26-28 April, Madrid: the 9th European Conference on Tobacco or Health


  • The European Congress on Tobacco or Health (ECToH), opened by H.M. the Queen, was held in Spain for the first time, organised by the Spanish Association Against Cancer, along with the Spanish Committee for the Prevention of Smoking and the Association of European Cancer Leagues.
  • The aim of the congress was to promote a youth movement against tobacco and continue working under one goal: to achieve the first tobacco-free generation in Europe by 2040.
  • ENSP proudly contributed and provided the 9th edition of ECToH with expertise and support to empower the young generation.
  • The Congress represented the starting point for youth activism against tobacco. The roadmap was established through the work of more than 100 young people who called the new generations of Europe to action.
  • Over 80 tobacco experts and more than 500 people met over three days. A total of 223 tobacco abstracts have been received.
  • Spain is still the European country with the lowest price for cigarettes: a pack costs half as much as in France and in almost all European countries except those in the East.
  • According to the Association’s study entitled The Influence of Video on Demand and Social Media Platforms”, 9 out of 10 young Spaniards are exposed to ‘digital smoke’, as smoking and vaping are trending on social networks.

More than 500 people gathered in the morning of April 26 for the ninth edition of the European Congress On Tobacco Or Health (ECToH), held at the IFEMA in Madrid and organised by the Spanish Association Against Cancer, along with the Spanish Committee for the Prevention of Smoking and the Association of European Cancer Leagues. The congress was opened by Her Majesty the Queen, as permanent President of Honour of the Spanish Association Against Cancer and the association’s Scientific Foundation Association, and ended on 28 April.

Her Majesty the Queen opened the event and met with 100 young European anti-smoking activists

© Casa de S.M. el Rey
© Casa de S.M. el Rey

Her Majesty the Queen said at the opening, “The focus of this 9th Conference is encouraging because young people have an important role in spearheading the movement to ensure that smoking is not the leading cause of avoidable death in the world. Those of us who have been young and, on many occasions, unaware of the risks associated with the use of tobacco and nicotine products, would have wanted to have all the information and capacity to see how things really stand that you do today. I am sure none of you here today would go into a coffee shop and ask for a cocktail of ammonia, cadmium, tar, acrolein, carbon monoxide, acetone, arsenic, hydrogen cyanide, nicotine and formaldehyde, among other ingredients, am I right?”

© Casa de S.M. el Rey

The Minister of Health, José Manuel Miñones, and the Portuguese Secretary of State for Health Promotion attended the first day of the congress, where tobacco experts, researchers, government representatives and health professionals are working with the aim of continuing to make progress in protecting the population from tobacco smoke and promoting youth activism to tackle smoking, all with one aim: to achieve the first tobacco-free generation in Europe by 2040. The congress will also be attended by Borja Cabezón, Ambassador at Large for the Covid-19 Crisis and Global Health at the Ministry of Foreign Affairs, European Union and Cooperation, and Raquel Yotti, Secretary General for Research at the Ministry of Science and Innovation.

“To achieve a tobacco-free generation by 2040, we need young people to lead the social movement against tobacco across Europe. Only they have the power to stop the gigantic machinery of the tobacco industry,” said Ramón Reyes, president of the Spanish Association Against Cancer.

Over the course of these three days, more than 80 experts addressed topics such as tobacco marketing strategies, the influence of social vulnerability on tobacco use, healthy European cities, factors influencing people’s behaviour in tobacco use and the importance of engaging young people in the fight against tobacco.

Youth activism with regards to smoking – a reality

Since its inception, the tobacco industry has been at the forefront of influencing public opinion. One of its tactics is to use these legal loopholes to position itself in the opinion of our youngest people. Video-on-demand platforms and social media have now become a space for promoting tobacco and new nicotine products. It is essential to work at an early age and raise awareness among young people about the harmful effects of tobacco and its new products,” said Dr. José María Martín-Moreno, professor of preventive medicine at the University of Valencia and chair of the 9th ECToH Madrid 2023 Scientific Committee.

Young people are a vulnerable group when it comes to consuming tobacco and its new products, said Rui Medeiros, president of the Association of European Cancer Leagues: “Special attention must be paid to younger people because, in Europe, 93% of smokers start smoking before they turn 26. The European Union still has a high number of smokers: 26% of the population and 29% of young people aged 15-24. Although the EU is working on measures to curb smoking, the WHO Framework Convention on Tobacco Control is being rolled out unequally across Europe.”

To continue to make progress in the fight against tobacco, it is essential to make young people aware of their important role in it. For this reason, over 100 young people have been present during these three days of the congress, working jointly with tobacco experts on proposals and initiatives aimed at continuing to promote the fight against smoking and calling on more young people to take part in activism.

