EDITORIAL
The Madrid 2023 Declaration ‘For a Tobacco-Free Generation
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1
European Conference on
Tobacco or Health 2023 Scientific
Committee
2
Spanish Association Against
Cancer, Madrid, Spain
3
Department of Preventive
Medicine and Public Health and
INCLIVA, University of Valencia,
Valencia, Spain
4
Association of European Cancer
Leagues, Brussels, Belgium
5
Portuguese League Against
Cancer - North /Molecular
Oncology and Viral Pathology
Group, Research Center of IPO
Porto, Porto, Portugal
Submission date: 2023-09-20
Acceptance date: 2023-09-28
Publication date: 2023-12-18
Tob. Prev. Cessation 2023;9(December):38
KEYWORDS
TOPICS
ABSTRACT
The consequences of tobacco are devastating. Not only is tobacco use the leading
cause of preventable disease and death in Europe and worldwide, but it also
harms our planet, causing environmental damage along the whole cycle from
the cultivation of tobacco plants to post-production consumer waste. All variants
of tobacco and related products are harmful, and there is no safe threshold of
exposure.
All types of tobacco and non-medicinal nicotine products are highly addictive,
and have detrimental effects on the environment. We know that it is possible to
significantly reduce the threat and impact of tobacco use by taking appropriate
action. And yet:
• Authorities and society at large (with each one of us bearing responsibility)
lack the courage needed to eradicate this threat;
• A wide range of novel and emerging tobacco and related nicotine products have
aggressively penetrated the European market, which needs to be much more
strictly regulated.; and
• Certain population groups are more vulnerable and suffer more intensely from
this threat, and urgent measures are needed to reduce health inequality in
tobacco control.
For all the above reasons, THE MADRID 2023 DECLARATION calls for the
active involvement of individuals (particularly young people), institutions,
companies, health professionals, media, experts, civil society, and policy makers,
to join efforts to achieve the goal of a ‘Tobacco-Free Generation’ in Europe. With
the purpose of accelerating advances towards this ambitious aim, the participants
collectively endorsed this Declaration and committed themselves to work on the
following objectives for 2030:
1. Adopt and enforce tobacco control policies to ensure full implementation of
the WHO Framework Convention on Tobacco Control and existing European
and national regulations and broaden the scope to include novel and emerging
products.
2. Eradicate all forms of advertising and promotion of tobacco and its emerging
variants (including nicotine and non-nicotine related products) on audiovisual
platforms, social media, and other channels.
3. Adopt and enforce regulations to protect policy making processes from tobacco
industry interference, including obligations on transparency.
4. Address the roles of social, political, cultural, behavioral, and commercial
determinants of health contributing to the uptake of tobacco and related
products.
5. Ensure an appropriate legislative framework that safeguards children and
adolescents from tobacco and nicotine products by preventing their uptake including reducing their appeal and affordability.
6. Address health inequalities by adopting structural
policies and interventions to reduce disparities.
7. Preserve the environment from the pollution and
degradation linked to tobacco and related products.
8. Encourage active citizenship to achieve a tobaccofree society.
9. Ensure universal coverage and access to evidencebased interventions to help smokers to quit.
10. Promote independent research and innovation
on tobacco prevention and control, including data
exchange and collaboration among countries, and
widely share all relevant information and results
with the public. We agree, unequivocally, to
jointly design a realistic and achievable roadmap,
with well-defined and targeted steps to make an
imminent tobacco-free next generation a reality.
The time to act is now! Our children have the
right to live in a tobacco-free environment. It is our
ethical obligation and our responsibility to protect
their health and the planet we leave for the future
generations. Let us put words into action and do all
we possibly can – right now – to eliminate tobacco
use.
Madrid, 28 April 2023.
The consequences of tobacco are devastating. Not only is tobacco use the leading cause of preventable disease and death in Europe and worldwide, but it also harms our planet, causing environmental damage along the whole cycle from the cultivation of tobacco plants to post-production consumer waste. All variants of tobacco and related products are harmful, and there is no safe threshold of exposure.
All types of tobacco and non-medicinal nicotine products are highly addictive, and have detrimental effects on the environment. We know that it is possible to significantly reduce the threat and impact of tobacco use by taking appropriate action. And yet:
Authorities and society at large (with each one of us bearing responsibility) lack the courage needed to eradicate this threat;
A wide range of novel and emerging tobacco and related nicotine products have aggressively penetrated the European market, which needs to be much more strictly regulated.; and
Certain population groups are more vulnerable and suffer more intensely from this threat, and urgent measures are needed to reduce health inequality in tobacco control.
For all the above reasons, THE MADRID 2023 DECLARATION calls for the active involvement of individuals (particularly young people), institutions, companies, health professionals, media, experts, civil society, and policy makers, to join efforts to achieve the goal of a ‘Tobacco-Free Generation’ in Europe. With the purpose of accelerating advances towards this ambitious aim, the participants collectively endorsed this Declaration and committed themselves to work on the following objectives for 2030:
Adopt and enforce tobacco control policies to ensure full implementation of the WHO Framework Convention on Tobacco Control and existing European and national regulations and broaden the scope to include novel and emerging products.
