June 2017
"What a difference two years make…"
Message from Dr Francisco Rodriguez Lozano, ENSP President
These past months have been extremely busy for ENSP and I would like to express how grateful and proud I am to all our network members, more active than ever, for coming together to make tremendous progress on tobacco control issues. ENSP is the most important network of organisations working in tobacco control in Europe, and this for the last 20 years. With more than 50 members in 35 Countries, 23 EU Member States and 12 Non-EU, we are celebrating this year our 20th anniversary.
When opening the Second ENSP International Conference on 24 May in Athens, standing in front of a full plenary room of over 300 delegates, I could not help but tell myself how glad and happy I was. Indeed, the last time I happened to be in this the city was in 2015, when I just had been elected as the new President for ENSP. What a difference two years make. Standing in front of all those delegates and welcoming them to our event made me think that we have come a long way...

ENSP International Conference on Tobacco Control
On 24-26 May 2017, ENSP held its 2nd Annual International Conference on Tobacco Control in Athens, Greece, which gathered around 300 participants and presented more than 100 scientific abstracts.

The conference hosted interventions by international experts in tobacco control throughout a number of plenary and parallel sessions, symposia, workshops and project meetings. Topics included tobacco control and global development goals, Article 5.3, implementation of FCTC and TPD, Secondhand tobacco smoke and e-cigarettes emissions, NGOs advocacy, e-cigarettes, tobacco economics, illicit trade, Tobacco dependence treatment and Article 14, tobacco in our societies and the issue of human rights, next steps in tobacco control at global level.

We look forward to seeing many of you for our 3rd ENSP International Conference on Tobacco Control taking place in Madrid, Spain in May 2018.
ENSP 20 Years Anniversary
ENSP Anniversary Awards
Celebrating the 20th anniversary of the Network, ENSP wished to pay tribute to the strong commitment and great achievements of ENSP members and friends throughout the years. Two awards ceremonies took place, one in Athens during the closing of ENSP International Conference on 26 May 2017 and the other at ENSP-ERS event at the Press Club Brussels for World No Tobacco Day 2017.
ENSP Monograph:
The Network - 20 years of Tobacco Control History in Europe

The European Network for Smoking and Tobacco Prevention was born 20 years ago in 1997 with organisations, but above all, people who recognised their responsibilities in relation to the health of citizens in Europe. In the first 20 years leading up to 2017, the network alternated florid and challenging times, but ENSP resisted well in the hardest periods thanks to the dedication and perseverance of those who believed and supported the idea to stay united through thick and thin, together stronger, collectively more impactful.
To celebrate the colleagues and friends, who never deserted the network and contributed to ENSP’s successful emergence from the difficult times to be more active, more determined, more resourceful than ever, ENSP has published a monograph titled The Network: European Network for Smoking and Tobacco Prevention 1997-2017, 20 years of Tobacco Control history in Europe. The monograph is a small gesture to thank loyal supporters of ENSP for always believing that real trust, solidarity and partnership among members can achieve the unthinkable and reach the unattainable.

WHO World No Tobacco Day 2017 Awards
The winners

Every year, WHO recognizes individuals or organizations in each of the six WHO Regions for their accomplishments in the area of tobacco control. This recognition takes the form of WHO Director-General Special Recognition Awards, World No Tobacco Day Awards. The awardees were selected by a Committee on the basis that they have made an outstanding contribution to the advancement of the policies and measures contained in the WHO FCTC and its guidelines, particularly in relation to this year's theme: "Tobacco - a threat to development".

European Region awardees:

  • Mrs Milojka Kolar Celarc, Minister of Health, Republic of Slovenia
  • Department of Health, Ireland
  • Dr Lenka Teska Arnoštová, Deputy Minister of Health, Czech Republic
  • Dr Srmena Krstev, President of National Tobacco Control Committee, Republic of Serbia
  • Unfairtobacco, Germany
  • National Healthy Lifestyle Center, Kazakhstan

ENSP congratulates all the winners and in particular our partner Unfairtobacco. This German NGO shows how tobacco growing, cigarette production and smoking negatively influence sustainable development.

