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Red Series

Tobacco Prevention and Tobacco Control

Special Volume II

Deutsches Krebsforschungszentrum, Heidelberg

German Cancer Research Center, Heidelberg

The Campaign at a Glance

Smokefree 2006

Red Series Tobacco Prevention and Tobacco ControlSpecial Volume IISmokefree 2006 – The Campaign at a Glance

© 2006 Deutsches Krebsforschungszentrum, HeidelbergGerman Cancer Research Center, Heidelberg

1st Edition: circulation 1000

Suggested citation:Deutsches Krebsforschungszentrum (Ed.): Smokefree 2006 – The Campaign at a Glance.Heidelberg 2006

Cover picture (Ashtray with Flower): Ashvin Gatha & Tushita Bosonet Living Color, CH-1807 Blonay

Layout:Komplus GmbH, Heidelberg

Responsible for the content:Dr. Martina Pötschke-LangerGerman Cancer Research CenterUnit Cancer Prevention andWHO Collaborating Centre for Tobacco Control

Im Neuenheimer Feld 280D-69120 Heidelberg

Phone: +49 – (0) 62 21 – 42 30 07Fax: +49 – (0) 62 21 - 42-30 20

Email: [email protected]: www.tabakkontrolle.de

Project Management:Susanne SchunkGerman Cancer Research Center

The campaign Smokefree 2006 was funded by the

Bundeszentrale für gesundheitliche Aufklärung, BZgA

Federal Centre for Health Education

Anett KoscheDeutsches Krebsforschungszentrum,Heidelberge-mail: [email protected]

Dr. Martina Pötschke-LangerDeutsches Krebsforschungszentrum,Heidelberge-mail: [email protected]

Susanne SchunkDeutsches Krebsforschungszentrum,Heidelberge-mail: [email protected]

Authors (in alphabetical order)

German Cancer Research Center, Heidelberg

Deutsches Krebsforschungszentrum, Heidelberg

Authors (in alphabetical order): Annett KoscheDr. Martina Pötschke-LangerSusanne Schunk

Project Manager “Smokefree 2006”: Susanne Schunk

Red Series

Tobacco Prevention and Tobacco Control

Special Volume II

Smokefree 2006 –

The Campaign at a Glance

Contents 3

Contents

Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

1 “Smokefree 2006” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.1 Goal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

1.2 Launch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

1.3 Prizes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

1.4 Winners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

1.5 Conclusion 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

1.6 Long-term Success of the Campaign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

2 Activities of the Coordinating Office at the DKFZ . . . . . . . . . . . . . . . . . . . . . . . .

2.1 Communication with the Press . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

2.2 Communication with Multipliers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

2.2.1 Companies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

2.2.2 Pharmacies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

2.2.3 Health Insurances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

2.2.4 Doctors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

2.2.5 Hospitals / Clinics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

2.2.6 States, Cities and Towns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

2.2.7 Associations, Organizations, Clubs . . . . . . . . . . . . . . . . . . . . . . 23

2.2.8 Schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

2.3 Information by Internet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.3.1 Publication of the “Smokefree 2006” Campaign Through . .

External Internet Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

2.3.2 Extension of Service at www.rauchfrei2006.de . . . . . . . . . . . . . 28

2.4 Communication with Participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.4.1 Motivational Newsletters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

2.4.2 Groups of Regulars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

3 “Smokefree 2006” – Participants’ Comments . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.1 Incentive to Quit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

3.2 Motivation to Persevere . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

3.3 Enjoying Not Smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

3.4 Reasons to Participate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

3.5 Life After the Campaign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

GREETINGS FROM THE WORLD HEALTH ORGANIZATION (WHO)

Dear Organizers of the International Quit&Win Campaign in Germany:

Tobacco use remains the leading preventable cause of death in the world. The tobaccocontrol community has built impressive momentum, pushing forward in an ever-increas-ing number of countries, states, and cities with effective measures to protect the healthof all from the harms of tobacco.

I would like to congratulate you, and the entire International Quit&Win team, on thesuccess in 2006 of the seventh internationally coordinated Quit&Win contest, thebiggest effort ever, involving 700 000 smokers/tobacco users from 85 countries aroundthe world. Your activities supporting cessation are crucial to millions of individual suc-cess stories and, at the same time, are an integral part of any successful tobacco con-trol strategy.

This is why the World Health Organization (WHO) continues to enthusiastically supportInternational Quit&Win, as a valuable tool available to the global tobacco control net-work that is now working so hard to turn back the tobacco epidemic. It is this kind ofcollaboration and coordinated activity with other organizations that will allow us to makethe most of tobacco control resources to help today's smokers take back their healthand quit smoking for good, and prevent future generations from experiencing the harm-ful burden of tobacco addiction.

