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European smoke-free class competition
  1. REINER HANEWINKEL,
  2. GUDRUN WIBORG
  1. Institute for Therapy and Health Research
  2. Düsternbrooker Weg 2
  3. 24105 Kiel, Germany
  4. hanewinkel{at}psychologie.uni-kiel.de
  5. National Public Health Institute
  6. Department of Epidemiology and Health Promotion
  7. Helsinki, Finland
    1. MERI PAAVOLA,
    2. ERKKI VARTIAINEN
    1. Institute for Therapy and Health Research
    2. Düsternbrooker Weg 2
    3. 24105 Kiel, Germany
    4. hanewinkel{at}psychologie.uni-kiel.de
    5. National Public Health Institute
    6. Department of Epidemiology and Health Promotion
    7. Helsinki, Finland

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      Editor,—In the school year 1997/1998, a school-based European smoking prevention project, the Smokefree Class Competition, started for the first time. Target groups for the competition were pupils aged 12–14 years. Research has shown that there is a strong positive correlation between the age of starting to experiment with cigarette smoking and the probability of becoming a regular smoker. In a study by Meier,1 60% of regular smokers started smoking by the age of 13. However the probability of becoming a smoker after adolescence is quite low.2Therefore the principal aims of the smokefree class competition are to delay or prevent the onset of smoking and the reduction or cessation of cigarette smoking in pupils who have already experimented with smoking.

      In the 1997/1998 school year Denmark, Finland, France, Germany, Italy, Spain, and the United Kingdom took part in the competition. In the 1998/1999 school year Austria, Belgium, Greece, and The Netherlands will join in. The table shows an overview of the participating schools and classes in the school year 1997/1998.

      Participating schools and classes in the Smokefree Class Competition, school year 1997/1998

      Although the competition has some flexibility regarding the national rules so that details can be developed to suit the needs and circumstances of individual countries, the general rules are the same in each country: (a) the classes decide to be a non-smoking class for a duration of six months; (b) the classes themselves as well as the teachers monitor smoking status of the pupils and report on it regularly; (c) regular smoking is not accepted; and (d) if pupils experiment with smoking once, the class can still participate in the competition.

      Classes in which pupils refrain from smoking for this period of time can participate in a national prize draw. The prizes vary in the different countries. For instance, in Germany 74 cash prizes will be given to the winning classes, worth about US$25 000. The money has to be spent on class activities. Moreover pupils can enter a European prize draw where they can win a trip to one of the other participating countries.

      The idea for the Smokefree Class Competition arose in Finland, where it has been carried out annually since 1989/1990. The effectiveness of the competition was evaluated in Finland in a quasi-experimental control-group design with repeated measures in the school year 1991/1992.3 The sample consisted of 97 randomly selected participating and non-participating classes in grade eight (14-year-olds). Smoking status was assessed anonymously using self-report before, one month after, and one year after the competition.

      From pre-test to one month post-test, daily smoking increased by 2.3 percentage points among those pupils who participated in the competition until the end. In the control group smoking increased by 5.1 percentage points. Among pupils who decided to participate in the competition (participants and dropouts), daily smoking increased by 3.1 percentage points. The odds ratio (OR) between this group and the control group, tested by logistic regression analyses, was 1.55 (p = 0.0268) using smoking at pre-test as a covariate. From pre-test to the one year post-test, the increase in smoking was similar in both groups (OR = 1.25, p = 0.15).

      Two-thirds of the classes dropped out of the competition because pupils started to smoke. Over the period evaluated, the best predictor of dropout was a high smoking rate at the beginning of the competition, which indicates that the programme is not appropriate for classes with a high number of regular smokers. This finding also suggests that many pupils told the truth when smoking status was assessed weekly.

      Regarding the difference from pre-test to one month post-test, it is possible that student self-selection might explain these results, because classes from the whole country were invited to participate in the competition. Therefore the control group in this study was drawn from classes that had already decided not to take part in the competition beforehand.

      An evaluation of the effectiveness of the competition will be carried out on a European level. In Germany a control-group study with repeated measurements will be carried out; because the competition will only be implemented in selected regions, classes and pupils in the other regions can serve as controls.

      Acknowledgments

      The programme is carried out in cooperation with the European Network on Young People and Tobacco and is financially supported by the “Europe against Cancer Programme” of the European Commission.

      References

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