One of its founders, Sonja von Eichborn, presented at ENSP-ERS World No Tobacco Day Celebration in Brussels and threw light on the fact that tobacco companies are encouraging child labour on farms in poorer countries such as Malawi, Zambia, Tanzania and Brazil.


ENSP-ERS Celebration of World No Tobacco Day 2017
On 31 May 2017 ENSP and ERS held a successful celebration of World No Tobacco Day at the Press Club Europe, Brussels. This high-level meeting on tobacco control set a strong focus on the WHO World No Tobacco Day Theme 2017: Tobacco - A threat to development. The event launched the Europe United Race Against Tobacco.
With representatives from WHO Europe & FCTC, the European Commission, the European Parliament, national governments and international NGOs, the event brought together responsible partners in tobacco control from all European countries with the aim of discussing how governments could join forces to reach the 2030 sustainable development goals in the context of the WHO FCTC.
Don't burn away your future:
Innovative initiative by WALCE to urge Belgian smokers to quit
On 30 and 31 May, Women Against Lung Cancer in Europe (WALCE), in partnership with ENSP, ELF, ERS and AIPO, organised 2 successful initiatives dedicated to tobacco dependence treatment.

A 2-day exhibition took place in Square de la Monnaie under the title “Go out of the Tunnel. Don’t burn away your future”. In the structure shaped as a giant cigarette, pulmonologists and advisors provided counselling, educational materials on smoking cessation and basic spirometry tests to passers-by. In 2 days
600 visitors went through the tunnel and 450 spirometry tests were conducted by medical professionals.
High level roundtable on FCTC Artice 14 at the European Parliament on WNTD
On 31 May, WALCE and partners held a high-level event entitled “WHO FCTC Article 14 – Time to prioritise tobacco cessation and dependence treatment” at the EU Parliament in Brussels. The event was hosted and moderated by MEP Gilles Pargneaux, and gathered international experts on the subject.
Commissioner Andriukaitis participated in the conference and strongly supported the topic of the event in his speech, which illustrated the threat posed by tobacco on sustainable development worldwide and emphased the need to focus on providing accessible cessation in Europe where smoking rates are still one of the highest.

Read the full speech ...
Smokefree Week in Catalonia: Smoke less, Walk more
The Catalan Institute of Oncology (ICO) organised a range of activities to celebrate WNTD this year, which translated into an entire "Smokefree Week".

Being the coordinator of the
Catalan Network of Smoke Free Hospitals, ICO helped more than 70 hospitals in preparation and organisation of different activities during the No Tobacco Week under the slogan “Smoke less, Walk more”.

Among the activities organised by the Institute, an info stand was opened to raise patients' awareness, as well as their relatives and professionals, on the importance of quitting smoking. It also aimed to promote healthy lifestyle habits, especially among children, whom participated in a drawing a contest on the theme “Smoke less, walk more”. The award ceremony was held on 31 May 2017.

Additionally, on 3 June ICO and the Hospital of Sant Joan de Déu co-organised the first Smokefree Event at Tibidabo Amusement Park, Barcelona. According to Spanish legislation it is prohibited to smoke in amusement parks, however, full compliance has not yet been achieved. To that end, Tibidabo Park initiated the Smoke Free Event with the objective to promote smokefree environments and extend the initiative to other Spanish parks.

WNTD activities in Kiev urging the Parliament to implement new tobacco control laws

Tobacco-related diseases are one of the most significant threats to public health – annually about 63 000 Ukrainians die due to smoking.

On 31 May 2017 participants in an action in the capital city Kiev urged Andriy Parubiy, Speaker of Parliament , to put the bills No 2820 and 4030a to a vote in order to reduce smoking prevalence and improve health prospects for citizens in Ukraine.

Lilia Olefir, the Executive Director of NGO Advocacy Center Life explained: “24% of Ukrainians smoke. The only way to eliminate the tobacco burden in Ukraine is to reduce the smoking prevalence. The most efficient measure to combat tobacco is legislative regulation of this issue."

The latest anti-tobacco measures in Ukraine were implemented in 2012, and civil society urges the Parliament to act on the draft laws.
Draft law No 2820 is aimed to introduce big pictorial warnings (65%) on both sides of the cigarette pack, ban cigarettes with flavour, provide regulation of e-cigarettes and herbal mixes, and ban tobacco advertising on the Internet. At the same time draft law No 4030a suggests to ban tobacco products display at points of sale, update the smoke-free legislation and introduce mechanisms of anti-tobacco laws enforcement.


