The ambition of SILNE-R is to learn, by in-depth comparisons of seven European countries, how strategies and programs to prevent youth smoking could enhance their effectiveness by taking into account the opportunities, barriers and resources present at local levels. We expect to generate the fine-grained evidence that is needed to support decision makers in implementing smoking prevention strategies that are responsive to local conditions, effective in using available resources, and inspired to reduce inequities. Such evidence-based programs will constitute a significant step forwards in tackling youth smoking now, and in preventing a persistently high burden of tobacco-related disease in the future.

The general aims of the project are:

1. to assess how recent strategies and programs to prevent youth smoking have been implemented at national, municipal and school levels, and how they have influenced smoking behaviour of 16 year old adolescents in seven European countries,
2. to develop and to disseminate the fine-grained evidence that is needed to support decision makers in implementing strategies to prevent youth smoking in local settings, with due attention for program costs and for inequalities in smoking.

The specific aims of this project are:

1. to assess how smoking prevention strategies were implemented within seven countries, at national, municipal and schools levels, and how the process of implementation varied between countries, cities and schools,
2. to assess how the implementation of these strategies influenced smoking-related behaviour of 16 year old students in 60 schools, and how this impact varied according the students’ gender, socioeconomic position and social network,
3. to estimate the program costs associated with the implementation of prevention strategies at national, municipal and school levels, and to estimate the cost-effectiveness of the different prevention strategies,
4. to integrate the outcomes of these evaluations into refined “models of change” that inform decision makers about how strategies can be effective in tackling smoking by taking into account the opportunities and barriers present at local levels,
5. to develop and to disseminate recommendations to support decision makers at (inter)national, municipal and schools levels in implementing youth smoking prevention strategies that are context-sensitive, cost-effective, and equity-oriented.