Perceived barriers to Finland’s tobacco endgame
| Theme: insufficient funding | |
| Too few resources for the 2030 Initiative | “So there’s basically no one who is really doing full-time work on 2030 Tobacco–Free Finland.… ASH Finland is more or less doing it as kind of a side job.” |
| NGOs indispensable to tobacco control | “… the public agencies don’t do the campaigning. It’s the NGOs that run the campaigns and I have noticed that’s a little different compared with many countries, for example, Denmark.” |
| Activities of NGOs are not well coordinated | “…because (quitline) is run by one (NGO), the NGO is not really recognised as part of smoking cessation - at least not officially. But we have been around for 15 years.” |
| Theme: political and legal barriers | |
| Compromise among political parties | “… unlike other Nordic countries, we don’t have one big body which could have a hegemonic position to introduce policies; so we have a coalition government.” |
| Compromise among government ministries | “… the Ministry of Social Affairs and Health is not totally free to create their own policies. They have to negotiate with the Ministry of Finance and Ministry of Trade.” |
| Supply-side strategies won’t work in the EU | “Reducing supply if there is demand is a very problematic situation since we are in the middle of Europe with free trade.” |
| Theme: institutional practices | |
| Low quality of health ed. in vocational school | “(Vocational students) are more likely to be disadvantaged…school health facilities, health education, etc is actually dealt worse than if you go into academic track school.” |
| Compliance w/ school smoking policy varies | “(Vocational schools) have this one leader in a very high level, then they have several unit leaders or unit chiefs that are responsible for what happens in the specific unit.” |
| Employee smoking and school leadership | “So if you have a lot of personnel smoking in (vocational schools), you don't really have a committed school head master - it’s not school board in Finland, it’s school leaders.” |
| Theme: ambivalence about mass media | |
| Mass media campaigns are viewed ineffective | “I'm a firm believer of campaigns. But when it comes to general non-targeted mass media campaigns, I have very little confidence in their efficacy or power to change thinking.” |
| Mass media campaigns are not the priority | “So why is the Ministry of Health not asking THL* to implement a huge Tobacco-free 2030 campaign and give the resources to do it? That's a good question.” |
| Mass campaigns are incompatible w/ culture | “… (Finns) are not that easy to jump on those movements.” |
| Theme: lack of prioritising smoking cessation | |
| Low priority for standardising services | “The Ministry is not earmarking resources at the national level to develop a system where in every health centre, in every hospital, at all levels of healthcare there would be standardised system on smoking cessation. That is a big issue.” |
| Cessation services not well-known/marketed | “…in order to get physicians to (advise patients to quit smoking), they need to know where to refer patients. This is the link that is missing.” |
| Healthcare not viewed as a cessation resource | “(Patients) don't see healthcare as a place to stop smoking…. And then all the expertise at the moment in Finland is in healthcare.” |
*National Institute for Health and Welfare (THL).
EU, European Union; NGOs, non-governmental organisations; ed., education; w/, with.