Article 14 of the Framework Convention on Tobacco Control (FCTC) requires signatory Parties to take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence. Detailed provisions include the obligation to establish in health care facilities and rehabilitation centers programmed for diagnosing, counselling, preventing and treating tobacco dependence ( Art. 14 c). Furthermore, there is an obligation of collaboration with other Parties to facilitate accessibility and affordability for treatment of tobacco dependence including pharmaceutical products pursuant to

Article 22. Such products and their constituents may include medicines, products used to administer medicines and diagnostics when appropriate.

In order to advise national governments and health professional bodies in Europe on how to fulfil these obligations, it is of utmost importance to gain knowledge about current smoking cessation practice in each country. Smoking cessation clinics have an important role in promoting and supporting smoking cessation treatment in the general population. Therefore, the collection of information on infrastructure of smoking cessation clinics, their organisation, definition, and good practice in each of the 27 EU Member States is essential. Based on the collected evidence, expert consensus must be developed among leading health professionals to facilitate practical implementation of smoking cessation clinics in Europe.

The French experience of setting up a database on smoking cessation clinics and the development of expert consensus on national level on definition of good/bad practice, will be the basis for this research project. An array of international literature gives insight into the smoking cessation treatment programmes and guidelines available in Europe and internationally and will guide the development of European consensus.

The aim

• Development of a database on smoking cessation clinics, with information on organization, definition, and good practice in each of the 27 EU Member States • Setting up of a network of experts on smoking cessation clinics across Europe

• Creation of expert consensus on definition of smoking cessation clinics and identification of good/bad practice.

Goal for the first year of the project

• Collect existing data on number of clinics, definitions, activities and current practice of smoking cessation clinics across the 27 EU countries • Obtain a first expert consensus on definition of good practice, bad practice and practice needing improvement.

• Establish a draft list of smoking cessation clinics based on the first expert consensus.

Goal for the second year of the project

• Consult smoking cessation clinics and other stakeholders on the draft definitions proposed for good practice, bad practice and practice needing improvement • Refine expert’s consensus on definitions of good practice and identify list of tools to improve current practice • Establish a final list of smoking cessation clinics corresponding to expert consensus definitions.

• Disseminate the results of the project.

The process

The OFT will be the leading organization for the project implementation. However during the implementation period the advice and largest consensus achievable among European experts will guide every step of the process. A full time coordinator will be responsible for the project management assisted by expert consultants.

Action Plan

1st Year:

• Identification of a list of corresponding experts in each of the 27 EU Member States • Creation of a project working group from among the identified experts (6 – 12 experts) based on multidisciplinary and geographical coverage • Development of a pilot survey questionnaire starting from the French experience and complemented by an analysis of the international literature • Collection of lists of existing smoking cessation clinics and definitions of good/bad practice in a pilot sample of countries by way of the common questionnaire

• Creation of a web based data base on smoking cessation clinics in Europe and good practice examples ( good practice manuals or other materials) and feed the results from the pilot study into the system.

• After collection of data, Approval of the project working group of definition and criteria to classify existing data in 3 categories:

o good practice o indeterminate practice

o practice needing strong improvement.

2nd Year:

• For the second step of the project, national correspondents in the 27 EU countries will be consulted on the questionnaire and definitions of good practice proposed by the project group • National information will be analyzed, the need for improvement identified and the questionnaire updated • A second round of data collection will be initiated with the help of the national correspondents

• The data base will be completed and the definition of good practice, indeterminate practice and practice needing strong improvement finalised.

Time table for the first year (2010)

First trimester(December 2009-Fevruary 2010)

• A collection of existing data will be collected and set in a common data base :

o individual smoking clinic o national or regional coordinator o existing good practice manual (or similar) o existing definition

o key persons in the 27 EU countries

Second trimester (Mars 2010-May 2010)

• Meeting with identified national available correspondents (project working group)

o examination with 6-12 experts of the first draft of data base, proposal for correction of the form of the definitive data base o first list of words that need definition

o consensus of how to improve the consensus on good practice

Third trimester (June 2010-August 2010)

• New meeting of experts

o final agreement on the experts consensus process o approval of the first series of definition o approval on the fist list of smoking clinic

o approval on the data base format and improvement need

Fourth trimester (September 2010-November 2010)

• Publication on line of the first pilot rooster (non definitive at this period) (interactive data base + pdf format) • Publication of the points of consensus (good and bad practice) and point needing new expert consensus

• Communication on this first year of work

Outcome for the second year (2011)

Polish the work of the first year

• Update countries profiles and collected the 3 missing countries up to 27 • Collect Tobacco cessation service data up to 3000 centers • Collect 30 examples of good practice

• Collect 10 examples of bad practice

Continuous the project as planned

• Adoption of a EU code for tobacco cessation services • Creation and experimentation in 4 countries of a self audit tool for tobacco cessation services • Translation/adaptation at national regional level of definitions, code and self audit tool up to 4 countries • Networking patients database managers up to 4 national /regional databases

• Dissemination of results

o From blog to internet website o presentation at 2 or more EU congress and 4 or more national congress o edition of a brochure on the project

o preparation of a scientific publication