Smoking: An Endemic Problem in Bosnia and Herzegovina

Smoking is rife in Bosnia and Herzegovina (BiH), where the price of a pack of cigarettes is one of the lowest in Europe and Central Asia. The country ranks number 8 in the world in terms of smokers per capita and the percentage of adolescent smokers is steadily increasing.

Every year, 5 million people die worldwide directly as a consequence of tobacco smoking, with an additional half a million deaths attributed to the effects of second-hand smoke. Tobacco kills more than tuberculosis, HIV/AIDS and malaria combined and could kill over 1 billion people during the 21^st century if effective measures are not taken, according to the World Health Organization.

Tobacco consumption is a serious health, economic, social and financial issue for BiH. The impact on its society is severe, causing an increase in diseases, disabilities and premature deaths, as well as a financial burden on smokers and their families, health service providers, and employers.

With this in mind, the World Bank, in partnership with the BiH State and Entity authorities and the Government of Switzerland, organized the International Tobacco Control Conference in Sarajevo on 5-6 November, the first conference of its kind ever held in BiH.

The two day Conference aimed to raise the profile of tobacco control in BiH and to learn about tobacco control programs and the experiences of other countries. Among the attendees were key government officials and health specialists from Albania, Bosnia and Herzegovina, Brazil, Kosovo, Montenegro, Slovenia, Serbia, Turkey, and Ukraine, as well as experts from the World Health Organization, the World Bank, and civil society.

Officials from Brazil, Slovenia, Turkey and Ukraine highlighted their countries’ experiences in dealing with tobacco control and the implementation of smoke-free programs. The conference also provided an opportunity for the participants to establish an informal regional network through which they can continue to discuss tobacco control issues and learn from each other.

“It really makes a lot of sense that we start dealing with this issue that generates huge direct and indirect costs for the country. If the Turks are no longer smoking like Turks, we in BIH don’t need to either”.
Zoran Ivancic, Public Interest Advocacy Center, Bosnia and Herzegovina

To keep the momentum going, the World Bank Country Office in BiH has submitted a proposal to the Swiss Development Agency to fund a five year risk factors awareness program in BiH, with the aim of decreasing the prevalence of risk factors for NCDs (tobacco use, physical inactivity, alcohol abuse, and unhealthy diet). 

“Tobacco Control is work that needs many hands. We need lots of work and energy to move the agenda forward.”
Vera da Costa e Silva, National Public Health School, Oswaldo Cruz Foundation, Brazil

In addition to the Conference, a discussion took place with the BiH State and Entity authorities on different tobacco taxation models prepared by the World Bank, and a separate training was organized for 8 NGOs from BiH on tobacco control advocacy.

The Conference was a good start, but much work remains to be done in order to change attitudes to smoking in Bosnia and Herzegovina, which can only succeed through a comprehensive program that involves multiple actors and sustained efforts.