These presentations were made in the workshops where the barriers to effective prevention were discussed. Presenters were asked to describe an area of practice and the difficulties and problems they had experienced in undertaking the work.
Dr Costa outlined the Institute's Tobacco and Cancer prevention programme. Research has been carried out into the family and individual behaviour and attitudes of 11-16 year old school pupils. A Health Centre specialising in cessation was set up which provides support to six regional centres and has a direct telephone link with heart and lung specialists. The Institute offers consultancy on cessation and training and support to health centres.
Fabien Tuleu presented the work of the inter-regional delegation for Health Promotion in north eastern France. In smoking prevention, the committee co-ordinate programmes over eight local government areas; offer technical and methodological support to projects; and experiment in developing innovative community based, holistic approaches. Teaching materials are also developed and information on tobacco and tobacco control initiatives collected and disseminated.
Elena Malvezzi described the VISP campaign which is aimed at 10-11 year old children in schools in and around Milan which involves doctors in giving presentations to the children. Children receive a folder called the 'History of the Tobacco City' and those who agree not to smoke and convince their family and friends to do the same become VISP, which means they are intrepid, carriers of the message and become members of the Non-Smoking Generation. During 1995, the league distributed 20,000 kits called 'Tobacco City' and increased the membership of the non-smoking generation to 3500 children.
Joergen Falk presented a project called the Non Smoking Year Group, a five year project which aims to make non smoking the norm in one year group in Danish schools. 2350 schools are involved and particular attention has been given to involving teachers, headmasters and school nurses, as well as pupils. Various techniques have been used in the five phases of the project including the mass media, teaching materials, competitions and magazines. Other health issues have been incorporated into the campaign as the children have got older, and the style of the materials was changed to maintain the appeal of the message as the children grew up. Evaluation has been undertaken at several stages of the project with all participants. The results showed a high level of participation amongst schools, and considerable use of the materials by the teachers.
Georgios Katevas reported a study which had involved young people in researching their contemporaries attitudes to smoking. A questionnaire was administered in schools in semi-urban areas. 992 students were questioned (437 boys and 555 girls). When asked why people smoked 62% said it was to 'show off', 64% thought it was because of 'weak character', c 20% thought it was for a sense of freedom. Reasons for smoking related to 'looking mature' (72%), pressure from advertising (10%) and coping with problems (52%). 75% thought that more understanding of smokers' problems would help restrict smoking.
Several pieces of work from Sweden were presented jointly by this group of people. All three emphasised how collaboration with other organisations and individuals had supported their work. The campaign to secure the Tobacco Control Act in 1993 had involved many different organisations which had built up their skills in lobbying politicians and using the media. Health education work included collaboration with women's magazines, the Miss Sweden competition, and international athletics. A programme to prevent young people starting to smoke or using moist snuff, a particular problem in Sweden, was devised which relied on a partnership between young people and an adult of their choice where following health education on smoking in school, at age 12, the young people made a pact with a smokefree adult to stay smoke free for three years.
Dr Llivina described the situation in Spain, and the particular difficulties created by the governmental structure of seventeen autonomous regions. To help overcome this, a National Committee of Tobacco Control has been set up so that campaigners can join forces in lobbying for legislation. Raising awareness amongst professionals is a priority so an information network has been set up to address the lack of access to scientific literature, to share practice, and to collect relevant information with which to generate political support.
The following manuals were presented to conference as examples of collaborative practice between countries.
In order to tackle smoking prevention, it is necessary for education on smoking to be part of mainstream education and for the maximum number of people, from a variety of disciplines, to have basic skills and competencies in delivering health education. The manual adopts a holistic approach covering the social aspects of smoking and health as well as the biological and psychological aspects. This approach will be transferable to preventive work on other health issues. The manual has three main sections: a theoretical framework within which tobacco prevention is tackled; various methodologies for prevention; and practical exercises. Each chapter covers a tobacco related issue like social norms, health and illness, or behaviour, giving both theory and methods for tackling the issue. The trainer is encouraged to identify the aims and objectives of their intervention and various exercises are included with instructions on how these should be carried out. There is a section on developing a project on smoking and health which covers methodologies, financing, logistics and evaluation.
Smoking and alcohol are covered in this guide which has been developed by the Italian League Against Cancer and translated from Italian into English. In part one the harmful health effects of tobacco and alcohol are outlined and in the second part, games and activities for raising the issues and generating discussion are described. Europe against Cancer, the World Health Organisation and the Italian League collaborated in publishing the document.
Four people made this presentation jointly, reflecting the collaborative
nature of the development of this manual. They were Marie-Odile
Colin and Anne Le Cain of Pataclope, France; Gerry McElwee of
Northern Ireland SmokeBusters and Caroline Rasson of FARES, Belgium.
The idea for developing this manual arose at the Montpellier conference
where club co-ordinators realised that they were dealing with
common issues and questions from young people. It is a practical
guide rather than a scientific document containing theoretical
information, details of the knowledge a teacher must have before
doing preventive education, information on evaluation and activities
and materials for use in teaching. Guidance is given on effective
communication skills and techniques. The emphasis is on a holistic
approach, where the emotional and social issues of smoking are
considered. The techniques incorporated in the pack therefore
aim to empower the young people and to increase their self-confidence.
An expert group of scientists and communication specialists advised
the project team developing the manual.
A section on the questions commonly asked by young people is included.
These cover smoking and health, passive smoking, dependence and
addiction, economics and ecology. Within these topics there are
six sections: a list of questions that might arise; suggestions
of how the adults might respond; methods which could be used in
responding; possible pitfalls; key ideas to stress and a list
of misconceptions about the question which the adult needs to
address before talking to young people.