Welcome to new ENSP members and partners
New ENSP members
University of Vlora "Ismail Qemali", Department of Healthcare

The Faculty of Public Health at the “Ismail Qemali” University graduates general and specialized nurses in various sectors of nursing and public health service. Starting from September 2011, this faculty is operating from a new stage ( from the Faculty of Nursing to the Faculty of Public Health) which has brought forth opportunities for a qualitative improvement of academic programs, provided during the academic year.

Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology in Warsaw

The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology (MCMCC) is the leading Polish comprehensive cancer centre, as well as the primary government research institution devoted solely to oncology. Founded in 1932 by Maria Sklodowska-Curie, it is currently divided into 28 specialised clinical departments responsible for the diagnostics and therapy of different tumour types such as: Breast Cancer Clinic, Head and Neck Cancer Clinic, General and Visceral Surgery, Thoracic Surgery, Urology, Gynaecology, Haematology, Soft Tissue/Bone Sarcoma and Melanoma Clinic, Radiation Oncology, Brachytherapy and Diagnostic Radiology, Pathology and Molecular Medicine and Cell Research. Oncology, Gastroenterology, Cancer Epidemiology and Prevention Division and others.

See the map of ENSP members.
New ENSP partners
WALCE (Women Against Lung Cancer in Europe)

WALCE is a non-profit organisation initiated in 2006 by Dr Silvia Novello, current President of WALCE and Dr Enriqueta Felip, both members of the Scientific Committee of “National Lung Cancer Partnership”. The organisation has the primary aim to increase awareness among women about the significant increase of lung cancer and to provide and disseminate information about the disease in terms of prevention, diagnosis and treatment with focus on women as main caregivers. WALCE is involved in advocacy, education activities and support initiatives for patients suffering from lung cancer and their families.

See all ENSP partners.
European Public Health NGOs call for an enhanced EU action in the field of human health

On 6 June 2017, 39 European NGOs collectively voiced their concern about the future of public health to President of the European Commission, Jean-Claude Juncker.

The letter was initiated following signals about possible discontinuation of the European Health Programme and the European Commission's informal evaluation of the need for health programmes and EU activities on health policy.

The coalition of NGOs is concerned that the EU will focus less on public health, which may regress health outcomes in Europe. The NGOs highlighted that health is absolutely and unequivocally a core business of the EU. Protection of a high level of human health and wellbeing is entrenched in the Treaties of the European Union. EU collaboration in the field of health is indispensable for the future of Europe and rebuilding the trust of citizens in the European Union. More health initiatives are needed to unlock the full potential of economic and social policies.

The letter calls for an enhanced EU action in the field of health that brings the EU closer to its citizens, by protecting patients and consumers and improving people’s health. This investment will foster cross-country collaboration, integrate the action of Member States and help them to address the unprecedented challenges Europe is facing in public health.

Read the full letter...
Support a healthier future for 220 million allergy and asthma patients in Europe

Allergy and asthma are among the most frequent chronic diseases in the European Union (EU). Over 150 million EU citizens – almost one in three people – suffer from allergy, 70 million Europeans have asthma, around 100 million live with allergic rhinitis, and 17 million with a food allergy.

By 2025, it is estimated that one half of the entire EU population will be affected by these diseases. Today, there is still no cure for allergy and asthma, and large discrepancies in monitoring, prevention, early diagnosis, treatment and care exist across Europe. Strong and unified European political leadership is urgently needed to successfully curb this dramatic epidemic for the benefit of our patients, economies and society.

That is why, ENSP supports EFA and EAACI to create a healthier and happier future for the over 220 million allergy and asthma patients in Europe. Share the Call to Action for Allergy and Asthma now and ask your representatives and friends to sign it!

Luk Joossens: A Fight Against Tobacco in Belgium

In 2016 Luk Joosens published the book "De tabakslobby in België" (Tobacco lobby in Belgium). Earlier this year, it was translated into French under the title of "La guerre du tabac en Belgique" (Tobacco War in Belgium).

