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The battle against smoking in Turkey

By Lale Tokgozoglu, FESC - Vice-President of the Turkish Society of Cardiology

Smoking is one of the most important reversible risk factors. It has been a major health problem in Turkey for a long time. According to the TEKHARF Study conducted in 1990, 70 % of Turkish males and 20 % of females smoked. In a 10 year follow up of the same study, smoking prevalance increased in the females and the youth.

The fight against tobacco

We recently completed the Euroaspire III study looking at risk factors in patients who had been hospitalised for coronary artery disease and were able to get numbers from Turkey. We found that half the smokers continued to smoke after the coronary event. Although 11% were thinking of quitting at some time, 27% planned to do nothing about this. Despite these numbers, fighting with tobacco has been a long journey in Turkey.

For the first time in 1991, a law was passed to ‘prevent the harm caused by tobacco and its products’. However it was vetoed because prohibiting advertisement was found against freedom of trade. Later in 1996 with a new law, all advertisement concerning tobacco was banned for good. In addition, a note saying “cigarettes are harmful to your health” became mandatory on all packages. This was complemented by a smoking ban in public transport, and places for education and sports.

A 'Heart Health Policy’ for Turkey

In 2006, the Turkish Society of Cardiology together with the Ministry of Health prepared a ‘Heart Health Policy’ in Turkey. This was a long document which covered issues from education to treatment both documenting the present state and planning for the future. In fact, this was one of the first Heart Health Policies to be written in Europe consistent with the Luxemburg Decleration. In this document, smoking, hypertension and obesity were determined as priorities to protect heart health.

In 2008, the law to prevent the harm caused by tobacco products was revised. In this revision, more strict measures were taken. Smoking was banned in all closed public places, transportation and restaurants and cafes. It also prohibited selling cigarettes in places where education and sports were performed or to anyone at all under age 18. Penalties were defined for those not complying with rules.The main aim was to protect the children and provide a healthier environment for them.

This recent regulation was announced at the Turkish Parliament, at the Turkish Society of Cardiology’s  joint press conference with the Parliament Chairman and the Chairman of the Parliament Health Commission on the occasion of the World Hypertension Day and put in effect on the National Youth Day, May 19, 2008.

Although this is very new, the positive consequences of the law are emerging already. Compared to June 2007, cigarette consumption in June 2008 fell from 10.68 billion to 10.22 billion which is 26 million packages (520 million cigarettes) less per month. In the first few months, 20.000 YTL were collected as penalty for not complying.

These are large steps taken and will have more consequences with widespread use. We hope to see the health benefits in the years to come.

Read more about the Turkish Society of Cardiology and their activities