May 2018 
ENSP request for a European Union Directive
for a total ban of the use of tobacco and related products in public and work places

Dear Commissioner Andriukaitis,

On 30 November 2009, the Council Recommendation on smoke-free environments was adopted, as the result of a consultation and legislative process, calling on Member States to act in three main fronts:

  • Adopt and implement laws to fully protect their citizens from exposure to tobacco smoke in enclosed public places, workplaces and public transport, within three years of the adoption of the Recommendation
  • Enhance smoke-free laws with supporting measures such as protecting children, encouraging efforts to give up tobacco use and pictorial warnings on tobacco packages.
  • Strengthen cooperation at EU level by setting up a network of national focal points for tobacco control.

Despite not having any specific directive from the European Commission or strong obligations, the majority of EU countries have adopted comprehensive national smoke-free laws in public and workplaces. Among these, Ireland, the UK, Romania, Bulgaria, Malta, Spain and Hungary have the strictest smoke-free provisions with a complete ban on smoking in enclosed public places, on public transport and in workplaces, with only limited exceptions allowed. Belgium, Spain and Poland are undeniable examples of countries where the adoption of comprehensive legislation led to very significant drops in tobacco smoke exposure within a short time period.

But this incredible progress and fantastic results are currently being threatened at national level by the tobacco industry, which you are fully aware, is pushing for the normalisation and the widespread use of tobacco and related products (including electronic cigarettes and heated tobacco) in public and workplaces.

In addition to the increased number of industry-sponsored events to lobby policy makers, tobacco companies are writing directly to government representatives misinforming them about the effectiveness of those new products as smoking cessation tools, minimising their negative health effects[i]and pushing for a review of existing smokefree legislations[ii]. Also, loopholes in existing smokefree legislations are being used to advertise those falsely so called “safer products” to young people[iii]and to renormalise tobacco use in public and work places.

Indeed, in many countries where there is a smoking ban, tobacco companies are advocating for governments to allow the use of novel products in public and workplaces, as they do not produce smoke. This would be totally counter productive and would defeat the purpose of all smokefree legislations, which have the objective to protect the citizens from exposure to second-hand smoke and therefore to any other hazardous substances such as heated tobacco vapour.

Despite claims from the tobacco industry that those new products can reduce harm up to 90-95% compared to conventional cigarettes, independent research has confirmed high levels of carcinogenic substances[iv]and similar levels of nicotine and tar than conventional cigarettes[v].

With the current scientific evidence, national and international organisations including the European Respiratory Society or the French Alliance Against Tobacco[vi]have demonstrated that heated tobacco products are shown to: 1) be harmful and addictive; 2) undermine smokers’ wish to quit; 3) undermine ex-smokers’ wish to stay smoke-free; 4) be a temptation for non-smokers and minors; 5) impose a risk of re-normalisation of smoking; and 6) impose a risk of dual use with conventional cigarettes.

In order to protect European citizens’ health as well as preserving the vital progress achieved through the adoption of comprehensive tobacco control legislations in most of EU members states, the European Network for Smoking and Tobacco Prevention (ENSP) and its 60 members are strongly urging the EU Commission to initiate the legislative process in order to adopt a European Union Directive for a total ban of the use of tobacco and related products in public and work places, with clear indication for heated tobacco products and electronic cigarettes  to be treated as conventional cigarettes.  


 European Network for Smoking and Tobacco Prevention - ENSP




[iv]Auer R, Concha-Lozano N, Jacot-Sadowski I, et al. Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name.  JAMA internal medicine2017;177(7):1050-52. doi: 10.1001/jamainternmed.2017.1419 [published Online First: 2017/05/23]

[v]Li X, Luo Y, Jiang X, et al. Chemical Analysis and Simulated Pyrolysis of Tobacco Heating System 2.2 Compared to Conventional Cigarettes.  Nicotine Tob Res2018 doi: 10.1093/ntr/nty005 [published Online First: 2018/01/11]


ENSP-CNPT Conference:
 Register now before it is too late!
This year's conference is will be a bilingual event, catered for English and Spanish speaking delegates, as ENSP partnered with the Spanish national coalition CNPT to provide sessions for international and national delegates. So far, more than 200 people have registered to attend the three day events and many more are expected to sign up in the next couple of weeks. Places for the conference are limited, so the organisers very much encourage those who have not yet registered to do so as soon as possible to avoid disappointment. 
ENSP-CNPT International Conference on Tobacco Control 
14-16 June 2018 - Madrid (Spain)

Please visit the 
Conference website for further information on the programme, venue and organising your trip to Madrid.

