European smokefree class competition: a measure to decrease smoking in youth

This letter corrects misleading and incorrect statements about the smokefree class competition (SFC) in a recent paper.¹

Statement 1. “Modified versions of this competition should be developed, using … group influence in a positive way. For instance, a non‐smoking contest is being developed in Geneva using student's creativity and peer support in the class” (p. 759).

• The authors fail to say that one of them is involved in the initiative they promote.

• What they describe as “new approach… to smoking prevention” (p. 759) is a copy of SFC: classes have to stay smokefree for several months and can win prizes.

• Their assumption that “using of student's creativity” is a new component in their version of SFC is wrong: this component was added to SFC years ago and most of the participating countries apply it.

Statement 2. “The competition is based on a logic of exclusion, suspicion, and mistrust” (p. 759). “…the central principle is … to apply negative peer pressure upon teenage smokers” (p. 757).

• Empirical data indicate different conclusions: in a representative population based sample of 6887 Swiss students and 440 teachers there was no difference regarding violence among classes participating in SFC and non‐participating classes. Compared with non‐participating classes, classroom climate was better in classes participating in SFC.

• In a study with 2695 pupils from Wales, 33.6% in the SFC group reported having been victims of bullying, compared with 38.4% in the comparison group.

• The authors assert that negative peer pressure is a central principle in SFC. At the same time, they presume that their copy of SFC provokes “group influence in a positive way” (p. 759). As copy and original SFC are almost identical, they should provoke the same kind of group influence.

Statement 3. “Non‐voluntary test of saliva cotinine to detect tobacco use” (p. 758).

• This paragraph has nothing to do with the European SFC; none of the European Member States partners of SFC has applied tests of salivary cotinine.

Statement 4. “Scarce evidence for ... efficacy” (p. 757).

• Two controlled and two RCTs evaluated the campaign,²,³,⁴,⁵ three of them indicating short term effects regarding smoking initiation. All studies were published in peer reviewed journals, one being classified as number 1 study in the Cochrane review.

Statement 5. “Lack of a theoretical basis” (p. 759).

• The theoretical foundation of SFC and the copy of the competition in Geneva are identical: social learning theory.