Background and challenges to implementation:
Tobacco use is highly addictive and harms every organ in the body. Tobacco users are therefore likely high among healthcare users and look to health professionals first for help and support.
To effectively delivery on this high expectation health professionals need to work in supportive environments.
Hospital and healthcare services have an obligation to reduce the use of tobacco in all its forms and its deleterious health effects. This obligation should be seen in a larger dimension of tobacco control, tobacco cessation and prevention activities in hospitals and healthcare facilities and should also include the participation in tobacco prevention activities at community level to create a tobacco free environment for all.

Intervention or response:
By networking and using diffusion of innovation theory strategies to support sharing and learning, the Global Network for Tobacco-free Healthcare Services (Global Network) has developed an effective implementation concept for tobacco management that is validated already in 22 countries globally.
The concept is centered on 8 Standards, supported by a monitoring and quality improvement self-audit tool and a peer review recognition process for high level implementation of the 8 Standards.
The Global 8 Standards integrate FCTC guidelines and other key aspects for tobacco control into a comprehensive, whole organisation and systematic approach.

Results and lessons learnt:
Since its inception in 2000, the Global Network has grown from 7 European members to 39 registered members in 22 countries worldwide. Many members are in themselves networks of multiple individual healthcare services.
High level implementation has been verified, validated and given global recognition in 5 Recognition GOLD Forum Processes to 30 healthcare services in 7 countries.

Conclusions and key recommendations:
By joining healthcare service globally together, the Global Network (www.ensh.org) believes that high level implementation in all healthcare services of the 8 standards will contribute significantly to the delivery on FCTC on a global level.