ECToH Milan 2026 Declaration calls on EU, national and city policymakers to act decisively against tobacco and a rapidly expanding nicotine market. Next ECToH announced in Brussels in 2029.
As the Association of European Cancer Leagues (ECL), marks 30 years of the European Conference on Tobacco or Health (ECToH) in Milan this week, public health leaders are issuing a clear message to European decision-makers: tobacco remains a leading cause of preventable death and cancer in Europe, and the EU should urgently adapt its Tobacco Directives to address the new generation of nicotine products that pose growing risks to public health.
The EU’s tobacco directives have a strong track record. Together, they helped reduce smoking prevalence across all European countries. They were, however, built for a different era, and they are not yet equipped to address a market increasingly shaped by heated tobacco, e-cigarettes and nicotine pouches — products contributing to a worrying rise in nicotine use among young Europeans, with e-cigarette prevalence among 13–15-year-olds in the WHO European Region close to double the global average (14.3% versus 7.2%).
ECL is calling on the European Commission to strongly and swiftly revise the Tobacco Products Directive and the Tobacco Advertising Directive to cover not only tobacco, but all nicotine-containing products, to close existing regulatory gaps, and to set a strong minimum standard, one that protects citizens across the EU while leaving Member States free to go beyond.
“The next generation of EU directives must be ambitious, and answer to the challenges of today,” says Alba Gil, Senior Policy Officer at ECL. “They should set the floor, not the ceiling and they should not stand in the way of Member States that want to go further in prioritising public health. Tobacco control has advanced because countries were willing to lead. The role of EU legislation is to make that leadership possible, not to limit it.”
The Milan Declaration: a call across every level of government
Today in Milan, at the European Conference on Tobacco or Health hosted by LILT, the Italian League Against Cancer, 900 public health professionals from all over the European region and beyond, adopted the Milan 2026 Declaration “Nicotine-Free Spaces for Healthier Cities” . The Declaration calls on EU institutions, national governments and local authorities to act decisively against tobacco and nicotine harm. The Declaration recognises that progress depends on action at every level: ambitious EU law, strong national policy, and cities willing to lead. Milan itself is cited as an example, having extended smoke-free rules to outdoor public spaces, a reminder of what engaged citizens and municipal leadership can achieve.
“ECToH has proved itself again to be a great opportunity for the entire European tobacco control community to come together. ECL, and our member cancer societies, are proud to be a driving force behind this conference for many years.” said Wolfgang Fecke, ECL Executive Director. “It is where the people working on this issue across our continent share what is working, learn from one another, and build the collective momentum that progress in tobacco control depends on. That is what makes ECToH so valuable, and why we are already looking forward to continuing this conversation in Brussels in 2029.”
Looking ahead: ECToH 2029 in Brussels
ECL is proud to announce that ECToH will return in 2029, hosted in Brussels by Kom op Tegen Kanker, the Belgian Cancer Society. Convening in the EU capital in the months leading up to the 2029 European elections, ECToH 2029 will be an important moment for the European tobacco control community to engage with incoming policymakers and carry forward the agenda set out in the Milan Declaration.