Here in the Tobacco Free Initiative at WHO, our work remains focused on the areas ofbuilding national capacity, surveillance and monitoring of tobacco use and tobaccoindustry activities, and, of course, pushing for country ratification and implementation ofthe WHO Framework Convention on Tobacco Control. By the end of 2006, the Treatyhad reached a total of 142 Parties, maintaining its course as one of the most rapidly andwidely embraced treaties in United Nations history. Now, more than ever, our effortsmust increase if we are to carry this success through to implementing comprehensive,effective tobacco control measures at country level, especially in developing nationswhere the burden of disease and death from tobacco use are highest.

4 Greetings from the World Health Organization (WHO)

One of the greatest values of International Quit&Win is that it reminds us all, whateverour role in tobacco control, of the fact that we are working for individuals and their fam-ilies. Seeing the growth, year after year, of this contest is encouraging. It means morepeople are seeking support in their cessation efforts and successfully quitting tobaccouse.

Significant challenges remain ahead. However, new opportunities and initiatives contin-ue to develop, one of which is your upcoming Smokefree 2008 campaign. I wish you allsuccess, and urge the public and others in the tobacco control community to join forceswith cost-effective public information and mass media campaigns and local awareness-raising events. Together we will keep working to remove tobacco use from the top ofthe list of preventable causes of death. This epidemic can be stopped with our concert-ed action worldwide.

Your success is the sum of individual achievement for all those who have quit smokingor using tobacco through Quit&Win, a source of inspiration to us all. On behalf of theWorld Health Organization, and the millions of people you support, congratulations,again, on a fantastic German Quit&Win Campaign 2006, especially to the organizers atthe German Cancer Research Center and the Federal Centre for Health Education andthank you for your continued dedication and hard work.

Dr Yumiko Mochizuki-KobayashiDirector, Tobacco Fee InitiativeWorld Health Organization

Greetings from the World Health Organization (WHO) 5

Foreword

The task of the German Cancer Research Center (Deutsches Krebsforschungszentrum)is to systematically investigate the mechanisms of cancer development, to identify can-cer risk factors and to make a noticeable contribution to cancer prevention in the gener-al public. The knowledge that 30 percent of cancer cases would be avoidable if peopledidn’t smoke demonstrates that tobacco prevention and support for giving up the addic-tion are urgent concerns of cancer prevention.

Since 2000, the German Cancer Research Center has carried out “Smokefree” cam-paigns every two years in collaboration with the Federal Centre for Health Education.Just recently the “Smokefree 2006” campaign has finished. For the fourth time, thecampaign succeeded in motivating tens of thousands of smokers to try together to stopsmoking and not to smoke for at least four weeks. In total, more than 250,000 smokershave taken part in Germany in all initiatives so far and many more smokers have madeuse of additional support services without signing up to take part. The primary goal ofparticipants is not to stop smoking for a short time, but to quit smoking for good.Therefore, cessation support services such as smokers’ helplines and Internet sites willbe continued beyond the campaign.

The “Smokefree” campaigns are carried out without advertising budget and require acomprehensive communication concept in order to inform the public as broadly as pos-sible. First of all, this includes coverage in mass and specialist media. Another key ele-ment is collaboration with numerous cooperation partners such as pharmacies, healthinsurances, public facilities, hospitals, doctors’ offices and companies. This publicationprovides an insight, for the first time, into the steps that are necessary to make the con-cern of a unique initiative known to smokers and nonsmokers within a period of fourmonths. Thereby we meet a need expressed by numerous organizations and institu-tions working in this or related health areas. This insight is also intended to motivatepeople to take an active part in the next campaign, “Smokefree 2008”, and to carry outtheir own campaigns directed at the public.

We would like to direct your particular attention to the participants’ stories, whichimpressively describe that smoking cessation is not easy but easier to manage togetherand, in any case, worth it.

Prof. Dr. Otmar D. WiestlerChairman and Scientific Director German Cancer Research Center

Heidelberg, in October 2006

6 Foreword

Smokefree 2006 7

1.1 Goal of the Campaign

The “Smokefree 2006” campaign (German“Quit&Win” campaign) is intended to en-courage as many smokers as possible toquit smoking for at least four weeks inorder to achieve a step towards long-termsmoking cessation.