Eradicate all forms of advertising and promotion of tobacco and its emerging variants (including nicotine and non-nicotine related products) on audiovisual platforms, social media, and other channels.
Adopt and enforce regulations to protect policy making processes from tobacco industry interference, including obligations on transparency.
Address the roles of social, political, cultural, behavioral, and commercial determinants of health contributing to the uptake of tobacco and related products.
Ensure an appropriate legislative framework that safeguards children and adolescents from tobacco and nicotine products by preventing their uptake including reducing their appeal and affordability.
Address health inequalities by adopting structural policies and interventions to reduce disparities.
Preserve the environment from the pollution and degradation linked to tobacco and related products.
Encourage active citizenship to achieve a tobacco-free society.
Ensure universal coverage and access to evidence-based interventions to help smokers to quit.
Promote independent research and innovation on tobacco prevention and control, including data exchange and collaboration among countries, and widely share all relevant information and results with the public. We agree, unequivocally, to jointly design a realistic and achievable roadmap, with well-defined and targeted steps to make an imminent tobacco-free next generation a reality.
The time to act is now! Our children have the right to live in a tobacco-free environment. It is our ethical obligation and our responsibility to protect their health and the planet we leave for the future generations. Let us put words into action and do all we possibly can – right now – to eliminate tobacco use.
Madrid, 28 April 2023.
*Other members of the of the ECToH 2023 Scientific Committee
Tit Albreht, National Institute of Public Health, Slovenia
Mariluz Amador, Spanish Association Against Cancer (AECC)
Pilar Aparicio, Ministry of Health, Spain
Javier Ayesta, Spanish Society of Tobacco Experts (SEDET)
Vidal Barchilón, Spanish Society of Family and Community Medicine (SemFYC)
Josep Maria Borras, ICO & Spanish Cancer Strategy for the Ministry of Health
Kristin Byrkje, Smoke Free Partnership (SFP)
Angela Cioubanu, WHO European Office for Prevention and Control of Noncommunicable Diseases
Raul de Simon Gutierrez, Spanish Society of Primary Care Physicians (SEMERGEN)
Jorge del Diego Salas, Consejeria de Sanidad, Junta de Andalucia, Spain
Enriqueta Felip, Spanish Society of Medical Oncology (SEOM)
Esteve Fernandez, Tobacco Control Unit, Catalan Institute of Oncology
Ana Fernandez, Spanish Association Against Cancer (AECC)
Josep Figueras, European Observatory on Health Systems and Policies
Daniela Giangreco, Association of European Cancer Leagues (ECL)
Mervi Hara, Action on Smoking and Health (ASH Finland)
Francisco Garcia Rio, Spanish Society of Pneumology & Thoracic Surgery (SEPAR)
Adelaida Lozano, Federation of Associations of Community Nursing and Primary Care (FAECAP)
Liliana Mahulea, Spanish Society of Primary Care Physicians (SEMERGEN)
Florin Mihaltan, European Network for Smoking and Tobacco Prevention (ENSP)
Iveta Nagyova, European Public Health Association (EUPHA)
Haik Nikogosian, Global Health Centre, the Graduate Institute of International and Development Studies in Geneva
Ma Jose Peña, Spanish Society of General and Family Physicians (SEMG)
Veronica Perez, Spanish Society of Primary Care Physicians (SEMERGEN)
Carlos Rabade, Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)
Francisco Rodriguez Lozano, European Network for Smoking and Tobacco Prevention (ENSP)
Maribel Soteras, Spanish Committee on Tobacco Prevention (CNPT)
Lucienne Thommes, European Cancer Leagues (ECL)
Rosa Maria Urbano Garrido, Spanish Society of Public Health and Health Administration (SESPAS)
ACKNOWLEDGEMENTS
The authors would like to thank all the participants, scientific societies,
and health advocates who generously supported the ECToH Conference,
which took place from 26 to 28 April 2023, in Madrid, Spain. Special thanks
to Andres Zamorano as President of the Spanish Committee on Tobacco
Prevention (CNPT) and through him to all CNPT members. Moreover, we
extend our sincere gratitude to the constituents of the European Cancer
Leagues (ECL) and the Spanish Association Against Cancer (AECC), and
particularly to Wendy Winn (ECL Proofreading & Editing), Rocio De la Calle
(AECC Institutional Relationships team member), Nuria Masana (AECC
Public Affairs Director), and Ramon Reyes (AECC President).
CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure
of Potential Conflicts of Interest and none was reported.
FUNDING
There was no funding for this research.
ETHICAL APPROVAL AND INFORMED CONSENT
Ethical approval and informed consent were not required for this study
DATA AVAILABILITY
Data sharing is not applicable to this article as no new data were created.
PROVENANCE AND PEER REVIEW
Commissioned; internally peer-reviewed.
DISCLAIMER
Javier Ayesta, Florin Mihaltan and Francisco Rodriguez Lozano report that
they are Editorial Board members and that they had no involvement in the
peer-review or acceptance of this article and had no access to information
regarding its peer-review. Full responsibility for the editorial process for
this article was delegated to a handling editor of the journal. The views and
opinions expressed in this article are those of the authors.