1 October 2021

October: Breast Cancer Awareness Month

In 2009, the Canadian Expert Panel on Tobacco Smoke and Breast Cancer Risk concluded that smoking is associated with breast cancer and that there is a consistent causality between second-hand smoke exposure and premenopausal breast cancer.

The International Agency for Research on Cancer (IARC), evaluated the results of numerous studies and concluded that evidence for tobacco smoke carcinogenicity in breast cancer exists. 


The European Prospective Investigation into Cancer and Nutrition study found higher risk of breast cancer for former/current smokers or those exposed to second-hand smoke. Other risk factors are: the duration of smoking, number of cigarettes smoked, age at initiation, and years of cessation. 



ENSP Brochure 2021: Ending tobacco epidemic, an essential step for beating cancer

Every year, 3.5 million people in the EU are diagnosed with cancer, and 1.3 million die from it. Over 40% of cancer cases are preventable. Without reversing current trends, it could become the leading cause of death in the EU. In 2020, the Commission released its Europe’s beating cancer plan aiming at reducing the cancer burden for patients, their families and health systems. Tobacco is a great risk factor for cancer, often still unknown and underestimated. Thus, every month in 2021, ENSP dedicates a section of "The Network" to a certain type of cancer and its link to tobacco.

Stay tuned for ENSP ECTC webinars announcement: October-December 2021

For any inquiries regarding the Conference please send an email to

Publications and initiatives

Provide your feedback on the EU Single Use Plastics Directive

From 22 September 2021 to 20 October 2021  (midnight Brussels time), the Commission launched a call for feedbacks aiming at finalizing the initiative related to single-use plastics.


Get involved by submitting your views related to the reporting of data on the post-consumption waste of tobacco products with plastic filters!

The Single Use Plastics Directive (Directive (EU) 2019/904) requires EU countries to provide the Commission with data on collected waste of: (i) tobacco products with filters; (ii) filters marketed for use in combination with tobacco products. This initiative will lay down the rules for reporting these data and information, together with the format for the quality check report.

New Essential Medicines Lists published: WHO prioritizes access to diabetes and cancer treatments

WHO today published the new edition of its Model Lists of Essential Medicines and Essential Medicines for Children, which include new treatments for various cancers, insulin analogues and new oral medicines for diabetes, new medicines to assist people who want to stop smoking, and new antimicrobials to treat serious bacterial and fungal infections.
The listings aim to address global health priorities, identifying the medicines that provide the greatest benefits, and which should be available and affordable for all. However, high prices for both new, patented medicines and older medicines, like insulin, continue to keep some essential medicines out of reach for many patients. “Diabetes is on the rise globally, and rising faster in low- and middle-income countries,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
The move to list long-acting insulin analogues (insulin degludec, detemir and glargine) and their biosimilars, along with human insulin, is intended to increase access to diabetes treatment by expanding the choice of treatment. The list also includes Sodium-Glucose Co-transporter-2 (SGLT2) inhibitors empagliflozin, canagliflozin and dapagliflozin as second line therapy in adults with type 2 diabetes.
Cancers are among the leading causes of illness and death worldwide, accounting for nearly 10 million deaths in 2020, with seven out of 10 occurring in low- and middle-income countrie. Four new medicines for cancer treatment were added to the Model Lists: Enzalutamide, Everolimus, Ibrutinib, and Rasburicase. The listing for imatinib was extended to include targeted treatment of leukaemia. New childhood cancer indications were added for 16 medicines already listed, including for low-grade glioma, the most common form of brain tumour in children.
With regards to smoking cessation, two non-nicotine-based medicines – bupropion and varenicline – join nicotine-replacement therapy on the Model List, providing alternative treatment options for people who want to stop smoking. Listing aims to support the race to reach WHO’s ‘ Commit to Quit’ campaign goal that would see 100 million people worldwide quitting smoking over the coming year.

EHN Position Paper on Heated Tobacco Products and cardiovascular disease

On World Heart Day, EHN published a position paper on Heated Tobacco Products, as a continuation of the position paper published in 2019 concerning electronic cigarettes. While HTPs were disregarded from that position paper because of the lack of scientific evidence, this new document brings out the latest evidence on the impact of heated tobacco products on cardiovascular health and aims at highlighting EHN's recommendation for a proper regulation of these products.