1.2 Launch of the Campaign

Starting from Ash Wednesday, March 1,2006, entry cards were available nation-wide in pharmacies, health insuranceoffices of AOK, BARMER and BKK,doctors’ offices, hospitals, social servicefacilities and companies. A press con-ference with campaign patron UllaSchmidt, German Minister of Health, washeld to kick off the campaign. Participants were required to send back anentry card or sign up on the Internet atwww.rauchfrei2006.de. Registrations werecollected and processed at the GermanCancer Research Center (DeutschesKrebsforschungszentrum, DKFZ).

Participants pledged not to smoke fromMay 1 to May 29, 2006.

Nonsmokers who were willing to supportand motivate participants were also invit-ed to participate and sign up on the entryform.

The sign-up deadline was May 1, 2006.

1.3 Prizes of the Campaign

In Germany, prizes amounting to a total ofEUR 10,000 were awarded. In each of thetwo categories, “Adults” and “Youth

under 18”, two EUR 2,500 prizes wereawarded to a smoker who refrained fromsmoking for four weeks in May and to ahelper who supported him or her. In addi-tion, a European regional prize of USD2,500 and an international super prize ofUSD 10,000 were drawn.

The winners were interviewed on thephone about their smoking status. In addi-tion, they had to provide a urine test asproof of smoking cessation. The winnerswere sent a cotinine test strip, which theyhad to take to their doctor. The doctor per-formed the test and gave notice about theresult to the Coordinating Office at theDKFZ. At a press conference on May 30,2006, the winners and the helpers werepresented their prizes by Sabine Bätzing,Drug Commissioner of the FederalGovernment.

1.4 Winners of theCampaign

Category “Adult Participants”

Jakob Heinz is a 48-year-old professionaldriver from Ludwigsburg in the Germanstate of Baden-Wuerttemberg. On April24, Heinz had bought his last cigarettepacket and smoked less and less sincethen. He lit his last cigarette on April 30,2006 at 4 p.m. This marked the end of asmoking career that had started 30 yearsago. “I’m jumping for joy,” says the win-ner. He came across the brochure aboutthe “Smokefree 2006” competition duringan office visit to the company physician.“This is very interesting for me,” hethought and took an entry card. The twodaughters of his partner, who was hishelper, encouraged him: “You should par-

1 “Smokefree 2006”

ticipate. You will make it.” Now everybodyin the family is so happy. (Fig. 1: second toleft / DKFZ)

Irene Bauer is Mr. Heinz’ helper: “Shesupports me not only in quitting. She sup-ports me in life, she is my partner.” Dayafter day, Bauer, an accountant by profes-sion, has supported him. She knows thosefirst days of smoking cessation all toowell: “I quit smoking last year.” Just assmoking cessation, the distribution of theprize is “a family matter”, too. The daugh-ters have already scheduled a shoppingtour. (Fig. 1: left / DKFZ)

Category “Juvenile Participants”

Silvia Schröder is 17 years old and is thewinner of a draw among all juvenile partic-ipants. Silvia Schröder is from Neuklosternear Wismar (Mecklenburg-Vorpommern)and is an 11th grader at an economics highschool. She had been smoking for two anda half years – secretly at first and whenshe was 16 also in front of her parents,who are avid nonsmokers. Ever sincethen, they had been trying to convince herto quit. But Silvia, who loves to party andgo to the disco, felt she simply needed to

smoke in order to be accepted by herfriends. However, despite smoking 20 cig-arettes a day, Silvia secretly thought that“it was time to quit smoking”. Thus, thenewspaper clip about “Smokefree 2006”that her mother gave her was just thething she needed. With her dad by herside, she felt she could make it. And shedid! The future commercial law studentstill loves to go to the disco and says thatit’s “not so hard any more to put up withother people’s smoke”. (Fig. 1: second toright / DKFZ)

Hans-Jürgen Schröder supported hisdaughter and has won the EUR 2,500helper prize. He calls himself an “strongopponent of smoking”. Therefore, he andhis wife were very sad when they realizedthat Silvia smoked. “We kept addressingthe topic and reminding her that sheshould think about her health.” ButSchröder, a police officer aged 49, knowswhat young adults feel like in a peergroup. As a prevention counselor, he trav-els around schools and vocational trainingfacilities to educate young people aboutthe dangers of alcohol and drug consump-tion. “And nicotine is a drug, after all,even if it’s legal.” (Fig. 1: right / DKFZ)

Figure 1:

The winners of the campaign

„Smokefree 2006“:

Irene Bauer, Jakob Heinz,

Silvia Schröder, Hans-Jürgen

Schröder (left to right), Photo:

German Cancer Research

Center, Unit Cancer

Prevention 2006.

