Ten-year results of a community-based anti-smoking program (as part of the North Karelia Project in Finland

Abstract

The North Karelia Project was launched in 1972 to carry out a comprehensive community-based programme to reduce the high rates of cardiovascular disease (CVD) in North Karelia, Finland. Among the main intermediate objectives was the reduction of smoking rates, especially among the male population which had much higher CVD and smoking rates than the female population of the area. The intervention was based on the application of behavioral and social theories in a community setting, with emphasis upon a broad range of activities and upon community participation. The programme was evaluated by standardized examination of large representative cross-sectional population samples in 1972, 1977 and 1982, in North Karelia and in a matched reference area. The proportion of current smokers among 30- to 59-year-old men in North Karelia decreased from 52% in 1972 to 44% in 1977, and to 38% in 1982. In the reference area the respective smoking rates were 50, 45 and 45%. About 27% of male smokers in North Karelia stopped smoking during the project period, while in the reference area the proportion was 10% (P<0.001). Among women the initially low smoking rates increased in both areas by 7%—due to new birth cohorts with higher smoking rates entering the age group of the study. At the same time, the prevalence of ex-smokers among women at the outset.