With smoking primarily affecting lower socioeconomic groups across Europe, the EU is looking at overcoming increasing socioeconomic inequalities related to health. Indeed, many European countries have tightened tobacco control, and different programmes continue to combat the phenomenon, representing an array of so-called natural experiments on encouraging cessation. The EU-funded project SILNE (Tackling socioeconomic inequalities in smoking: Learning from natural experiments by time trend analyses and cross-national comparisons) sought to document and tackle these inequalities. To achieve its aims, the project analysed studies on the topic covering different market segments and countries. It looked at how youth and adults stopped smoking, the effect of pricing policies and smoking bans, initiation during adolescence and other important considerations on smoking behaviour. In effect, the project team gathered all the results of these natural experiments on controlling tobacco with the aim of developing viable strategies for reducing socioeconomic inequalities in smoking. This was achieved by analysing trends, conducting comparisons among European nations, and reviewing relevant studies with the aim of disseminating combined findings across the continent. Valuable insight emerged from the project, such as the results of a new survey on smoking among 16-year-old students in 6 European countries. The survey found that the risk of smoking increased with the number of smokers that adolescents have among their friends. It also found that smoking was very strongly related to lack of school engagement, school burnout and low academic achievement. SILNE assessed the impact of specific tobacco control policies on trends in smoking cessation, looking at if and how this impact varies according to socioeconomic group. Up to now, more than 15 papers have been published on its findings such as cross-border cigarette purchasing, the impact of pictorial cigarette warning labels and reasons for using electronic cigarettes. Several papers were also published per country, including Italy, Lithuania, Netherlands, Portugal, Spain and Ukraine. The project vigorously disseminated all its results to stakeholders, from academics to professionals, through journals, conferences, workshops and newsletters as well as online. Efforts were also made to disseminate the results to policymakers and the general public. There is no doubt that the project's results will help governments and policymakers control smoking more effectively, ultimately reducing health costs and saving lives.
Smoking, socioeconomic inequalities, health, tobacco control, natural experiments