Young people spoke out against tobacco

Young people have taken the floor to say enough to tobacco and all related products during this edition. Young people, the business objective of the tobacco industry, have launched an activist movement at this Congress to confront the enormous machinery of these companies which, with a thoughtful and calculated strategy, aims to ensure that new generations continue to consume their products at the expense of their health and freedom.

9 out of 10 young people between 16 and 21 years old have had some exposure to tobacco use or vapers on social networks or video-on-demand platforms. The use of actors,  streamers, YouTubers and influencers by the tobacco industry is a strategy aimed at getting young people started using these toxic products. The strategy works because, among those who have been exposed to some form of smoke inhalation, there are more than twice as many smokers as among those who have not.

During the Conference, Lo Que de Verdad Importa Foundation, a strategic ally of this initiative, and more than 300 young people debated, contributed ideas, listened to international experiences and mobilized to achieve the first tobacco-free European generation by 2040. In this sense, the Spanish Association Against Cancer and the main youth associations such as the Lo Que de Verdad Importa Foundation, Red Cross, Greenpeace, FAD Youth Foundation, Scouts of Spain, State Confederation of Student Associations, Talent for the Future, the Youth Council of Spain, Youth Platform Spain and UIB HEALTHY UNIVERSITIES NETWORK and European entities expert in tobacco:  ENSP and ECL have teamed up with the aim of giving youth a voice to achieve the first tobacco-free generation in Europe.

Part of ENSPNext at ECToH

The aim of these alliances is to raise awareness among future generations of their importance in social changes since they are the protagonists of a change in perception around the consumption of tobacco and new nicotine products. Young people in Europe will have the opportunity to stand up to the tobacco industry and be part of the change because, at present, according to the study of the Association’s Cancer Observatory, attitudes towards new forms of consumption are much more positive than towards traditional tobacco. 53.1% of young people in Spain believe vaping is better than smoking cigarettes because it doesn’t leave bad odours and 51.4% think it is easier to quit.

ENSP had the opportunity to organise expert meetings as side discussions during the Congress. Moreover, a cohort of representatives from ENSPNext was present in Madrid in the role of rapporteurs, poster chairs and/or speakers at different oral and poster sessions. Besides its members presenting in different sessions, the Youth Group member Darius Lotrean was nominated as Finalist in the ECToH Poster Award, and Cristina Kiryakos received the Oral Communication Award.

The Congress ended with the “MADRID 2023 Declaration “For a Tobacco-Free Generation” which calls for action with a focus on young people for, among other actions:

  1. Implement tobacco control policies that ensure full implementation of the WHO Framework Convention
  2. Eradicate all forms of advertising and promotion of tobacco and its emerging variants
  3. Adopt and enforce regulations to protect policy-making processes from tobacco industry interference, including transparency obligations
  4. Ensure an appropriate legislative framework that protects children and adolescents from tobacco and nicotine products by preventing their use, including by reducing their attractiveness and affordability.
  5. Preserve the environment from pollution and degradation linked to tobacco and related products.
  6. Encourage active citizenship to achieve a tobacco-free society.

Read the full declaration here…


“Everyone Against Cancer” and the fight against tobacco

Worldwide, 1 in 2 men and 1 in 3 women will have cancer in their lifetime. Worldwide, it is estimated that there will be 21.6 million cases by 2030, of which more than 330,000 will be in Spain. In Spain, one person is currently diagnosed with cancer every 2 minutes.

The Association aims to reach 70% survival by 2030, but to achieve this it needs the unity of entities, public administrations, media, companies and political parties, in other words, the whole of society. “Everyone Against Cancer” has therefore been set up as a tool for social mobilisation and an excellent opportunity to promote and structure public-private partnerships and provide the fight against cancer with the resources it needs.

This union is necessary to deliver on the goal, providing the necessary resources for cancer research, increasing and promoting early detection programmes and ensuring equitable access to programmes, as well as increasing cancer prevention, raising awareness of the harmful effects of tobacco and its new products, working together with governments to achieve smoke-free spaces that protect society and especially children from the harmful effects of tobacco smoke. All this is to ensure that by 2040 there is a generation that has never smoked or inhaled tobacco smoke.

World No Tobacco Day 2024

The Member States of the World Health Organization created World No Tobacco Day in 1987 to draw global attention to the tobacco epidemic and the preventable death and disease...

Read more
Joint Press Release: European Societies call for an EU Endgame on Tobacco

30 May, Brussels – Ahead of World No Tobacco Day 2024, European scientific, healthcare professional and other civil society organisations call for an EU Endgame on Tobacco.  Noting the official...

Read more
Global Youths’ Declaration Takes Aim at Tobacco Industry Accountability

Global Youth Voices, a movement of youth-led organizations representing over a million of youth worldwide, has come together on a groundbreaking declaration to hold the tobacco industry accountable and...

Read more