Accelerating Tobacco Cessation within Healthcare Systems of European LMICs: A Multi-Country Implementation-Effectiveness Trial (ACTS)

Project duration: September 2026 – August 2031

Call/Program/Scheme: HORIZON Europe

Client / Financier: European Commission

Participating institutions:

University Medical Center Hamburg-Eppendorf (UKE), Germany
University of Vlora (UTV), Albania
Institute of Public Health (IPHA), Albania
National Institute of Health named after Academician S. Avdalbekyan (NIHA), Armenia
European Network for Smoking and Tobacco Prevention (ENSP), Belgium
Charles University (CUNI), Czechia
L. Sakvarelidze National Center for Disease Control and Public Health (NCDC), Georgia
Ilia State University (ILIAUNI), Georgia
Mario Negri Institute for Pharmacological Research (IRFMN), Italy
Institute of Public Health of Serbia “Dr Milan Jovanović Batut” (IPHS), Serbia
Institute of Economic Sciences, Belgrade (IEN), Serbia
The University of Manchester (UNIMAN), United Kingdom

Principal investigator (PI): Dr Marcus-Sebastian Martens, University Medical Center Hamburg-Eppendorf (UKE), Germany

The role of IEN in the project: IEN is a partner institution

IEN project team (manager/coordinator, team members):

Dr Jovan Zubović (IEN team coordinator)
Dr Olivera Jovanović
Dr Boban Nedeljković

Description:

ACTS aims to improve the availability and sustainability of smoking cessation support within routine healthcare in Serbia, Albania, Armenia and Georgia. It brings together 12 institutions from nine countries, coordinated by the University Medical Center Hamburg-Eppendorf in Germany. The project examines how evidence-based interventions can be adapted to local contexts and integrated into everyday healthcare practice.

Activities include reviews of national policies and existing services, surveys and qualitative research, consultations with patients and healthcare professionals, and development of a tailored intervention package. A cluster randomised trial will involve 1,700 patients across 34 primary and specialist care sites. The intervention will combine behavioural support, pharmacotherapy and digital tools. The study will assess smoking cessation outcomes alongside the conditions for programme adoption, implementation and maintenance.

The Institute of Economic Sciences, together with the University of Manchester, develops the health economics component: analysis and estimation of costs and healthcare resource use, and assessment of health-related quality of life. These findings will support evaluation of the intervention’s cost-effectiveness. Project results will inform practical guidance and policy recommendations for wider implementation and sustainable financing of smoking cessation support.

Keywords: smoking cessation; healthcare; cluster randomised trial; health economics; cost-effectiveness