At a time when Belgium is still falling back on the European tobacco control ranking, with only 49 points out of 100, at a time when tobacco is still the leading cause of avoidable deaths in Belgium, Luk Jossens, a true pioneer in this lifetime fight, describes the key points of the battle he has been fighting for decades: the battle against tobacco.
"Tobacco War in Belgium" points out the power held by the tobacco industry in Belgium to diminish advertising legislation, sow doubts about the real danger of secondhand smoking, influence the content of numerous Royal Decrees on tobacco control and, finally organised cigarette illicit trade of cigarettes.

The book also underlines the fact numerous well-known Belgian politicians and public figures have been involved with the tobacco industry through several years. Essentially, Luk Joossens asks how tobacco manufacturers have been able to continue the production of products that kill half of their consumers and how the by-passing of tobacco-related regulations has become a Belgian national sport.
The book answers these fundamental questions, as well as other key points. It walks the reader around the long fight against the tobacco industry taken on by Luke Joossens througout his career.


Trends in European smoking behaviour according to new Eurobarameter report

The new EU Eurobarometer report "Attitudes of Europeans towards tobacco and electronic cigarettes" published on 30 May 2017 shows that smoking prevalence in the EU has remained stable at over one quarter of the population since 2014.

The research has been conducted by TNS Political & Social, who finalised the study fieldwork in March 2017 in all 28 EU Member States.
The report includes the following findings:
  • The overall population of EU smokers remained stable since 2014 (26%)
  • 91% of smokers smoke daily (3 points decrease from 2014)
  • 79% of smokers prefer boxed cigarettes, hand-rolled cigarettes are most popular in Hungary (49%)
  • Around half of all smokers consume cigarettes with special characteristics (17% smoke additive free or "organic" cigarettes
  • 16% smoke light cigarettes and around 10% smoke slims
  • 52% of smokers started before the age of 18 years
  • E-cigarette uptake increased slightly from 2014 (12% to 15%)
Read the full report...

How can the WHO FCTC contribute to worldwide sustainable development

The WHO FCTC Secretariat and the UN Development Programme have published a discussion paper entitled "The WHO Framework Convention on Tobacco Control an Accelerator for Sustainable Development", aiming to explore how the implementation of the WHO FCTC coincides with the UN Sustainable Development Goal (SDG) targets.

The report provides a number of recommendations for countries to integrate tobacco control into national SDG implementation strategies:
  • When integrating tobacco control into their SDG implementation strategies, countries should identify potential win-win sectors that would be strongest for deepest partnerships;
  • As part of SDG implementation efforts, development partners should invest in capacity building for advocating, supporting and monitoring tobacco control;
  • All stakeholders should identify key "opponents" to tobacco control and remind "neutral" parties to stick to their obligations on removing those opponents from policy processes;
  • Development partners should support Parties by investing in new mechanisms, modalities, and technologies for enhanced tobacco control.
Read the full discussion paper...
EUREST study: Assessing the evidence on toxicity, addictiveness and attractiveness of tobacco ingredients
On 12 May 2017, the European Commission published the report Study on the assessment of available evidence on toxicity, addictiveness and attractiveness of ingredients contained in tobacco and related products on the basis of information submitted by the industry in the context of reporting obligations introduced by Directive 2001/37/EC prepared by the EUREST Consortium (European Regulatory Science on Tobacco).
The objective of the study was to provide the Commission with an overview of assessment of available evidence on toxicity, addictiveness and attractiveness of ingredients contained in tobacco and related products on the basis of information submitted by the industry in the context of reporting obligations introduced by Directive 2001/37/EC.

