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2007 the content of carbon oxides should correspond to the European standards of 10 mg per cigarette. • Since the 1st of January 2005 a State Regulation has been in force mandating requirements on tobacco product packaging, i.e., ingredient disclosure and printed health warnings on tobacco. The size of the health warnings, their color and contrast are specified. Producers and traders observe this regulation and tobacco products without such warning labels are no longer seen. • Celebration of the World No Tobacco Days has turned into an opportunity used throughout the country to increase the knowledge of the general population about the harmful impacts of smoking. • Bulgaria was one of the countries which joined the international campaign “Quit & Win”. Basic data about participants’ characteristics were acquired via application forms. The analysis contains data about: age, gender, present smoking per day by the time of entering the campaign, number of previous attempts to quit, years of smoking, and who directed the participant towards smoking cessation. The success rate (the proportion of quitters) was estimated as soon as the campaign was over. The “Quit & Win” campaign embraced young adults. The use of mass media gave the public a chance to talk about the problem of active and passive smoking and how to quit smoking; • Since 1995 an international children’s drawing competition “No to cigarettes” has been organized as a successful project for smoking prevention in childhood and adolescence; • The mass media have a constantly increasing role in raising awareness of smoking as the major risk factor for over 20 highly prevalent, socially significant diseases; • The collaboration with NGOs has been encouraged. Several NGOs perform anti-smoking activities: “Women Against Smoking”, “Bulgarian Association of Health Promotion Schools”, “Bulgarian Red Cross”, “Combat Cancer Foundation”, etc. The objectives of the NGO “Women Against Smoking” are to promote the development and implementation of a long-term policy for tobacco control among the female population and to reduce the exposure of children; • Bulgaria takes an active part in the international information exchange and in the different tobacco control initiatives of the WHO. Since 2005, the Ministry of Health has been involved in the realization of the WHO tobacco control project “Public Health Capacity Building for Strengthening Tobacco Control in South-Eastern Europe”.
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The International WHO Project “Global Youth Tobacco Survey” of 2002 gave unique information about the prevalence of smoking among the Bulgarian students. The research data presents a solid evidence that childhood and adolescent smoking represent an extremely serious public health problem deserving high priority, and underlines the imperative necessity for developing and implementing preventive programs from the early school-age aimed to prevent or delay smoking initiation. Such programs should also provide help to those who wish to quit. The results support the need for a differentiated approach towards developing intervention programs and for specific adaptation according to age and gender peculiarities (CDC 2003). The new National Health Strategy 2008–2013 (Ministry of Health, 2008) foresees updating the National Program on Tobacco Control in correspondence with the philosophy and action directives of the European Strategy for Tobacco Control and the WHO Framework Convention on Tobacco Control. It can be concluded that a considerable number of tobacco control initiatives have been developed, however in practice, little has been actually implemented. Many of the control measures related to tobacco product advertisement and sale and banning smoking in public places are not respected. The high smoking prevalence in Bulgaria shows that tobacco control measures are not efficient. Tobacco will remain a major threat to the health of the population unless comprehensive and immediate efforts are taken to curb its use.
4.1.3.3 Drug use and Abuse Drug use and abuse is a result of interactions between the individual, the substances, and the environment. The adoption of this approach determines the importance of social measures and policies for preventing such behaviors. Years ago, people thought that drugs were only used among particular groups. Today it is well known that drugs are present among all groups. Marginalized youth are particularly susceptible to the enticement of drugs. People like the homeless, institutionalized children, and refugees are particularly at risk of drug abuse. At the same time, there is considerable abuse of drugs among socially integrated young people (Popov 2004). Information, education, treatment, and rehabilitation are key pillars of the national policy for drug demand reduction. Тhe Law on Health,
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2004 (Art. 53) states that the Ministry of Health and the NGOs create conditions to prevent the use of narcotic drugs, ensure the provision of health promotion actions and necessary healthcare to the people affected, and national intervention programs are developed for this purpose. A National Drugs Council (NDC) was set up in compliance with the Drug and Precursor Control Act of 1999. It is the body responsible for the implementation of the national policy against drug abuse and drug trafficking, a body that adopts the National Anti-drug Strategy of the Republic of Bulgaria. A National Program for Prevention, Treatment and Rehabilitation of Drug Addictions in Bulgaria 2001–2005 was developed with the main objective to support the implementation of a health care reform in the field of problems associated with the abuse of narcotic drugs (NDC 2006). The National Drug Service at the Ministry of Health is the national competent body for control over all drug-related activities and the body assisting the Minister of Health in exercising control over the fulfillment of obligations ensuing from international treaties Bulgaria is a party to. The National Centre for Addictions is a special structure within the Ministry of Health and is responsible for coordinating and providing methodical guidance on prevention, treatment, health harm reduction, and rehabilitation of drug users and addicts. The National Centre for Addictions also exercises specialized control over treatment and acts as a drug addiction expert body. There are many other ministries and bodies involved in the comprehensive and intersectoral policy against drugs use and abuse. For instance, the Ministry of Education and Science is engaged with the prevention of drug, tobacco, and alcohol use and abuse in youth population. The Ministry of Defense is responsible for the development and implementation of preventive, treatment, and rehabilitation activities against drug use in the army. The State Agency for Youth and Sports promotes mass sports activities as an alternative to drug use in leisure time, and promotes healthy behavior among young people in general. The Ministry of Labour and Social Policy supervises workplace preventive actions and assists in the social rehabilitation and reintegration of drug users and addicts. Among the tasks of the Ministry of Interior is the prevention of adolescent crime and violent behavior. A balanced drug policy involves decentralization of activities and establishment of local Municipal Drug Councils. Their obligations are related to the development, adoption, and implementation of municipal programs for prevention, treatment, and rehabilitation of drug addiction.
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