Two workshops of ENSP partners are OPEN for pre-registration:

  • Taking on the Industry – a Strategic Planning Session for EURO advocates organised by Campaign for Tobacco-Free Kids
  • Using Human Rights arguments and frameworks to advance tobacco control, a practical approach organised by Action on Smoking & Health, US

Places are limited to 25-30 participants for each workshop.

World No Tobacco Day
New heated tobacco products: No Smoke? No fire?
30 May - European Parliament, Strasbourg (France)  
ENSP and ERS are joining forces this year for an event at the European Parliament in Strasbourg (France) to inform, discuss and provide delegates with evidence on heated tobacco products. On 30 May 2018, to celebrate World No Tobacco Day, researchers, policy makers and advocates are invited to a information session to understand the extend of the issue on the public health behind those so-called "harm reduction" products, which are being aggressively promoted by the tobacco industry in many European countries, as well as around the globe. 
To attend this topical event, please register now by clicking on the "register" button below. 
For enquiries please send an email to
World No Tobacco Day
Roundtable on Tobacco and Cardiovascular Disease
6 June - European Parliament, Brussels

On 6 June 2018 the European Heart Network, together with Smoke Free Partnership and with endorsement from ENSP and the World Health Federation is organising a roundtable on tobacco and heart disease, hosted by MEP Cristian Busoi. 

Tobacco use is an important risk factor for the development of cardiovascular disease. The aim of this Roundtable is to increase awareness of the link between tobacco use and cardiovascular diseases, such as heart disease, stroke, and to raise support for actions to reduce the burden of tobacco related cardiovascular diseases on individuals and society. 

The event will also host the WNTD 2018 Award Ceremony to celebrate individuals or organisations in WHO Europe Region for their accomplishments in the area of tobacco control .

Read more about WNTD 2018...
Tobacco control achievements and priority areas in the WHO Europe Region: A review

Tobacco control efforts have been advancing globally, including the adoption and entry into force of the World Health Organization (WHO) Framework Convention of Tobacco Control (FCTC), as well as the adoption of the European Union EU Tobacco Products Directive. With the present review, the European Network for Smoking and Tobacco Prevention (ENSP) and European Respiratory Society (ERS) aim to provide a comprehensive overview on the status of WHO FCTC implementation, policy achievements and priority areas across countries in the WHO Europe Region.

The review was conducted through a triangulation of data extracted from a survey administered to ENSP members, the WHO FCTC Implementation Database, Tobacco Control Laws and the Tobacco Control Scale 2016.

Using the WHO MPOWER measures as a framework, we report on the implementation status of nine FCTC articles across 47 countries in the WHO Europe Region. The average number of articles fully implemented was 3.58. FCTC articles least fully implemented were: Article 5.3 on Tobacco Industry Interference (25.5%, n=12), Article 20 on Research (34.0%, n=16), and Article 15 on Illicit trade (40.4%, n=19). The most commonly fully implemented articles were: Article 8 on Smoke-free legislation (63.8%, n=30), Article 16 on Underage sales (57.4%, n=27), and Article 6 on Price and tax measures (51.2%, n=24). Policy achievements and recommended priority areas for future national tobacco control activities varied greatly among countries.

Findings highlight the multitude of successes in tobacco control efforts across the region in recent years, but point out the need to address gaps in FCTC implementation.

Read the full article.
Juul electronic cigarettes:  
New threat to European youth?
Introduced in 2015, Juul electronic cigarettes have quickly skyrocketed in popularity among teens and college students across the United States, according to widespread news reports. Educators and students report an alarming level of Juul use in middle and high schools, making this an urgent public health problem.