To address this objective, the EUREST Consortium, comprising BFRAA and ENSP, carried out the following tasks:
  • Provided an overview of the toxicological data submitted by tobacco product manufacturers and importers under Article 6 of the former Tobacco Products Directive 2001/37/EC13 in the period 2002-2014 either in electronic or paper form.
  • Carried out a detailed quantitative/qualitative assessment of submitted internal industry studies and documents not available in the public domain as identified in WP1 so as to assess the comprehensiveness and quality of evidence derived from the internal insert studies in light of regulatory needs.
  • Developed recommendations regarding studies to be carried out by the manufacturers in light of the enhanced reporting obligations foreseen for priority additives, and outline a template for the reporting of the reports in line with Article 6 of the TPD and on the basis of the results of WP2.
Read the full report...
Launch of new media campaign resource to support tobacco control policies worldwide
On the occasion of World No Tobacco Day 2017, the global public health organisation Vital Strategies launched a new graphic warning and mass media campaign resource - Media Beacon - to help governments and civil society build support for tobacco control policies and combat the global tobacco epidemic.
Media Beacon is an online library of adaptable anti-tobacco materials, which have been tested and proven as best practice tobacco control campaigns and resources. Many of the campaigns and images are free or low cost to license and simple to adapt, enabling governments and civil society to rapidly implement population-level anti-tobacco communication campaigns and graphic warnings on tobacco packs.

The resource also includes three newly created “Campaign in a Box” television public service announcements, ready for use in low- and middle-income countries.


Can e-cigarette be an effective cessation tool?

On 30 May the article "Electronic cigarettes, quit attempts and smoking cessation: a 6-month follow-up" was published in Addiction.

Based on the conflicting evidence that use of e-cigarettes promotes cessation in regular smokers, the study aimed to assess whether regular use of e-cigarettes while smoking is associated with subsequent smoking cessation.
2057 smokers aged 15 to 85 years were recruited through an access panel and responded to a 6-month follow-up. The three outcomes assessed at 6 months were: a minimum 50% reduction in the number of cigarettes smoked per day, quit attempts of at least 7 days and smoking cessation of at least 7 days at the time of follow-up. Logistic regressions were performed to model the three outcomes according to regular e-cigarette use at baseline, adjusted for socio-economic variables and smoking behaviours.

The study found that among people who smoke, those also using an e-cigarette regularly are more likely to try to quit smoking and reduce their cigarette consumption in the next six months. It remains unclear however whether regular e-cigarette users are also more likely to stop smoking.

Read more [FR]...
WHO Europe Tobacco Control Playbook
WHO's Tobacco Control Playbook developed by its Regional Office for Europe aims to provide a single source of information explaining how tobacco industry players proactively misinform the general public, and offers governments as well as the public health community clear evidence-based responses to their deceptive arguments.
To disseminate this important work carried out by WHO Europe, the Network features key arguments from the Playbook of relevance to ENSP members and stakeholders in the tobacco control community. Read more about how governments can enact tobacco control public health measures without infringing the tobacco industry’s commercial rights.
"Is tobacco smoking a free and informed choice?
Tobacco smoking is highly addictive and, in most cases, starts in childhood. The tobacco industry's marketing, research and public relations activities are a source of misinformation. These issues make it difficult for people to make free and informed choices about tobacco smoking.

Key messages illustrating and summarising the danger of free will argument:
  • Smoking is not a free choice – it is addictive; most smokers start as children, long before they can understand either the harms or the concept of addiction; and quitting smoking can be very difficult.
  • Smokers are not well informed about the harms of smoking, the risks to themselves, and the suffering likely to result in them and their families.
  • Tobacco companies have a long history of denying and undermining the evidence, marketing to children, promoting products as though they conferred health benefits, and opposing measures that would inform smokers properly and reduce smoking.
  • Governments have a responsibility to inform the community about harmful products and behaviours and take action that will protect public health.

Read more about the argument of the industry presenting smoking as consumers' free and informed choice in Tobacco Control Playbook.

Luxembourg transposes the TPD beyond its provisions

During the public hearing on 1 June, the majority of Members of Parliament of Luxembourg passed the parliamentary file 7030, which enforces the fight against smoking in Luxembourg and strengthens the protection of non-smokers, in particular minors. The main changes foreseen in the text will transpose Tobacco Products Deirective. Furthermore, Luxembourg adopts some anti-smoking measures beyond its minimal provisions.
  • Ban on flavored cigarettes and tobacco
  • Introduction of 65% warning illustration or photograph
  • Ban on smoking at children's playgrounds
  • Ban on the use of electronic cigarettes in the areas where traditional smoking ban applies
  • Ban on the sale of tobacco to minors under the age of 18 (current age is 16)
  • Ban on smoking in sports facilities for minors under the age of 16 who play sports there
  • Prohibition of smoking in vehicles in the presence of a minor under 12 years old
  • Ban on the sale of tobacco products online

Read more [FR]...

