pesce 08

EUROPEAN STAKEHOLDER
CONFERENCE
General Practitioners and
the Economics of Smoking
Cessation
(EU Grant Agreement 2005319)
Barcelona, 27-28 March 2008
With the support of:
Generalitat de Catalunya
Departament de Salut

Project Co-ordination
Sibylle Fleitmann
Tel: + 49 (0) 231 72 55 964
e-mail: s.fleitmann@gmx.de
Project Administration
Dr Jean Daver
Project Secretariat
TABAC & LIBERTE,
10 rue des Arts, F-3100 Toulouse
Tel: + 33 562 88 67 74
Mobile phone + 33 6140 85 628
asso.tabac-et-liberte@wanadoo.fr
www.tabac-liberte.com
Financial Management
Antonella Cardone
Tel: + 39 (0) 5046171
e-mail: units@uniterzosettore.it
This project receives financial support from the European Commission Public Health
Programme 2003-2008 (Grant Agreement 200 5319). The responsibility of the information
contained in this document lies with the authors. The Commission is not responsible for any
use that may be made of the information contained therein.

FOREWORD
PESCE “General Practitioners and the Economics of Smoking Cessation“ is cofunded
by the European Commission (Grant Agreement 2005319) in the frame of the
Public Health Programme 2003-2008. The aim of the project is to develop evidence
based policy recommendations and practice based implementation strategies to
increase engagement of General Practitioners in smoking cessation.
The Barcelona stakeholder conference on 27-28 March 2008 is the final step in a
comprehensive development process. It is the result of long working hours and an
intensive reflection process. Without the trust, friendship and goodwill of all our
partners, it would not have been possible to run this multinational and multifaceted
project while respecting precisely the contract terms of the EU project grant.
At the Barcelona stakeholder conference, we will be presenting the results of this
common effort. We sincerely hope that you will support the outcome of our work.
Together we will finalise implementation strategies based on the policy recommendations
to shape the future role of General Practitioners in our health care systems
in Europe.
While we can agree on common objectives and efficient solutions that will lead to a
better integration of General Practitioners in the overall effort to reduce tobacco
consumption in Europe, the implementation and timing of activities must take place
on a national level. General Practitioners’ role and activities must be integrated into
the cultural environment, the legislative framework, the different health systems and
according to the available financial resources of each country.
In the long term, by letting each country evolve individually towards a common
objective at their own pace, we will succeed in integrating prevention into our health
care systems to the greatest benefit of the citizens of Europe.
We would like to take this opportunity to thank our partners for their help to reach
our common goals. We would especially like to thank:
• the participants of this conference who will determine the project results through
their valuable input
• the experts who shared their knowledge, analysed the scientific evidence and
have helped us to develop the Warsaw policy recommendations
• the researchers who gathered the scientific evidence on national and European
levels
• the associated and collaborating partners who, through their active participation
and availability, made this project a success
• the funders who believed in our project and supported us financially.
