PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

38 Acting early on NCDs The Partnership for Health System Sustainability and ResilienceRegulatory interventions Beyond fiscal measures, the reports document various regulatory tools employed to shape environments that make healthy choices easier and unhealthy choices more difficult. Advertising restrictions represent a common approach, with the Spain report describing strict prohibitions on tobacco and vape advertising, whilst the Italy report references a 1983 law comprehensively banning all tobacco advertising. Germany was the last EU nation to implement tobacco billboard advertising bans in 2022, with the restriction extended to e-cigarettes in 2024. The creation of smoke-free environments has proven one of the more successful regulatory interventions according to several reports. The Spain report correlates comprehensive smoking bans in public spaces with significant declines in smoking rates, whilst the Japan report describes the 2020 indoor smoking ban under the amended Health Promotion Act as representing a major cultural shift (Nakamura, 2024). The Greece report, however, demonstrates implementation challenges, noting that the 2019 anti-smoking law showed initial promise but “monitoring of smoking in public spaces became less strict” following COVID-19 lockdowns. The Canada report describes the 2018 Cannabis Act, which embedded public health safeguards such as restricted youth access, mandatory health information provision, and compliance measures, showing how frameworks for potentially harmful substances can integrate prevention from the outset rather than retrofitting it later (Health Canada, 2024, Rosenberg, 2024). It also highlights the federal use of Gender-Based Analysis Plus (GBA+), an analytical tool to systematically incorporate equity considerations in policy and programme design, representing an effort to address the social determinants of health in a structured way (Government of Canada, 2025a). Food environment regulations reveal varying approaches to making nutritional information accessible and encouraging healthier choices. The France report highlights the Nutri-score system, a front-of-pack five-colour rating system that has gained adoption across multiple European countries, demonstrating how well-designed interventions can spread beyond national borders. This contrasts sharply with the Germany report’s documentation of reliance on voluntary industry pledges for food reformulation, which have produced disappointing results and highlight the limitations of non-mandatory approaches (Grea et al., 2024). Education, literacy and life-course approaches Health education initiatives documented in the reports reflect growing recognition that prevention must begin early and continue throughout life. The Poland report describes the introduction of health education as an optional school subject from 2025/2026, covering physical, mental, sexual, and environmental health. The Spain report mentions school-based education through its Strategy for Nutrition, Physical Activity, and Obesity Prevention as part of broader health promotion efforts. Digital innovation in health literacy appears prominently in the Greece report, with “Healthflix” and “Health Advisor” platforms described as tools designed to enhance population health literacy through accessible, technology-based solutions. These initiatives aim to encourage engagement with early preventive services and also serve as a reminder calendar for medical and diagnostic appointments. The life-course perspective increasingly shapes prevention strategies according to the reports. The Japan report’s description of the Community-Based Integrated Care System exemplifies this comprehensive thinking, providing integrated prevention, housing, and lifestyle support with flexibility for regional adaptation (MHLW, 2024c). The Spain report’s documentation of the Active Ageing Strategy recognises that prevention needs differ across life stages, promoting physical and social engagement specifically tailored for older adults (Ministry of Health, Spain, 2022a). The Germany report notes its National Prevention Strategy includes specific focuses on “Health in childhood”, “Health at work and in life”, and “Health in old age”.