EHN's recommendations with regard to HTPs are:

  • A clear definition of HTPs is imperative.
  • Users of HTPs suffer from similar, devastating effects on cardiovascular health as conventional cigarettes. HTPs can therefore not be recommended as safe alternatives, nicotine replacement therapies or quit aids.
  • HTPs produce second-hand smoke, both indoors and outdoors and can therefore not be considered safe for non-users.
  • Considering the similarities in CVD outcome in users of HTPs and conventional cigarettes, both should be subject to the full effect of the Tobacco Products Directive. In countries where the TPD does not apply, HTPs should be subject to the same smoke free legislation.
  • Considering the similarities in CVD outcome in users of HTPs and conventional cigarettes, taxes and excise duties on HTPs should be at the same level as for conventional cigarettes.

WHO Report on e-cigarettes and heated tobacco products

A report of the WHO Study Group on Tobacco Product Regulation provides evidence-based recommendations for Member States about tobacco product regulation. The outcomes and recommendations address a number of issues concerning novel and emerging nicotine and tobacco products, such as electronic nicotine delivery systems (ENDS), electronic non-nicotine delivery systems (ENNDS), and heated tobacco products (HTPs) and improves understanding of Member States on these products.
One of the main recommendations in the report is that policy-makers should maintain focus on evidence-based measures to reduce tobacco use, as outlined in the WHO Framework Convention on Tobacco Control (WHO FCTC). This includes novel and emerging tobacco products, which are being pushed by the tobacco industry. Moreover, countries are urged to implement the report’s recommendations. There is sufficient information about nicotine and tobacco products to act to protect the health of their populations, especially younger generations.

National news

Belgian Pro League partners with Foundation against Cancer

A new partnership has arisen between the Belgian Pro League and the Foundation against Cancer, a collaboration that seeks to enforce the No Smoking policy across all Belgian football stadia from the start of the 2021-2022 season. 


This policy is related to any form of smoking, including cigarettes, cigars, e-cigarettes, other devices that heat the tobacco, and the use of other types of tobacco products, ensuring that all these products are being prohibited during Belgian Pro League, the 1B Pro League and the Croky Cup competitions, side events and all other side activities.


The collaboration between the Belgian Pro League and Foundation against Cancer will provide counseling and smoking cessation services to strengthen the common effort of protecting the stadium users from second-hand smoke. This policy is also in line with the national Smoke-Free Generations campaign by encouraging other organizations in the sport or other sectors to consider introducing their own policy and to contribute to the protection of children against tobacco.


Observatoire de la Santé Hainaut invites municipalities and institutions to join Smoke-free Generations Project

At the national level in Belgium, Smoke-free Generation is a broad movement of citizens and organisations that strive for a society in which no one suffers or dies from the consequences of smoking, including passive smoking.
On September 29, a dozen municipalities in the province of Hainaut came to the Observatoire de la Santé to discover the Tobacco-Free Generations project and discuss its implementation on their territory. The possibilities of support and the practical aspects of such a project were presented under the umbrella of the Belgian Alliance against Tobacco and in collaboration with the Belgian Foundation against Cancer.
The site of the Observatoire de la Santé became smoke-free almost a year ago and aims to inspire other institutions or municipalities to follow the process with the ultimate goal of ensuring a healthy future for the young generation, so that children can grow up without seeing smoking around them.

Now also indexed in PubMed Central. Learn more...

The latest publications in the TPC Journal:
Maria Gangadi, Natasa Kalpourtzi, Magda Gavana, Apostolos Vantarakis, Gregory Chlouverakis, Christos Hadjichristodoulou, Gregory Trypsianis, Paraskevi V. Voulgari, Yannis Alamanos, Argiro Karakosta, Giota Touloumi*, Anna Karakatsani*
Kellen Nyamurungi Namusisi, Frances Thirlway, Noreen D. Mdege, Joseph K. B. Matovu
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