My sincere thanks to all of you,
Jean Daver MD, PhD
Chairman of Tabac & Liberté
PESCE Project Leader
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PESCE PROJECT PARTNERS
PROJECT LEADER
Dr. Jean Daver, Tabac & Liberté, France
PROJECT COORDINATION
Ms. Antonella Cardone, Consultant on
Social and Public Health issues, Italy, -
Financial co-ordination
Ms. Sibylle Fleitmann, Independent Consultant
Tobacco Control, Germany – Project
co-ordinator
Ms. Marie-Hélène Weber, Pierre Fabre
European Affairs, France - Logistics
ASSOCIATED PROJECT PARTNERS
Dr. Tibor Baska, Comenius University Jessenius
Faculty of Medicine, Slovakia
Dr. Carmen Cabezas, Health Department
of the Autonomous Department of Catalonia,
Spain
Prof. Luke Clancy, The Research Institute
For a Tobacco Free Society (RIFTS), Ireland
Prof. David Cohen, School of Care Sciences,
University of Glamorgan, Wales
Dr. Tibor Demjen, Smoking or Health Hungarian
Foundation, Hungary
Dr. Evangelos Filopoulos, Hellenic Cancer
Society, Greece
Dr. Giovanni Invernizzi, Italian School of
General Medicine (SIMG), Italy
Dr. Annelies Jacobs, Radboud University
Medical Centre, Centre for Quality of Care
Research (WOK), The Netherlands
Prof. Ulrich John and Dr. Sabina Ulbricht,
University of Greifswald, Germany
Ms. Martine Stead, Centre for Tobacco
Control Research, University of Stirling &
the Open University, Scotland
Dr. Hans Storm, Danish Cancer Society,
Denmark
Ms. Ann Van den Bruel, Katolieke Universiteit
Leuven (KUL), Belgium
Prof. Antonio Vaz Carneiro, Faculty of
Medicine, University of Lisbon, Portugal
Prof. Witold Zatonski and Ms. Marta Porêbiak,
Health Promotion Foundation, Poland
COLLABORATING PROJECT PARTNERS
Prof. Olaf Aasland, Institute of Health
Management and Health Economics,
Norway
Dr. Andi Aristotelous, Ministry of Health,
Cyprus
Dr. Michael Callens, Mutualité Chrétienne
de Belgique, Belgium
Dr. Janis Caunitis, Health Promotion State
Agency, Latvia
Dr. Jacques Cornuz, Swiss Smoking Cessation
Network, Switzerland
Dr. Eirik Boe Larsen, European Union of
General Practitioners (UEMO), Belgium
Dr. George Kotarov, National Centre of
Public Health Protection, Bulgaria
Dr. Eva Kralikova, Institute of Hygiene and
Epidemiology Charles University, Czech
Republic
Dr. Wilfried Kunstmann, Bundesärztekammer,
Germany
Mr. Francis Grogna, European Network
for Smoking Prevention, Belgium
Prof. Florin Mihaltan, Institute of Pneumology
"M.Nasta", Romania
Dr. Vera-Kerstin Petric, Ministry of Health,
Health and Healthy Lifestyle Promotion
Sector, Slovenia
Ms. Christina Dietscher, Ludwig Boltzmann
Institute for Sociology of Health and
Medicine, Austria
Mr. Patrick Sandström, National Public
Health Institute KTL, Finland

Prof. Hanne Tonnesen, Bispebjerg University
Hospital, WHO-Collaborating Centre
for Evidence Based Health Promotion in
Hospitals and Health Services, Denmark
Dr. Aurelijus Veryga, Kaunas University
of Medicine, Lithuania
RESEARCHERS
General Practitioners and the Economics of Smoking Cessation in Europe
Dr. Joao Costa, Faculty of Medicine, University
of Lisbon, Portugal
Dr. Peter Csepe, Smoking or Health Hungarian
Foundation, Hungary
Ms. Laura Currie, The Research Institute
For a Tobacco Free Society (RIFTS), Ireland
Inge Haunstrup-Clemmensen, Danish Cancer
Society, Denmark
Ms. Inge Haunstrup-Clemmensen, Danish
Cancer Society, Denmark
Ms. Helena Koprivnikar, National Institute
of Public Health, Slovenia
Ms. Sophie Massin, CES-MATISSE, Université
Paris 1, Maison des Sciences Economiques,
France
Dr. Ivo Nagels, Fondation contre le Cancer,
Belgium
Ms. Maria Pilali, Hellenic Cancer Society,
Greece
Dr. Nicolo Seminara, European School of
General Medicine (SEMG), Italy
Ms. Kathryn Angus, Gayle Tait and Ingrid
Holme, Centre for Tobacco Control Research,
University of Stirling & the Open University,
Scotland
Ms. Lotje Van Esch, Radboud University
Medical Centre, Centre for Quality of Care
Research (WOK), The Netherlands
EXPERTS
Dr. Francisco Camarelles, Spanish Society
of Family Medicine, Spain
Dr. Dongbo Fu, World Health Organization
(WHO), Switzerland
Prof. Pierre Kopp, Université Paris 1 -
Panthéon - Sorbonne, France
Ms. Jennifer Percival, Royal College of
Nursing, UK
Dr. Luis Rebelo, Faculty of Medicine, University
of Lisbon, Portugal
Dr. Annie Sasco, INSERM, France
Mr. Kriztof Prezwosniak, Cancer Centre
Institute, Poland
Prof. Joy Townsend, London School of
Hygiene and Tropical Medicine, UK
FUNDING BODIES
- European Commission, DG SANCO,
Public Health Programme, Luxemburg
- Ministry of Foreign Affaires, France
- Mission Interministérielle de Lutte
contre les Drogues et la Toxicomanie
(MILDT), France
- Institut National du Cancer (INCa),
France
- Cancer Research UK (CRUK), UK
- Pierre Fabre Laboratories, France
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PESCE PROJECT DESCRIPTION
