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ENSP action for year 2015 [ENSP FY 2015] [671360] - Operating Grant
Project abstract

Within most European populations, smoking prevalence rates differ substantially according to people’s educational level, occupational class and income level. In the European countries, smoking inequalities are generally largest, and smoking is the largest single contributor to socio-economic inequalities in mortality. Significant inequalities in smoking are now emerging in all European countries, especially in the youngest generations. Tobacco products and secondhand smoke (SHS) kill, as documented in over 20 reports (eg: IARC, US Surgeon General). Exposure to SHS kills at least 79 000 people in the EU each year, incl. deaths from lung cancer, coronary heart disease, stroke and chronic non-neoplastic respiratory disease; plus deaths in childhood caused by SHS, deaths in adults from other conditions known to be caused by active smoking and the significant, serious morbidity, both acute and chronic, caused by SHS. Special Eurobarometer 385/2012 indicates that almost one third of European citizens currently smoke either cigarettes, cigars or a pipe. As smoking is responsible for half the difference in deaths across socio-economic groups, tobacco control has a major role to play in reducing health and social inequalities.ENSP plays a major role in Europe to prevent the tobacco industry from biaising and slowing down the tobacco control process. Indeed, ENSP was created for a tighter collaboration within the tobacco control community and for a stronger and united civil society action against tobacco. Key objectives during 2015-2017:- The support to the Directive 2014/40/EU and FCTC implementation- The facilitation of the creation and the operation of national alliances for tobacco control in Europe.- The stimulation of and the participation in European projects - The facilitation of networking in Europe- The collection and distribution of informationEuropean Network for Smoking and Tobacco Prevention 2015-2017: connecting, sharing, advocating to save lives!

Summary of context, overal objectives, strategic, relevance and contribution of the action

Within most European populations, smoking prevalence rates differ substantially according to people’s educational level, professional categories and income. In the European countries, tobacco-related inequalities are generally largest, and smoking is the most important single contributor to socio-economic inequalities in mortality. Significant inequalities in smoking are now emerging in all European countries, especially in the youngest generations. Every year, smoking kills 700.000 Europeans and exposure to SHS causes at least 79.000 deaths. As smoking is responsible for half the difference in deaths across socio-economic groups, tobacco control has a major role to play in reducing health and social inequalities.

The European Network for Smoking and tobacco Prevention plays a major role in Europe, especially to prevent the tobacco industry from biasing the tobacco control process and interfering in all activities. The organisation was created nearly twenty-years ago for a tighter collaboration within the tobacco control community and for a stronger and united civil society action against tobacco; and has the ultimate aim to reduce tobacco consumption in Europe.

The mission of the organisation is to develop a strategy for co-ordinated action among organisations active in tobacco control throughout Europe, by sharing information and experience, through coordinated activities and projects; by creating synergies among public health advocates thus increasing their capacity to direct their actions more effectively. ENSP acts as the lynchpin for its members, creating a central cohesive force for the European tobacco control movement.

With a forward vision, ENSP is working to eliminate the suffering of European citizens caused by ill health and early death due to tobacco-related diseases. It firmly believes that children and young people should be able to grow up without being targets of tobacco industry marketing seeking to lure them into a lifetime of addiction; and that all European citizens without exception should have access to safe clean air unpolluted by tobacco smoke. ENSP’s strategic goal is to make Europe completely smoke-free by 2040, and in order to do so, work towards full implementation of the WHO FCTC in Europe by 2020 as one of its priority.

Key objectives for year 2015 include:

• To support the Directive 2014/40/EU and WHO FCTC monitoring and implementation;
• To strengthen national cooperation and national coalitions in the EU;
• To facilitate networking and coordination among Tobacco Control action in the EU;
• To maximize ENSP information dissemination and capacity building role.

