Lars-Erik Holm

Tanning and risk perception in adolescents

Skin cancer is a rapidly increasing cancer form in many countries, and tanning is considered to be an etiologic factor of this type of cancer. Tanning is a type of risky behaviour, which has been found to be hard to change, particularly in the groups where it is most risky (children and adolescents). Exposure to ultraviolet radiation (UV), protective behaviour and risk perception with regard to tanning were investigated with a postal questionnaire in a large representative sample of Swedish teenagers 13, 15 and 17 years old (nu200a=u200a2615). Risky behaviour was most prevalent among girls and older respondents, in spite of their greater awareness of the risks, and the general female tendency towards risk avoidance. Cosmetic and social motives seemed to drive this type of risk taking behaviour. Comparisons of perceived personal risks of tanning and risks to other people as well as perceived control over the risks, showed personal risks to be perceived as smaller than risks to others, and perceived control to be an important factor in this form of unrealistic optimism. Although people may have more or less valid perceptions of the risks to others, they tend to have overly optimistic views of their personal risks when it comes to tanning. Risk communication is particularly difficult in cases like this. The problem of stimulating more prudent behaviour in teenagers with regard to tanning is discussed.

Who is a successful quitter? One-year follow-up of a National Tobacco Quit and Win Contest in Sweden

The first nation-wide Quit and Win Contest in Sweden was held in 1988 with 12,840 participants. This corresponds to a participant rate of 6.4 per 1,000 daily tobacco users in Sweden. In order to follow up the long-term effects of cessation and to analyse the determinants for successful cessation, a panel (n = 946) of randomized participants were followed-up at 6 and 12 months with a mailed questionnaire. This gave a complete set of data for 557 (panel) respondents. Available baseline data from the participants’ entry forms included sex, age, occupation, specific tobacco habits, quitting attempts during the previous year, and place of residence. At the 12-month follow-up 21% had been tobacco-free for the whole year. In addition 9% of the participants relapsed into tobacco-use, then quit again and were tobacco-free at the 12-month follow-up. The success rate for those participants (14%) who used smokeless tobacco (oral snuff) was similar to that of smokers. The logistic regression showed a significantly better prognosis for success among those without any earlier quitting attempts during the previous year (OR 2.35), if the subjects participated of their own volition rather than having been recruited by a non-tobacco user (OR 1.74), and if they were married/co-habiting (OR 1.92), the results were also significantly improved. The results also show that as a population-based method, Quit and Win produced many successful tobacco quitters, and one year after the contest one-fifth of the participants were still abstinent.

Cost-effectiveness of a tobacco `Quit and Win' contest in Sweden

Tobacco is one of the major causes of premature deaths in the world, and any effort to improve the cost-effectiveness of smoking cessation is worth while. The costs and effects in years of life saved (YLS) were estimated for a tobacco Quit and Win (Q&W) contest in Sweden. The contest was conducted during the autumn of 1988 and included two strategies: a national mass media strategy and an organizational strategy for Stockholm County. A total of 12,840 people participated in the Q&W contest. The model for analysis included programme effects and programme costs, and the data was presented in (YLS). Both effects and costs were discounted. Data about non-smoking participants after 12 months and the number of spontaneous quitters was based on random samples of participants and of the general population, respectively. The programme costs included intervention as well as evaluation costs, e.g. costs of personnel, campaign materials, distribution, prizes for the contest, rent and administration and overhead costs for the project group and the collaborating organizations. The cost per YLS varied between US

Creating partnership with the food industry in the Stockholm cancer prevention program

188 and US

EUROPE AGAINST CANCER

1222. The Q&W contest, as a method of helping tobacco users quit, compares favourably with most preventive and treatment programmes, and the method seems to be quite an effective way for society to use scarce resources.

CANCER RISKS IN SWEDISH LAPPS WHO BREED REINDEER

Creating partnership with the food industry, in the Stockholm cancer prevention program. Lena Kanström, Lars-Erik Holm, and Bo J. A. Haglund. (Department of Cancer Prevention, Radiumhemmet, Karolinska Hospital, S-104 01 Stockholm and Department of Social Medicine, Karolinska Institute, S-172 83 Sundbyberg) To facilitate the supply of healthful foods in institutional kitchens and restaurants, the Stockholm Cancer Prevention Program (SCPP) produced a cookbook in collaboration with the food industry and the SCPP. Fifty different organizations participated in this work. The development of the cookbook was made in several steps and started with a recipe contest to engage chefs and employees in restaurants and institutional kitchens. Criteria for the recipes were that they should present low-fat/high-fiber meals. Complementary recipes were recived from the food industry. All recipes were tested in 20 restaurants and institutional kitchens and 11 000 lunch guests assessed the palatability of the dishes. The cookbook was presented in conjunction with a food fair in 1989 and has until now been sold in about 4 000 copies. Production of a cookbook can thus be a focal point for involving food industry, restaurants and institutional kitchens in a community intervention program aiming at a change of dietary habits.