In June 2006, the European Commission awarded a 60% co-funding to PESCE, a
European project drawing together 31 partners from 27 countries. The grant was
awarded because of its multidisciplinary, multicultural and innovative nature, linking
social and economic considerations. The PESCE project runs from September 2006
to May 2008 and operates with a total budget of 658.000 ¤. Fifteen associated partners
contribute financially and share the scientific responsibility of the project. Another
sixteen collaborating partners contribute their expert advice and experience as well
as a number of experts chosen for their special knowledge and scientific reputation.
Tabac & Liberté, the largest non-governmental organisation in Europe specialising
in smoking cessation training of General Practitioners and health professionals at
a national level, is the initiator and co-ordinator of this large-scale project. The
elaboration of the PESCE project together with the European project partners is
based on four previous EU projects in the field of general practitioners, health
professionals and smoking cessation which were finalised between 1998-2006.
PROJECT OBJECTIVES
The general objectives of the project are to develop evidence based policy recommendations
and practice based implementation strategies through a large scale European
consultation process, taking into account national and cultural specificities:
• Promote increased smoking cessation interventions of General Practitioners (GPs)
in Europe by addressing the socio-economic environment of their practice
• Motivate decision makers to change the working environment of GPs through
political measures
• Highlight the economic benefit from increased smoking cessation interventions
on the health care budget in Europe.
PROJECT WORK PLAN
The PESCE project is divided in several work packages which are implemented under
the responsibility of one or more associated partners:
• Project management and coordination
• International review of the literature on factors that facilitate and hinder use of
smoking cessation interventions by GPs, and of interventions to change GP
behaviour.
• Review of the grey literature in 27 countries in Europe
• Estimate of the costs and benefits of measures to increase general practitioner
advice giving with respect to smoking cessation

• Organization of an expert meeting in Warsaw to develop evidence based policy
recommendations
• Organization of a European stakeholder conference in Barcelona to develop
implementation strategies and to adopt European policy recommendations elaborated
by the Warsaw experts conference
• Publication of a European project report, translation of the executive summary in
all languages of the EU and dissemination of policy recommendations on the
internet and through national press conferences and events
• Project evaluation.
EXPECTED OUTCOMES
General Practitioners and the Economics of Smoking Cessation in Europe
• Report on factors that facilitate and hinder use of smoking cessation interventions
by GPs, and of interventions to change GP behaviour
• Report on costs and benefits of measures to increase general practitioner advice
giving with respect to smoking cessation
• European consensus on evidence based policy recommendations and practice
based implementation strategies to improve smoking cessation interventions of
GP’s in Europe
Better integration of prevention in health care systems in Europe.
For further information on the PESCE project please go to www.tabac-liberte.com.
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WARSAW POLICY RECOMMENDATIONS
On 10-11 December 2007, 30 multi-disciplinary experts from 19 countries developed
policy recommendations to motivate engagement of General Practitioners (GPs) in
smoking cessation based on the PESCE project research findings. The results of this
comprehensive consensus procedure were the following basic recommendations by
the experts:
CAPACITY BUILDING
1 To address the professional competence in smoking cessation, training in smoking
cessation is needed for GPs at undergraduate and postgraduate levels as well as
continued professional development (CPD). It should be compulsory for undergraduate
and postgraduate training. It should be encouraged for CPD;
2 Specific communication skills on smoking cessation should be integrated into
GPs’ education and training programmes. A forum for communication among
colleagues to allow regular exchange of experience in smoking cessation interventions
should be created;
3 Participation of GPs in research projects such as clinical research trials and
observation studies on smoking cessation should be promoted. There is a need
to improve the body of evidence available on smoking cessation and methodologies,
as well as a need for standard research tools.