One step closer to smokefree Europe:
Czech Republic implements smoking ban
After years of being one of the last countries in the EU with partial smoking ban in indoors areas, a smoking ban finally entered into effect in Czech Republic on 31 May 2017. The ban covers bars and restaurants as well as public places like cinemas, theaters and sport stadiums. Prior to the ban, it was allowed for restaurant owners to decide whether or not they wanted to allow smoking within their establishments. According to data from Reuters, three out of four Czechs support the new ban.
After this Czech achievement, Slovakia is the only Member State left with no official smoking ban in place inside bars and restaurants. A few Member States, including Austria, Portugal and Romania, have implemented only partial bans on indoor smoking in public places.

New Tobacco Control legislation in Georgia came into force on 30 May

On 17 May 2017 The Parliament of Georgia adopted in the third hearing a new national tobacco control law, signed by the President of Georgia on May 30, 2017.

The new legislation introduces a comprehensive smoking ban in enclosed public spaces, workplaces and public transport, an extensive ban on the display of tobacco products at point of sale and standardised packaging.


Ukraine celebrates launch of national smoking quitline

On 20 June Ukraine launched its national quitline in accordance with the WHO FCTC treaty. The service is free of charge and is accompanied by a website providing guidance and support to smokers. The quitline site hosts multiple tools including testing, online consultation, medical advice services and access to literature on smoking cessation and relapse prevention.

Read more [UA]...

Congratulations to the UK!
Standardised packaging comes into force

Plain packaging law in the UK took effect as of 20 May 2017. Companies have had 12 months to sell old stock and fully implement the changes foreseen under the directive, which was adopted in 2014 but held up by a series of court cases testing its legality.

The directive extends to e-cigarettes, restricting tank sizes to 2 ml and the nicotine strength of liquids to 20 mg/ml. Furthermore packages must carry a 30% health warning label on the front and back reading: “This product contains nicotine which is a highly addictive substance.”


The International Tax and Investment Centre (ITIC) breaks free from tobacco influence

The International Tax and Investment Centre (ITIC), a non-profit education and research organization based in Washington DC, announced that it will no longer accept sponsorship from tobacco companies or permit their representatives to sit on its board.
Prior to the decision, tobacco control activists have voiced concern that ITIC was arguing against tobacco taxation as a front group for tobacco companies like PMI. Tobacco control advocates also argue that the decision to refuse sponsorship is a first step for institutions like ITIC and next steps are to follow including withdrawing all PMI-sponsored reports from circulation.

New published articles this month
Assessing demographic differences in decisional balance for smoking prevention and temptations to try smoking among adolescent subgroups
Marie Aline Sillice, Steven F Babbin, Andrea L Paiva, Colleen A Redding, Joseph S Rossi, Wayne F Velicer

Vape shop retailers’ perceptions of their customers, products and services: A content analysis
Jennifer Yo-ka Tsai, Ricky Bluthenthal, Jon-Patrick Allem, Robert Garcia, Jocelyn Garcia, Jennifer Unger, Lourdes Baezconde-Garbanati, Steve Y. Sussman

Tobacco control for all? The Belgian case
Pierre G. Bizel

Have higher cigarette taxes in the United States discouraged smoking? A review of data from 1999-2013
Ben Musumba Wamamili, Adam Philip Garrow

Standardized packaging and illicit tobacco use: A systematic review
Catherine Haighton, Catherine Taylor, Ailsa Rutter

Process evaluation and challenges of implementation of a school-based waterpipe tobacco smoking prevention program for teens in Lebanon
Dima Bteddini, Rima Afifi, Pascale Haddad, Lina Jbara, Hala Alaouie, Lama Al Aridi, Ziyad Mahfoud, Ahmad Al Mulla, Rima Nakkash

The Secondhand Smoke Exposure Scale (SHSES): A hair nicotine validated tool for assessing exposure to secondhand smoke among elderly adults in primary care
Constantine Vardavas, Israel Agaku, Filippos Filippidis, Antonis A Kousoulis, Charis Girvalaki, Emmanouil Symvoulakis, Manolis Tzatzarakis, Aristidis M. Tsatsakis, Panagiotis Behrakis, Christos Lionis
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