Gaining health : analysis of policy development in European ...

Chapter 4
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• positive changes in lifestyle (in terms of smoking, alcohol
use, overweight and physical activity);
• declining avoidable mortality;
• a lower incidence of acute myocardial infarction and
stroke;
• a declining number of disabled people and improved
quality of life;
• an increase in well-diagnosed and treated cardiovascular
patients, a reduction in the high-risk population and an
increase in successful rehabilitation; and
• a reduction in cardiovascular morbidity and mortality in
younger and middle-aged people.
The conceptual framework of the Programme puts special
emphasis on health promotion, on the lists of indicators
according to the European Community Health Indicators
(ECHI) system and the creation of a coherent database.
The document underlines the importance of PHC in the
community.
The document makes clear reference to other existing
policies and programmes, including the NPHP, the National
Cancer Control Programme and others, without making
clear its own added value. The key people in the planning
group may have an important lobbying function for securing
financing from the EU structural funds in the period of implementation
up to 2013. At the moment, the Programme
has no clear legal status or managerial structure.
2.7. Policies related to risk factors
There are clear-cut sub-policies for tobacco control and
nutrition. The alcohol policy is in a preparatory phase. A
strategy on leisure time physical activity is included in the
document outlining the National Sport Strategy.
2.7.1. Tobacco
Physicians in Hungary – reflecting international trends –
started to call attention to the devastating results of smoking
in the early 1980s (4).
Studies on the social and economic costs of smoking show
that from 1995 on, direct and indirect costs increased continuously,
exceeding by about three times state revenues
from the tobacco sector. Direct smoking-related costs,
including hospital care, disability pensions and subsidies on
pharmaceutical products, accounted for around 10% of the
total costs to the national Health Insurance Fund in all three
years for which calculations were made.
The NPHP lists tobacco control among its most important
programme elements. Within this framework, the 10-year
National Antismoking Action Plan states as its overall priority
to reduce smoking in Hungary by 8% every year.
With the ratification of the WHO FCTC in 2003, the
Hungarian Government assumed responsibility for creating
the institutional framework for developing and implementing
programme elements. The implementation of the FCTC
is in progress and a ban on cigarette advertising has been
introduced. Steps have been taken to provide smoke-free
environment for the public, such as a ban on smoking in
public buildings. The media pay increasing attention to the
issue and public acceptance of smoking has declined significantly
in the last few years.
Several anti-tobacco campaigns have been developed and
run in the last 20 years, aiming to draw the population’s
attention to the negative effects of smoking on their health
and quality of life. Campaigns are designed and carried out
by the Ministry of Health and the National Institute for
Health Development. Different programmes are designed
for smokers, to make them aware of the dangers of smoking
and encourage them to quit, while others are designed
to prevent young people taking up smoking (5).
One of the most widespread cessation campaigns is the
“Quit and Win” programme, which is part of the CINDI
framework activity in Hungary. The programme was
launched in 1998, and events were organized in every two
years (6). A number of active NGOs, including the National
Case studies: policy development in countries for tackling noncommunicable diseases