4 All health professionals who smoke should be supported to stop smoking;
RESOURCES
5 GPs should be provided with comprehensive information on available evidencebased
cessation services including type of service, location, referral procedures,
cost and contact details;
6 External cessation services should provide regular feedback to GPs on patient
cessation outcomes;
7 GPs should record and monitor the smoking status of all their patients and should
record their subsequent actions in an integrated routine record system. This
should become a routine activity;
8 A simple recording system on smoking cessation interventions should be incorporated
into existing information systems. This should include smoking status,
cessation activity and feedback;

9 Administrative obligations of GPs should be reviewed in the wider framework to
free time for prevention activities;
POLICY FRAMEWORK
10 Increase provision and financial support to strengthen smoking prevention and
cessation activities. Extra resources for reimbursement for specified smoking
cessation interventions should be included in the normal GP payment system;
11 GPs should play a central role in the formulation of evidence-based clinical
guidelines on smoking cessation. GPs should play a central role in identifying and
advising, intervening or referring smoking patients;
12 Smoke free policies should be established and enforced in GPs’ working environment.
Smoke-free policies should be implemented in compliance with the WHO
Framework Convention on Tobacco Control, referring to the role of GPs in smoking
cessation;
COMMUNICATION
General Practitioners and the Economics of Smoking Cessation in Europe
13 Smoking behaviour among GPs and other health professionals should be monitored
regularly. GPs should be targeted to participate in smoking cessation courses;
14 General population awareness of the benefits of smoking cessation regarding the
impact of both passive and active smoking should be promoted through mass
media campaigns and information material. To reduce the perceived lack of
acceptance of smoking cessation advice interventions, the general population
awareness of GPs as a point of contact for smoking cessation services should be
increased;
15 GPs’ awareness of the importance of smoking prevention and cessation for the
health of the general population has to be fostered.
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CONFERENCE PROGRAMME
Thursday, 27 March
8.30 - 9.30 h Registration – coffee
9.30 - 10.00 h Welcome and introduction
Jean Daver, Tabac & Liberté, France
Carmen Cabezas, Health Department of the Autonomous
Government of Catalonia, Spain
Antoni Plasència, Director of Public Health of the Health
Department of the Autonomous Government of Catalonia, Spain
Dr. Manuel Oñorbe, General Director of the Public Health
Directorate, Spain
SESSION I
Chairperson:
Jean Daver, Tabac & Liberté, France
10.00 - 10.20 h Policy development in the frame of the EU Public Health
Programme 2008-2013
Ms. Lourdes Chamarro, European Commission, Directorate
General Health and Consumer Protection
10.20 - 10.40 h WHO Report on the Global Tobacco Epidemic – The MPOWER
Package
Dr. Luminita Sanda, Tobacco Free Initiative, World Health
Organization
10.40 - 11.00 h Coffee break
11.00 - 11.50 h Review of the Literature on Factors That Facilitate and Hinder
Use of Smoking Cessation Interventions by GPs, and of
Interventions to Change GP Behaviour
Martine Stead, Centre for Tobacco Control Research, University
of Stirling & the Open University, Scotland
11.50 – 12.40 h Costs and Benefits of Measures to Increase General
