Health Education Research, Vol. 18, No. 5, 611-626,
October 2003
© 2003 Oxford University Press
The European Smoking prevention Framework Approach (EFSA): an example of integral prevention
Department of Health Education, Maastricht University, 6200 MD Maastricht, The Netherlands, 1 Department of Epidemiology and Health Sciences, University of Manchester, Manchester M13 9PT, UK, 2 National Public Health Institute, 00300 Helsinki, Finland, 3 National Institute for Health Promotion and Prevention (NIGZ), 3440 AM Woerden, The Netherlands, 4 Portuguese Council for Smoking Prevention, 1700-165 Lisbon, Portugal, 5 Danish Cancer Society, Department of Cancer Prevention and Documentation, 2100 Copenhagen, Denmark, 6 Regional Office for Cancer Coordination, 28003 Madrid, Spain, 7 Municipal Institute of Health, Health Promotion Unit, 08023 Barcelona, Spain, and 8 Stivoro, 2500BB The Hague, The Netherlands
E-mail: hein.devries{at}gvo.unimaas.nl
A smoking prevention project in six European countries (European Smoking prevention Framework Approach) was developed, featuring activities for adolescents, schools and parents, including out-of-school activities. Con sensus meetings resulted in agreement between the countries on goals, objectives and theoretical methods. Countries’ specific objectives were also included. National diversities re quired country-specific methods to realize the goals and objectives. The community intervention trial was used as the research design. Since interventions took place at the community level, communities or regions were allocated at random to the experimental or control conditions. Complete randomization was achieved in four countries. At baseline, smoking prevalence among 23 125 adolescents at the start of the project was 5.6% for regular smoking and 4.0% for daily smoking. Smoking prevalence rates were higher among girls than boys in all countries as far as weekly smoking was concerned. Process evaluations revealed that the project’s ambitions were high, but were limited by various constraints including time and delays in receiving funds. Future smoking prevention projects should aim to identify the effective components within the social influence approach as well as within broader approaches and on reaching sustained effects.
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