We think that one of the lessons of tobacco control over the last few decades is that it is important to keep the pressure up and maintain a high level of activity. In fact our data bear this out in the sense that several countries that maintained their tobacco control score nevertheless slipped down the table, as other countries improved their scores and overtook them. According to the stock analysts Morgan Stanley: “Of the various measures available to governments in reducing demand for tobacco, clearly the one that concerns the cigarette companies the most is rising taxation” (19). High price remains the most effective tobacco control measure, thus it is important to note that the price of tobacco products varies greatly in Europe. On 1 January 2007 a pack of Marlboro cigarettes ranged from € 1.17 in Latvia to almost € 7.89 in the UK and € 8.17 in Norway. Some European countries (France, Germany and the Netherlands) increased tobacco product taxes substantially in 2004, with a considerable effect on prevalence. However, the effect has been weakened as a result of cross-border shopping, so we recommend that the number of cigarettes that can be imported for personal consumption between EU countries, now at least 800 cigarettes, should be reduced to 200 per person. According to Morgan Stanley again: “The other two regulatory environment changes that concern the industry the most are homogenous packaging and below-the-counter sales. Both would significantly restrict the industry’s ability to promote their products” (19). Countries in the European Union have the option of requiring picture-based warnings on tobacco products (20). Pictorial warnings are a cost-effective way to inform smokers about tobacco products (21). So far Belgium is the only EU country to require pictorial warnings on cigarette packets (since 1 June 2007). Picture warnings are under consideration in other EU countries. Pictorial health warnings should become mandatory on the two main sides of tobacco products for all EU countries. The pictures should be renewed on a regular basis, with the aim that the whole pack would become a platform for mandatory health promotion messages. On the basis of the research reviewed in our introduction and our results, there are some serious short-comings in tobacco control in Europe at the moment. There is an urgent need for more investment. In the EU only the UK spent more than € 2 per capita per year on tobacco control. The 2004 ASPECT report recommended that EU Member States immediately increase per capita spending by € 1-€ 3 (22). No European country had banned smoking in bars and restaurants by January 2004. By July 2007 ten countries had introduced smoke-free bars and restaurants, and more countries are planning to do so. The most comprehensive European smoke-free legislation (a complete ban on smoking at the workplace – including bars and restaurants – with no exemptions at all) has been introduced in Ireland, Scotland and England. Genuinely comprehensive smoke-free legislation, which includes a total ban in all work places (including bars and restaurants), public places (including health and educational facilities) and public transport, should be a priority for every European country. Most European countries have adopted smoke-free legislation which does not comply with the guidelines agreed at the second Conference of the Parties (COP2) of the World Health Organization’s Framework Convention of Tobacco Control (FCTC), held in Bangkok in July 2007 (23). The guidelines emphasise that effective protection of health requires the creation of 100% smoke-free environments and that ventilation and designated smoking rooms are not acceptable approaches.