At the moment Juul cannot be sold in the EU because its nicotine content exceeds the levels allowed by the Tobacco Product Directive. However, Juul announced that it is expanding in Europe, and is hiring a number of London-based staff to cover the EMEA region and employees to prepare for the product launch in France.

Report the marketing of 
eCig and Heated Tobacco Products...

Do you have an event coming up or news to celebrate? 
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The Network - ENSP monthly newsletter
Congratulations to Turkey:  
Ratification of Illicit Trade Protocol
Turkey ratified the WHO FCTC Protocol to Eliminate Illicit Trade on 26 April 2018. 

Five more parties still need to join the Protocol before the 2nd July 2018 to reach the number of 40 in order for the Protocol to come into force and to have the first meeting of the parties in Geneva later this year. 


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 on how the tobacco industry continues to mislead the public about harmful effects of smoking and tries to undermine evidence-based public education campaigns.

Smoking is an adult behaviour and smokers are aware of the risks

Key Message:
Smoking is not an adult behaviour. Most smokers start as children, and around the world millions of children are smokers. Tobacco companies have a long history of targeting children and young people, exposing them to a wide range of advertising and other forms of marketing, and seeking to prevent measures that will reduce smoking in children and young people. "
Tobacco companies claim that smoking is an adult behaviour, and that they market and sell their products responsibly, and only to informed adult smokers. While in reality:
  • Smoking is not an adult behaviour. Most smokers start as children, and around the world millions of children are smokers.
  • Tobacco companies have a long history of targeting children and young people, exposing them to a wide range of advertising and other forms of marketing, and seeking to prevent measures that will reduce smoking in children and young people.
  • Smokers are not aware of the risks of smoking, and even when they are aware that smoking is harmful, often believe that the risks do not apply to them.
  • The tobacco industry has fiercely opposed evidence-based measures that will prevent the onset of smoking in children and make both children and adult smokers aware of the risks of smoking.
Read more in the WHO Tobacco Control Playbook.
New published articles

Johannes Thrul, Meredith C. Meacham, Danielle E. Ramo

Exclusive and concurrent use of cigarettes and alternative tobacco products among Hong Kong adolescents
Nan Jiang, SY Ho, Man Ping Wang, Lok Tung Leung, Tai Hing Lam

Passive exposure to e-cigarette emissions: Immediate respiratory effects
Anna Tzortzi, Stephanie Irene Teloniatis, George Matiampa, Gerasimos Bakelas, Vergina Konstantina Vyzikidou, Constantine I. Vardavas, Panagiotis K. Behrakis, Esteve Fernandez

A couples-focused intervention for smoking cessation during pregnancy: The study protocol of the Quit Together pilot randomized controlled trial
Cristian Ioan Meghea, Alexandra Brinzaniuc, Alexandra Sidor, Razvan Mircea Chereches, Dan Mihu, Cristian I Iuhas, Florin Stamatian, Gabriela Caracostea, Marina D Dascal, Kristie Foley, Adriana Baban, Thomas C Voice, Oana Maria Blaga

Uptake of e-cigarettes among a nationally representative cohort of UK children
Anthony A. Laverty, Eszter P. Vamos, Filippos Filippidis

Tobacco control achievements and priority areas in the WHO Europe Region: A review
Andrea Glahn, Christina Nicole Kyriakos, Cornel Radu Loghin, Dominick Nguyen, Polina Starchenko, Carlos Jimenez-Ruiz, Marine Faure, Brian Ward

Pennsylvania policymakers’ knowledge, attitudes and likelihood for action regarding waterpipe tobacco smoking and electronic nicotine delivery systems
Beth L. Hoffman, Megan C. Tulikangas, A. Everette James, Ariel Shensa, Jason B. Colditz, Jaime E. Sidani, Brian A. Primack

Impact of the Tobacco Treatment Guidelines for High Risk Groups (TOB.g): A pilot study among physicians specializing in CVD, Diabetes and COPD
Antigona Carmen TroforSophia PapadakisConstantine I. VardavasLucia Maria LotreanChristina-Maria GavrilescuVaso EvangelopoulouTheodosia PelekiLetitia TroforPanagiotis Κ. Behrakis

Assessment of the use of different forms of tobacco products among Nigerian adults: Implications for tobacco control policy
Nene Okunna

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