Practitioner Advice Giving with Respect to Smoking Cessation
Prof. David Cohen, University of Glamorgan, Wales

CONFERENCE PROGRAMME
12.40 - 13.15 h ROUND TABLE DISCUSSION: Presentation of PESCE policy
recommendations developed by the Expert Group in Warsaw
2007
Prof. Dr. Antonio Vaz Carneiro, Faculty of Medicine of Lisbon,
Portugal
Dr. Jean Daver, PESCE project leader – Tabac & Liberté, France
Dr. Carmen Cabezas, Health Department of the Autonomous
Government of Catalonia, Spain
Marta Porêbiak, Health Promotion Foundation, Poland
13.15 – 14.15 h Lunch
SESSION II
Chairperson:
Sibylle Fleitmann, PESCE project coordinator, Germany
14.15 -14.35 h ENSP - GPs and Health Professionals Projects
Dr. Hans Storm, Danish Cancer Society, Denmark
14.35 – 14.55 h Prevention and health promotion in clinical practice: the
views of general practitioners in Europe
Dr. Carlos Brotons, Sardenya Primary Health Care Center, Spain
14.55 - 15.15 h General practitioners’ and family physicians’ negative beliefs
and attitudes towards discussing smoking cessation with
patients: a systematic review
Dr. Florian Vogt, King’s College London, UK
15.15-15.35 h Easy to use smoking cessation tools for health professionals
Dr. Patrick Sandström, National Public Health Institute (KTL),
Finland
15.35-16.00 h Coffee break
16.00 - 16.20 h The NICE Review on the cost effectiveness of smoking
cessation
Dr. Tricia Younger, National Institute for Health and Clinical
Excellence (NICE), UK
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CONFERENCE PROGRAMME
16.20 - 16.40 h Effects of practitioner education, practitioner payment and
reimbursement of patients’ drug costs on smoking cessation
in primary care: a cluster randomised trial
Dr. Dorothee Twardella, Bayrisches Landesamt für Gesundheit
und Lebensmittelsicherheit, Germany
16.40 - 17.00 h Experience with reimbursement of smoking cessation
medication in Ireland
Ms. Laura Currie, The Research Institute for a Tobacco Free
Society, Ireland
17.00 – 17.20 h Are physicians appropriately prepared during pregradual
study to provide smoking cessation services? Global Health
Professional Survey findings from 7 European countries
Dr. Tibor Baska, Comenius University Jessenius Faculty of
Medicine, Slovak Republic
17.20 - 17.30 h Conclusion
20.00 h Conference dinner
Restaurant “La Fontana de l’eixample”
c/ Mallorca, 318-324
08037 Barcelona

CONFERENCE PROGRAMME
Friday, 28 March
09.00 - 9.30 h ROUND TABLE
Strategies to implement Warsaw policy recommendations
Chairperson:
Antonella Cardone, PESCE financial coordinator, Italy
Prof. Joy Townsend, London School of Hygiene and Tropical
Medicine, UK
Dr. Francisco Camarelles, Spanish Society of Family and
Community Medicine, Spain
Prof. Olaf Aasland, Institute of Health Management and Health
Economics, Norway
Dr. Dewi Segaar, STIVORO, the Netherlands
Dr. Michael Callens, Mutualité Chrétienne de Belgique, Belgium
09.30 - 11.00 h PARALLEL WORKSHOPS
WORKSHOP 1
Improving education and training
Chairpersons:
Dr. Sabina Ulbricht, University of Greifswald, Germany
Dr. Margrethe Smidth, Institute of GP Medicine, Denmark
WORKSHOP 2
Supporting GP’s activity
Chairpersons:
Dr. Olaf Aasland, Institute of Health Management and Health
Economics, Norway
Dr. George Kotarov, National Center of Public Health Protection,
Bulgaria
WORKSHOP 3
Influence of the Professional Environment
Chairpersons:
Giovanni Invernizzi, Italian School of General Medicine (SIMG),
Italy
Marta Porêbiak, Health Promotion Foundation, Poland
11.00 - 11.30 h Coffee break / Press conference
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CONFERENCE PROGRAMME
