Dr T. Piha, Finland

The experience of Finland has shown that health damage due to tobacco smoking can be reduced through a comprehensive strategy.

The importance of community action against tobacco is highlighted by the fact that the mortality rate due to lung cancer peaked in many countries about lo years after such action was started. In contrast, if no action is taken the mortality rate continues to increase.

The Finnish strategy consists of three major components: prevention of starting smoking; promotion of smoke-free environments; and support to smokers wishing to quit. The successful implementation of the strategy requires health education, taxation to increase cigarette prices, restrictions on marketing of tobacco (such as a ban on all advertising and sales restrictions) and smoke-free provisions in public places and at work. Research and monitoring underpin all efforts.

For the strategy to be effective, major interventions are indispensable, such as massive information campaigns. It is also important to address the needs of all population groups and ages. Another critical requirement is to sustain the effort over a long period of time, as it often takes many years before one can observe the impact of measures. Mobilizing political support is a must for all this, and making new alliances with groups of people not previously involved in smoking prevention activities, such as drug regulators, is a way of generating political momentum.