Impact of the Smokefree Class Competition – 2

The Society for Prevention Research1 published standards to assist practitioners, policy makers,
and administrators to determine which interventions are efficacious, which are effective, and which are
ready for dissemination. The Smokefree Class Competition meets these standards and is therefore suitable to
“go to scale”.

Process evaluation

Several process evaluation studies have been carried out in the European participating countries
demonstrating high acceptance and practicability of the programme2.

Outcome evaluation

Four studies all published in international peer reviewed journals have been realised to
measure the effectiveness of the approach under real classroom conditions 3-7.
A total number of 12,812 adolescents have been recruited for these studies. An overall analysis 8
showed that from baseline to follow-up test 12 to 24 months later smoking increased by 21.78
per cent points in the control group, compared to an increase of 16.02 per cent points in the intervention group.
At follow-up 27.57% of the pupils from the intervention group, and 35.91% of the pupils from the control group
are actual smokers (odds ratio (OR) = 1.61 (95% confidence interval: 1.43-1.81); p < 0.001).


In addition, a detailed cost-effectiveness study9 shows that SFC is a cost-effective school-based
intervention, providing net benefits of 5.59 (direct net benefits) and 15.00 Mio. Euro (incl. indirect net benefits)
for Germany only.


  1. Flay BR, Biglan A, Boruch RF, Castro FG, Gottfredson D, Kellam S et al. Standards of evidence: criteria for efficacy, effectiveness and dissemination. Prev Sci 2005; 6(3):151-175.
  2. Wiborg G, Hanewinkel R. Conception and process evaluation of a school-based non-smoking competition. Sucht 2001; 47(1):25-32 [German].
  3. Crone MR, Reijneveld SA, Willemsen MC, van Leerdam FJ, Spruijt RD, Sing RA. Prevention of smoking in adolescents with lower education: a school based intervention study. J Epidemiol Community Health 2003; 57(9):675-680.
  4. Hanewinkel R, Wiborg G, Isensee B, Nebot M, Vartiainen E. “Smoke-Free Class Competition”: Far-reaching conclusions based on weak data. Prev Med 2006; 43(2):150-151.
  5. Schulze A, Mons U, Edler L, Pötschke-Langer M. Lack of sustainable prevention effect of the “Smoke-Free Class Competition” on German pupils. Prev Med 2006; 42(1):33-39.
  6. Vartiainen E, Saukko A, Paavola M, Vertio H. “No Smoking Class” competitions in Finland: their value in delaying the onset of smoking in adolescence. Health Promot Int 1996; 11(3):189-192.
  7. Wiborg G, Hanewinkel R. Effectiveness of the “Smoke-Free Class Competition” in delaying the onset of smoking in adolescence. Prev Med 2002; 35(3):241-249.
  8. Hanewinkel R. “Be smart–don’t start”. Results of a non-smoking competition in Germany 1997-2007. Gesundheitswesen 2007; 69(1):38-44 [German].
  9. Hoeflmayr D, Hanewinkel R. Does school-based tobacco prevention pay off? The cost-effectiveness of the “Smoke-free Class Competition”. Public Health 2007; 10.1016/j.puhe.2007.05.007.

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