11.30 - 13.00 h PARALLEL WORKSHOPS
WORKSHOP 4
Developing a Policy Framework
Chairpersons:
Prof. Luke Clancy, The Research Institute for a Tobacco Free
Society, Ireland
Dr. Cassandra van den Berg, AGIS Health Insurance Company,
the Netherlands
13.00 - 14.00 h Lunch
WORKSHOP 5
Promoting GP’s role in society
Chairpersons:
Dr. Annelies Jacobs, Radboud University Medical Centre, Centre
for Quality of Care Research WOK, the Netherlands
Dr. Aurelius Veryga, Kaunas University of Medicine, Lithuania
WORKSHOP 6
The economics of smoking cessation
Chairpersons:
Prof. David Cohen, University of Glamorgan, Wales
Prof. Joy Townsend, London School of Hygene and Tropical Medicine,
UK
14.00 - 15.00 h Presentation of workshop conclusions and discussion
Chairperson: Prof. Luke Clancy, The Research Institute for a
Tobacco Free Society, Ireland
15.00 – 15.45 h ROUND TABLE
The way forward
Prof. Luke Clancy, The Research Institute for a Tobacco Free
Society, Ireland
Dr. Alfred Munzer, Framework Convention Alliance (FCA), USA
(tbc)
Prof. Florin Mihaltan, Institute of Pneumology "M.Nasta", Romania
Ms. Lourdes Chamarro, European Commission, Directorate
General Health and Consumer Protection
Prof. David Cohen, University of Glamorgan, Wales
15.45 - 16.00 h Conference conclusions
Jean Daver, Tabac & Liberté, France

GENERAL INFORMATION
VENUE AND DATES
IDEC
Universitat Pompeu Fabra
Balmes,132-134
08008 Barcelona
www.idec.upf.edu/espais/index_eng.htm
Thursday, 27 and Friday 28 March 2008
MAP OF LOCATION
C. COMTE URGELL
C. D’ENTENÇA
AVINGUDA DIAGONAL
C. CÒRSEGA
C. ROSSELLÓ
AVINGUDA DE ROMA
C. D’ARAGÓ
HOTEL EVENIA
ROSSELLÓ
Rosselló, 191
IDEC
PASSEIG DE GRÀCIA
RAMBLE DE CATALUNYA
C. BALMES
C. VALÈNCIA
C. MUNTANER
C. D’ARAGÓ
GRAN VIA DE LES CORTS CATALANES
GRAN HOTEL
CATALONIA
Balmes, 142-146
C. MALLORCA
C. CARME
RESIDÈNCIA
D’INVESTIGADORS
Hospital, 64
LA FONTANA
DE L’EIXAMPLE
C. GIRONA
LA RAMBLA
C. HOSPITAL
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GENERAL INFORMATION
HOW TO GET TO THE VENUE
Public transport
Bus: nº 7,15,16,17,27,28,31,33,63,66 and 67
Metro: L3 and L5, Diagonal station
FGC: Ferrocarrilas de la Generalitat de Catalunya, Provença station
Taxi
REGISTRATION
Please register to the conference on-line through the Technical secretariat
website: www.suportserveis.com
Registration includes: admission to the scientific sessions, conference
documentation, certificate of attendance, coffee breaks and lunch on Thursday
and Friday and official dinner on Thursday.
ACCOMMODATION
The Technical secretariat has booked a block of rooms at a special rate at
different hotels near the conference venue.
All registered delegates interested in booking a room can do it on-line through
the Technical secretariat website: www.suportserveis.com
Hotel reservation applications will be approved and confirmed in strict order
of receipt and payment.
Hotel reservation applications received after 1 March 2008 will be accepted
but hotel accommodation cannot be guaranteed.

GENERAL INFORMATION
CONFERENCE DINNER (Thursday, 27 March)
The official conference dinner will be held at La Fontana de l’eixample
(C/ Mallorca, 318-324, Barcelona).
The price of the dinner is included in the registration fee.
No transportation service will be provided to attend the official dinner.
How to get there:
Bus: nº 6,15,20,33,34,43,44,45 and 47
Taxi
TECHNICAL SECRETARIAT
(registration and information)
Calvet, 30
08021 Barcelona
Tel: +34932017571 Fax:+34932019789
E-mail: secretaria@suportserveis.com
www.suportserveis.com
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ASSOCIATED PARTNERS
COLLABORATING PARTNERS
SPONSOR