By ensuring the link between European Institutions and national tobacco control communities, ENSP plays a vital role in the implementation of WHO FCTC and the transposition of EU TPD in Europe as well as amongst Member States. By building the capacity of tobacco control alliances and coalitions, by linking regional networks and supporting its members present in 29 countries across Europe, it facilitates the flow of information and ensures effective communication between parties.

ENSP’s three tobacco control fields of work are:
• RESEARCH: ENSP works in partnership with Academics and Researchers to build, foster, promote and disseminate evidence-based and scientific arguments in order for stakeholders to build their case for further activities and counter the interference of the tobacco industry;
• PREVENTION: In order to prevent future generations from using tobacco, ENSP is committed to lead on a number of activities, linked with FCTC and TPD. These includes advocacy at European and national levels, challenging the interference of the tobacco industry, monitoring the marketing of existing and new tobacco products, supporting smokefree legislations, campaigning for higher taxation and promoting the Protocol to Eliminate Illicit Trade in Tobacco Products (Illicit Trade Protocol).
• TREATMENT: Tobacco Dep

Methods and means

As an information platform between EU institutions and national members, ENSP uses a mix of communication tools to disseminate and keep the network as well as the wider tobacco control community up-to-date with the most recent developments in tobacco control issues.

COMMUNICATION: ENSP works closely with its members in order to keep them informed but also provide them with a tailored support. Regular emails, mail-out and also personalised phone calls are used. The Secretariat, based in Brussels works as a reference point and a communication platforms for all tobacco control key players at European and national level.

CAPACITY BUILDING: Members and stakeholders’ capacity is generally very stretched, trying to cover the various strands of work for tobacco control. Thanks to its core function as a network, ENSP offers not only to its members but also to all stakeholders, a wealth of knowledge, expertise, resources and evidence, which are available from a number of sources. The Secretariat plays an important role in the collation, identification and dissemination of the information to the network, according to specific needs and contextual priorities.

PRESENTATIONS: ENSP participated in a number of international conferences and external congresses, as well as national events. When team members did not actively present the work carried, they chaired sessions or moderated group discussions. This is of course in addition to the organisation’s internal initiatives and meetings.

DISSEMINATION OF INFORMATION: Through a wide range of communication tools, including websites (the organisation’s but also for each individual EU projects), ENSP’s scientific journal, social media and newsletters, ENSP is a platform for information sharing with specific news related to tobacco control at European and global level, latest scientific research and evidence, members’ activities and project updates.

MEETINGS AND EVENTS: Twice a year, ENSP organises a network meeting, where members and stakeholders can share good practices, experience and expertise. In 2015, the first meeting took place in Athens (Greece), while the second one was in Vilnius (Lithuania). More than 50 delegates participated in the three-day events, which offered a combination of presentations and workshops. The Secretariat also took these opportunities to have members together to run its General Assemblies. Additionally, the Secretariat staff attended other meetings with partners and stakeholders, including EPHA network meetings, partners’ conferences, international congresses, working group meetings etc.

WRITE UPS: Part of ENSP advocacy work, positions statements, open letters and other press releases are produced on a regular basis, not only at European level but also at national level, in support of members. Some examples include letters to the Austrian and Lithuanian governments and an open letter to policy makers to comply to article 5.3 while implementing TPD.

Work performed during the reporting period

The evaluation of ENSP’s work in 2015 is very positive. All the objectives agreed in the work programme were achieved, even if some activities were not implemented exactly as planned.
The successes for the year amongst many include:
• An increased capacity for the Secretariat, based in Brussels;
• An improved communication and information sharing with partners and members;
• An effective dissemination and capacity building on FCTC and TPD implementation;
• Stronger relations between the Secretariat and members, as well as between members, with tailored support and quick responsiveness;
• A comprehensive dissemination of information and updates on broader tobacco control issues;
• An additional three EU-joint projects had confirmation for funding, which increased ENSP’s revenues and established its role within research;
• A series of successful events, to engage with members and stakeholders;
• A higher visibility at EU level, thanks to increased working contacts with EU institutions as well as further communication;
• A more stable financial situation.

