age limit of 18 for tobacco sales. 

The lack of implementation of legislation in Kosovo is evident. The new laws created after the 1999 war followed the premise of harmonization with European legislation. In this context, some laws were made with the interest of only appeasing international guidelines as a means of achieving the required level of democratization. Hence, while the process of adopting the laws is satisfactory, implementation is not visible. 

Why do anti-smoking laws struggle to take root in Kosovo?

At the beginning of 2024, there was a more evident attempt by the government to enforce the tobacco law. This is not the first attempt to fully implement the law, but there has been and will continue to be resistance to the matter. As such, we should critically ask ourselves some questions. Why do some laws in Kosovo stay on paper and never get implemented? And, more specifically, despite efforts, why do anti-smoking laws struggle to take root in Kosovo? How do corporate interest groups factor into the equation? 

Law and interest groups 

Legislative, administrative and judicial procedures of law-making are influenced by a variety of factors such as public opinion, the mass media, shock events and interest groups. Interest groups can influence the enforcement of laws and policies in a way that suits their interests but doesn’t necessarily align with broader society’s interests. In this context, mass media can play a crucial role in shaping public opinion and framing issues for broader society. Interest groups usually recognize this and frequently employ media strategies to garner support for their positions or to pressure policymakers. Furthermore, even mass media can channel interests that don’t align with the public opinion by being part of such strategies.

Interest groups can shape legislative agendas and priorities in such a way that results in the passage of symbolic or neglected legislation that meets all legal criteria but lacks meaningful enforcement or implementation. Such legislation is emblematic of the broader challenges in law implementation, which are often driven by outside interests such as influential groups or lawmakers’ self-serving motivations.

Interest groups can shape legislative agendas and priorities in such a way that results in the passage of symbolic or neglected legislation that meets all legal criteria but lacks meaningful enforcement or implementation.

One example is the international tobacco industry, which has long deployed sophisticated lobbying tactics to influence legislation and tobacco control regulations. For instance, in Georgia, the Business Association of Georgia, backed by Philip Morris International’s local branch, pushed for lower taxes and legalization of IQOS heated tobacco products. Similarly, in Kenya, British American Tobacco reportedly convinced the government to lift a ban on nicotine pouches, allowing British American Tobacco to reintroduce a product. 

The tobacco industry even argues that higher taxes on tobacco encourage smuggling. In Colombia, Philip Morris International worked with the National Federation of Departments to fight against tax increases in Congress while supporting anti-smuggling efforts financially. 

Similarly, Japan International Tobacco (JTI), owner of the Camel and Winston brands, highlights its efforts to fight tobacco smuggling and cultivates a socially responsible image by focusing on tobacco smuggling’s negative impact on communities. One wonders if company executives are similarly concerned about tobacco smoking’s negative impact on communities. 

Some may argue that companies in all industries engage in such behavior, prioritizing profit over societal well-being and seeking association with positive causes. This may be true, but it should not grant tobacco companies a free pass. They are, after all, producing and marketing what the WHO has noted is “the only legal consumer product that kills up to half of its users when used exactly as intended by the manufacturer.” As the Danish Institute for Human Rights concluded, “there can be no doubt that the production and marketing of tobacco is irreconcilable with the human right to health.” 

A current issue: Kosovo’s tobacco regulation 

Kosovo adopted its Tobacco Control Law following WHO standards. However, a study published in early 2024 by the Kosovo Advocacy and Development Centre (KADC) found that although tobacco control legislation has been passed, the tobacco industry’s continued efforts to weaken enforcement have posed a significant public health challenge. 

Despite strides made toward implementing tobacco control policies, the industry’s insidious tactics continue to undermine progress. According to the KADC study, the tobacco industry lobbies government institutions, manipulates tax policies and obstructs regulations. Leveraging economic laws and chambers, the companies exert undue influence, aiming to perpetuate smoking rates and safeguard profits. 

One example of what tobacco companies are willing to do to maintain their profits is the Philip Morris v. Uruguay case. In 2013, Philip Morris challenged Uruguay’s anti-smoking legislation through an international arbitration tribunal, alleging that the country’s public health measures such as graphic warnings on packaging and advertising restrictions devalued its cigarette trademarks and investments.

Philip Morris aimed to protect its profits from regulatory measures designed to reduce smoking rates and improve public health. Bringing such a case could also threaten other countries considering similar legislation. However, the tribunal ruled in favor of Uruguay and ordered Philip Morris to pay $7 million in legal costs.

In recent years, the tobacco industry has expanded into low and middle-income countries (LMICs), intensifying global inequalities. Smoking rates in LMICs are rising, particularly among adolescents, in part due to exploitation of lax regulation and marketing specifically targeting women. This could be the case in Kosovo given that the industry spares no effort to protect its interests, delaying administrative instructions, opposing key provisions of the Tobacco Control Law. 

The KADC study also detailed the potential use of media by the tobacco industry, exemplified by the “Vangjush Gambeta” award given annually by the Union of Albanian Journalists (UGSH). The award, inaugurated in 2009, is sponsored by JTI, showing how such companies may seek to cultivate a positive public image and bolster their reputation by influencing journalists and countering negative perceptions of the industry.

Several other findings were noted in the KADC study. Tobacco companies lobby against strict anti-smoking laws to protect profits, while bars and restaurants resist bans to retain customers and individuals addicted to smoking defy enforcement, viewing it as a threat to their habit. 

In our society, the enforcement of smoking laws carries significant weight, transcending mere legal compliance. We need to consider the burden placed on public health organizations tasked with mitigating the onslaught of smoking-related illnesses. With the lack of enforcement, these institutions find themselves grappling with the overwhelming strain on healthcare systems. 

Additionally, young people are not immune to the repercussions of this situation. Recent research revealed that sellers can easily sell cigarettes to children in Prishtina. Without the necessary enforcement mechanisms in place, these institutions face an uphill battle in instilling the importance of tobacco control among the population.

In essence, the neglect of smoking laws permeates beyond legal realms, seeping into the very foundation of our societal norms and institutions. Enforcement of this legislation is not merely a matter of legality but a vital component in preserving the well-being of our society as a whole.

Enforcement of this legislation is not merely a matter of legality but a vital component in preserving the well-being of our society as a whole.

Moreover, enforcing smoking laws is a stance against multinational corporations that prioritize profit over public health and environmental concerns. Governments standing up to these attempts by rigorously implementing smoking regulations demonstrate a commitment to safeguarding public health and environmental sustainability. 

Looking ahead, recent initiatives to enforce tobacco laws more strongly compared to previous years offer a glimmer of hope, provided that these efforts are sustained. Civil society, government institutions and international organizations must work collaboratively to address these challenges and ensure the effective implementation of tobacco control policies. The enforcement of smoking laws in Kosovo is not merely a legal obligation but a fundamental necessity for safeguarding public health and preserving societal well-being.

Feature Image: Atdhe Mulla / K2.0.