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Journal of Epidemiology and Community Health 2006;60:757-759; doi:10.1136/jech.2006.041509
Copyright © 2006 by the BMJ Publishing Group Ltd.

EVIDENCE BASED PUBLIC HEALTH POLICY AND PRACTICE

Some doubts about one of the largest smoking prevention programmes in Europe, the smokefree class competition

Jean-François Etter1, Paul Bouvier1,2

1 Institute of Social and Preventive Medicine, University of Geneva, Switzerland
2 Child Health Service (Service de Santé de la Jeunesse), Department of Education, State of Geneva, Switzerland

Correspondence to:
Correspondence to:
Dr J-F Etter
Institute of Social and Preventive Medicine, University of Geneva, CMU, case postale, CH-1211 Geneva 4, Switzerland; Jean-Francois.Etter{at}imsp.unige.ch

With over 600 000 participants in 16 countries, the smokefree class competition is one of the largest smoking prevention programmes in Europe. Participating classes that maintain a smoking prevalence usually below 10% are eligible for a contest and the winner is rewarded with money. There is however no convincing evidence that this competition has any effect on smoking prevalence beyond the short term, and this approach raises serious ethical issues. In particular, the central principle of this competition is to apply negative peer pressure upon teenage smokers. However, promoters of this competition have neglected to report the possible adverse consequences of using negative peer pressure upon smokers. This is a concern, because teenage smokers are more vulnerable than non-smokers, and they are at higher risk of suffering from psychological problems and school failure.

Keywords: smoking; school based services; adolescents; primary prevention


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