Despite the big effort put in developing and strengthening the relationships with organisations from Baltic States, Czech Republic, Slovakia, Croatia, Norway and Iceland, it is still work in progress, which will be strengthened during 2016. One main and cross cutting reason for not having additional members from those countries is the EU benefit as well as justifying the membership fee. Those countries tobacco control NGOs are generally very small – if any - and find it too challenging to work internationally.

Despite progress being made in Europe towards effective implementation of FCTC and towards the revision of the Tobacco Products Directive, several areas of concern in advancing tobacco control at EU and country levels remain:
• There are significant needs and gaps in advancing tobacco control in the EU in order to have tobacco control high on the EU and Member States political agenda;
• A lot of work still needs to be done to strengthen advocacy capacity and skills of National Tobacco Control Coalitions;
• There is a significant need and vital role for ENSP in advancing the effective development and implementation of the approved WHO FCTC article guidelines in the EU.

The main output achieved so far and their potential impact and use by target group (including benefits)

The main outputs that have been achieved include:

• By participating to all WHO-FCTC meetings in Europe, including the ten-year anniversary, the sub-regional meeting on scaling up the implementation of FCTC in South Eastern Europe Countries and the first meeting of the expert group to review reporting arrangements under WHO-FCTC, ENSP managed to built strong relations with FCTC Secretariat and actively reported on members’ implementation at national level;
• Letters sent out to policy makers, urging them to implement or respect specific FCTC articles. Therefore letters advocating for smokefree bans (Article 8) were sent to Austrian and Romanian Parliamentarians; the Lithuanian Government was urged to ratify the illicit trade protocol (Article 15); An open letter to all policy makers was published reminding them of their obligation to implement Article 5.3 (“Protecting policies from the interests of the tobacco industry”), while transposing TPD into national laws;
• Active prospection for new members, resulting in ten new memberships: five individual members and five full members, which makes it a total of 32 full, 8 associated and 16 individual members in 23 EU member states and 6 non-EU countries.
• Meetings with EU officials through events at the European Parliament as well as project meetings with DG Santé;
• Organisation of network meetings, welcoming over fifty participants, with information sharing and network opportunities to strengthen relations between members;
• Smooth running of EU projects, including the publication of related articles, the application for accreditation of a new cessation tool and the delivery of service contracts;
• Active communication with the appointment of a Communication manager, resulting in an increased visibility of ENSP, via its communication tools (website, social media and newsletter);
• ENSP members and Secretariat active participation in key international and national conferences, representing the organisation as well as highlighting the importance of tobacco control at European level;
• An increase in ENSP’s capacity, with the recruitment of new staff members along side successful project proposals;

Achieved outcomes compared to the expected outcomes


• ENSP has contributed to the implementation of the EU legislation in the field of tobacco products, advertising and marketing;
• ENSP’s position was confirmed amongst its peers and stakeholders as an important network in Europe with vital experience and its capacity to reach out widely to many members and a wide range of stakeholders;
• An increase in the synergy and the coordination with other Brussels-based organisations involved in tobacco control;
• Strong tobacco control activities and cooperation at national level, especially in countries where there are dynamic and organised ENSP members, which include Denmark, Ireland, Italy, Spain, Poland, France and Romania.
• A better reactivity and advocacy from members at national level, as ENSP provides continuous solutions to their requests and enquiries, with a fast turn around time;
• ENSP website is considered as a reference point for European tobacco control with news articles and updated information on the tobacco control;
• Effective project implementation plans for EU projects, including EPACTT, Tob-G, TackSHS, SILNE-R, EQUIPT and EUREST PLUS;
• ENSP is valued and recognition by its members and peers for its effective continuous dissemination of information for the network;
• Increased visibility from the communication activities as well as strengthening of ENSP’s scientific credibility, by becoming a consortium member for three new EU Research joint-projects;
• Consolidation of ENSP’s financial stability, and therefore strengthening of the work programme and ENSP’s role as a reference point for tobacco control at EU level;
• ENSP higher recognition at European level, both by institutions, other NGOs and general population

