The Department of Social Medicine of the University of Crete participates in the European Program FRESHAIR4LIfe, a program that aims to quit and avoid initiation of smoking in young adolescents, aged 14-21. By gathering information and talking to adolescents and people involved with them, there was an analysis of beliefs and perceptions towards smoking, a depiction of the currents state, an exploration of the causes that lead to smoking initiation and an investigation of ways to reduce adolescents' exposure to it. Finally, through actions in schools, an effort is made for adolescents themselves to create "Personal Plans" on how to say NO to smoking, while at the same time educationg teachers with techniques with which they can help adolescents in this effort.

This action targets both adolescents (aged 14-21) and teachers who deal with the respective age range of students.

The action lasts for four (4) years in total.

The FRESHAIR4Life project is a 4-year European action that aims to quitting and not initiation of smoking in young adolescents, aged 14-21. Universities from 5 countries participate in the program, with the team of the Department of Social Medicine of the University of Crete representing the Greek involvement. The team's activity takes place in the Prefecture of Heraklion, Crete. The program involves the participation of adolescents themselves, in order to identify their perceptions and opinions about smoking as well as the reasons they start smoking and how they themselves believe they can be protected from their exposure to smoking. At the same time, parents, teachers, people from the field of Health, from the Directorate of Secondary Education and from the Region of Crete are involved, giving their own experiences on the issue of smoking. Data were obtained from using both quantitative (questionnaires) and qualitative methods (interviews, group discussions). An innovative qualitative action of the program concerning adolescents was the "Photovoice" method. With this method, the adolescents themselves were mobilized, either individually or in groups, to find and photograph scenes from their everyday life related to smoking. Then the photos were printed and the students created a small poster with their own title and a small message that they would like to convey. The action was completed with an analysis of the image and the message by the adolescents themselves and further discussion by the rest of the participants. 27 students participated in this action who enthusiastically depicted their creativity.

In the second phase, the program included the choice of a low-cost action, easily implementable and that is considered to be effective in reducing the incidence of smoking in adolescents. The action selected by the Greek team and carried out in schools in the city of Heraklion is called "Implementation Intention". This action was based on a similar action in England (INTENT, Smoking Prevention Program) and aimed to helpd the adolescent himself to create a comprehensive plan on how to refuse to start smoking. 32 teachers from 6 different schools expressed interest in participating and getting involved in the program. The teachers were initially trained by members of the team of the Department of Social Medicine of the University of Crete on how to guide students to make their Personal Plan to refuse smoking and then applied it to over 600 students.

The positive influence of the program can be identified in two main pillars. The first pilar directly concerns adolescents. To begin with, they are given the opportunity to make their voices heard, which is not often the case, and to feel that they are actively involved in the effort to reduce the incidence of smoking. At the same time, students are actively involved in promoting anti-smoking messages in a creative and experiential way and not by being mere recipients. The second pilar is the creation of a group of teachers who will be able to implement the "Implementation Intention" action on a regular basis during the school year. Teachers, in fact, will be capable to train future colleagues (Teach the Teacher Model) gradually creating an ever larger team. In this way, conditions are created for continuous education and guidance of students on anti-smoking behaviors on a long-term level. And this is achieved by actively mobilizing students, escaping from the most common today practices with informative lectures. In conclusion, the program highlights the crucial role of the school and the teacher in shielding adolescents with anti-smoking practices. It is a step that brings us progressively closer to the vision of a "Smoke-free" society.
 

Leiden University Medical Center (LUMC)

International Primary Care Respiratory Group(IPCRG)

The University of Edinburgh

University of York

The action takes place in the Prefecture of Heraklion, Crete. Schools from the city of Heraklion, and from the villages of Archanes, Mires, Kastelli and Agia Varvara are involved in the action, as well as the University of Heraklion and the Mediterranean University of Heraklion

At this stage, the data from the feedback of the people involved have not been analyzed so as to have formal results on the impact of the project on adolescents and teachers. The feedback that adoelscents gave was quite positive. They showed particular interest in the "Photovoice" action, which seemed to raise their awareness of the problem of smoking in the modern society. At the same time, they expressed the view that with the action of the "Personal Plan" some adolescent smokers received additional help to quit smoking, while non-smoking adolescents felt more confident about not initiating smoking. The teachers approved both actions of the program, with almost all of them stating that they want to continue the implementation of the action of the "Personal Plan" in the coming years.