The uphill battle: the story of Georgia’s fight for a tobacco-free future

A new video recently launched by WHO/Europe tells the story of a long battle that united public health specialists, civil society activists, journalists and politicians against a powerful global industry that produces a highly addictive and harmful product. It describes how the fight against tobacco gained momentum in Georgia, and how the country continues to pave its way towards a tobacco-free future.

Not long ago, a third of Georgia's population of 3.7 million smoked. Prevalence of current tobacco smoking among adult men was among the highest in the WHO European Region – 57%. Women, too, had increasingly started using tobacco.

This had devastating consequences for individuals, families and all of society. Thousands of smokers and people exposed to tobacco smoke suffered from numerous diseases, including cardiovascular and lung diseases and cancers. Tobacco-related illnesses resulted in the death of 11 400 Georgians every year. In economic terms, the country lost about 2.4% of its gross domestic product annually as a result of tobacco use.

These alarming figures clearly indicated a need for strong and immediate action in the area of tobacco control. After various anti-tobacco campaigns and years of preparatory work by national and international partners, the Parliament of Georgia adopted a new tobacco control act on 4 May 2017.

The law introduced a series of advanced tobacco-control measures, and considerably increased implementation of the WHO Framework Convention on Tobacco Control (FCTC) provisions related to smoke-free environments; packaging and labelling; and tobacco advertising, promotion and sponsorship. It also strengthened the regulatory measures applied to traditional cigarettes as well as electronic cigarettes and heated tobacco products.

Georgia’s new law was introduced progressively, with the first measures entering force on 1 May 2018. The results were not long in coming. “Indeed, the legislation produced an effect. Within 1 or 2 years, the number of tobacco users was reduced by 1–2%. There was a reduction in the number of hospital admissions of people with acute strokes and heart attacks,” said Dr Amiran Gamkrelidze, Director General of the National Center for Disease Control and Public Health.

These results confirm what has been known for a long time: that tobacco legislation is working, that it is saving lives and improving the health of people.

Critics of the legislation argued that the public would not accept smoking bans. They claimed that the law would have a negative effect on businesses, particularly the hospitality sector, cause thousands of job losses, and encourage the development of a flourishing cigarette black market. Yet this never came to pass. In fact, the law received significant support from Georgians, with more than 79% of the population supporting smoke-free regulations and above 90% supporting a ban on tobacco advertising.

In Georgia’s story, it becomes clear that tobacco control gained momentum when different national stakeholders and international partners joined efforts to raise awareness of the harms of tobacco use and the tactics of the tobacco industry.

Georgia’s experience exemplifies important features of policy-making, particularly the significant role played by the media and nongovernmental organizations, as well as charismatic politicians who are committed to public health and willing to champion the issue while placing tobacco control high on the policy agenda.

According to Dr Marijan Ivanusa, Head of the WHO Country Office in Georgia from 2016 to 2019, “The main lesson learned during and after the law was endorsed in Georgia was that it's possible. It's possible in a middle-income country with very limited resources, despite the very strong opposition of the tobacco industry. It's possible, it's doable and people benefit from it.”

It is hoped that Georgia’s inspiring story will encourage other countries to step up their efforts to curb the epidemic caused by tobacco use.