• Tobacco consumption prevalence decreased in Europe, due to the long-term assessment of such measures;
• As new members from Poland joined ENSP in 2015, an on-going collaboration needs to be established in order to strengthen partnership and activities;
• Strengthened collaboration with certain countries, including Latvia and Estonia, have proved to be difficult due to the absence of leading organisations or financial issues with the main NGOs;
• Smoke Free Universities in Europe is an on-going process, which depends on national legislations and more particularly on individual institution’s policy;
• Organisations working with young people have been contacted and the revival of youth involvement in tobacco control in all EU Member States will take time, through a potential youth network.

Dissemination and evaluation activities carried out so far and their major results

ENSP uses a wide range of online and offline tools, as well as face-to-face events to inform members, stakeholders and the general public on tobacco control related information and activities carried out by the organisation.
• The website, which is a reference resource, combined with the Facebook page enable the Secretariat to inform the network, members and stakeholders, on developments, stories and news in the field of tobacco control. They are also being used to increase the impact of certain activities (letters, position statements, press release, registration for events) as well as sharing information in real time to the general public.
• For information that is mainly of interest to ENSP members or partners, emails are usually the preferred option, as it helps selecting the targets and allow (immediate) response.
• On an ad hoc basis, electronic news bulletins were produced, which combined news articles, members’ activities, ENSP project updates, event promotion/registrations, President’s messages.
• Twice a year, the Secretariat organises a two-day network meeting, which is a platform that enables members to 1. Formally present their work; 2. Discuss common needs; 3. Receive support from others as well as the Secretariat; 4. Learn from each other; 5. Informally network and exchange information. Last year, members gathered in Athens (Greece) in April and then in Vilnius (Lithuania) in October. The meetings are also combined with capacity building workshops on specific hot topics, defined by members, which also give them useful information to take back to their respective organisation/country.
• The members from the Network as well as the Secretariat have also greatly contributed to the dissemination of ENSP’s work and visibility by opportunistically participating to international and national conferences and making keynote presentations. In 2015, major conferences include World Conference on Tobacco or Health, where nine presentations by ENSP members and Secretariat were made. Others national congresses and events were also attended by members as presenters in Italy, Portugal, Poland, Switzerland etc.
• And last but not least, the very nature of ENSP’s work depends on its members. The dissemination process is therefore done through their communication channels (website, facebook, twitter, meetings etc.), to tailor the messages to particular groups, whether they are national policy makers, other NGOs and members (in the case of national coalitions and alliances) or general public.

An external evaluation was additionally conducted over an 8-week period starting in January 2016.
It involved three phases:
Phase 1: Qualitative Research
An evaluation team was established, including ENSP staff, a board member and the external evaluator.
Desk research was first developed analysing ENSP’s internal documents and materials.
With the Evaluation Team it was agreed to set up individual online interviews with members or stakeholders to assess the relevance and impact of ENSP and its activities. The interviews were carried out to assess the work set out in Work Package (WP) 2 and 7 of the work plan. The focus of this year’s evaluation was on the technical and operational deliveries of ENSP, as well as how ENSP can encourage and strengthen national cooperation, reactivate National Coalitions dynamics and add new countries membership.

Phase 2: Analysis
An analysis of the content, implementation, and impact of ENSP’s work in 2015 was developed. The evaluation investigated on the achievements during 2015 based on the planned activities in the Grant Agreement 671360. Action and impact also beyond the foreseen plan were analysed.

Phase 3: Communication flow and reports
Several calls were organized with ENSP staff and the evaluation team whenever necessary. To optimize the communication and review preliminary findings, a face-to-face meeting was organized in Brussels on the 11th February 2016 among the Eva