Health in All Policies – A Finnish pioneer programme paved the way for tobacco control


On World Health Day 2022, WHO emphasises the urgency of global actions needed to keep humans and the planet healthy and foster a movement to create societies focused on well-being.  A comprehensive community health programme, the North Karelia Project, was launched 50 years ago in Finland. The programme resulted in a decrease in coronary heart disease mortality in the middle-age North Karelian men by 84% during 1972 to 2014.

The objective of the North Karelia Project was to reduce the main risk factors (smoking, high serum cholesterol and blood pressure) for cardiovascular diseases, and mortality and morbidity from these diseases. With preventive activities the programme paved the way for progressive tobacco control.  Finland was among the first countries in the world to have tobacco control legislation in 1976. In addition, Finland was the first country in the world to include ending the use of tobacco and nicotine products in legislation.

– During the first firm steps in tobacco control in Finland, the North Karelia Project had an active role in increasing awareness and to support the development of tobacco legislation in the early 1970s. As a result of the project activities, tobacco control and smoking related health promotion were present in the media and discussed among citizens and political decision makers. The project led the way for our Tobacco Act and for the revolutionary objective to become a tobacco- and nicotine-free society by 2030, says Mervi Hara, the executive director of ASH Finland.

The project demonstrated that comprehensive tobacco control is successful. In the North Karelia in five years, the prevalence of smoking reduced among men from 52 per cent to 43 per cent, and among women from 12 per cent to 9 per cent. Thanks to the project, the smoking reduction was faster in the North Karelia than in the other areas of the country.

Sustainable solutions

Over ten years the Project carried out popular national TV Stop Smoking reality shows for smoking cessation.

– The North Karelia Project as an international pioneer programme for NCD prevention and health promotion has influenced in the WHO health promotion programs and international development in this field in many ways. The Project led several international Quit & Win programmes, the largest of which had some one hundred countries participating. Its´ success has also created interest in the tobacco control forums, states the project leader professor Pekka Puska.

– The North Karelia Project has demonstrated that population-based lifestyle interventions serve as a successful and a sustainable public health solution to the growing chronic disease burden, professor Puska continues.

Tobacco control is a significant part of non-communicable disease prevention and management which can be most efficient when individual and community interventions are applied simultaneously as done in the North Karelia Project.

Further information:
Pekka Puska, Professor, Chair of ASH Finland, tel +358407715571
Mervi Hara, Executive director, ASH Finland, tel +358 50 4602324