8 Smokefree 2006

1.5 Conclusion 2006

44,636 smokers in Germany decided toquit smoking in May and to take thefirst step into a non-smoking life. The information material was sent outin 75,000 campaign packages. A cam-paign package contained 50 entry cards,one poster, one showcase sticker, and adisplay stand. Thus, 4.25 million entrycards were distributed altogether. The demand for campaign packageswas so great that it would have beenpossible to disseminate another 20,000to 30,000 packages.

The campaign “Smokefree 2006” is per-ceived as an invitation to encourage smok-ers to attempt a four-week smoking ces-sation as a start into a smokefree life. Thismessage is taken up primarily by pharma-cies, doctors’ offices and companies.

Non-smoking employees, company physi-cians and trade unionists in companiesmake use of the opportunity to emphasizetheir wish for a smokefree working envi-ronment. A campaign for smokers, notagainst them, is an idea that people like totake up and support. Nonsmokers maytake part as helpers and, thus, supporttheir smoking colleagues.

Although there was a strong interest ininformation material about the campaign,

about smoking cessation and the topic of“smokefree workplaces”, participationnumbers have dropped by one-half com-pared to the previous campaign in 2004(Fig. 2). The trend in participation numbersin Germany is comparable to thoseobserved in other countries participating inthe Quit&Win program. According to theinternational organization center, thedownward trend in participation numbersis observed particularly in developed coun-tries. Like Germany, Spain and Switzerlandalso had a 50% drop in the number of par-ticipants.

Causes:

The “Smokefree 2006” campaign was notreceived with the same strong interest bythe media as in previous years. This wascaused by the wide press coverage of thetopic of smoking in Spring 2006. This year,political issues such as the smoking ban inbars and restaurants and the EU-widetobacco advertising ban have been muchin the focus, leaving little room for addi-tional coverage, since the press does notnormally cover the same health topic inmultiple ways. Thus, the “smoking” topichas clearly been dominated this year bythe ongoing political debate, and thehealth and advice columns of daily andweekly newspapers refrained from addi-tional coverage of the topic of smoking orsmoking cessation.

Smokefree 2006 9

Smokefree 2006 Adults Youth Smokefree 2004 Adults YouthPost card registrations 18,297 1,261 Post card registrations 39,056 2,149Internet registrations 24,016 1,062 Internet registrations 46,770 2,209

Total 42,313 2,323 Total 85,826 4,358Total number of participants 44,636 Total number of participants 90,184

Fig. 2:

Participation in Germany

in 2004 and 2006

Fig. 3:

Participation “Quit & Win

International” at a Glance

Year Number Number of Average Number Country Number of participants of countries participants of participants with most in country with most

per country participants participants2006 85 700,000 8,236 Russia 102,7842004 71 700,000 9,859 Germany 90,1842000 69 430,000 6,232 Chile unknown1994 13 60,000 4,615 Malta unknown

Although the “Smokefree 2006” campaignwas mentioned in the political coverage,information about participation modes wasoften not provided to readers, viewers orlisteners. Compared to previous years,there was not enough reference to theInternet address, www.rauchfrei2006.de,or the wide availability of entry cards inpharmacies, doctors’ offices, health insur-ance offices and companies.

In addition, a multitude of target-groupspecific programs for tobacco cessationare available today that did not exist at thetime of the first Smokefree campaign inGermany in 2000. The Federal Centre forHealth Education (Bundeszentrale fürgesundheitliche Aufklärung, BZgA) offerscomprehensive information material onsmoking cessation. New information andsupport programs on the Internet such asthe BZgA’s quit smoking program“Rauchfrei” (“Smokefree”) were addedlast year. Since September 2005, the tele-phone number of a smokers’ helpline pro-vided by the BZgA has been displayed oncigarette packages. This positive generaldevelopment may additionally have helpedto offer motivation and support for smok-ing cessation to smokers throughout theyear, so that there is no need to wait for aspecific initiative.

Health insurance providers have alsoextended their support of smoking cessa-tion. They organize special programs fortheir members and/or cover part of thecosts of participation in tobacco cessationclasses. In addition, they offer brochuresand information on the Internet. This isanother area where a positive trendtowards motivating smokers to quit smok-ing has been observed.

1.6 Long-term Success ofMass-Media Campaigns andits Relevance for Continuingthe “Smokefree” Campaignsin Germany:

About 33 percent of the adult populationin Germany are smokers, which is still fartoo many. On average, kids start smoking

today at age 13. In the group between 12and 17 years, the smoking rate is at 21percent of boys and 19 percent of girls. Asa result, the number of people who diefrom the consequences of smoking is high:more than 140,000 people each year. Inaddition, approximately 3,300 nonsmokersdie each year from exposure to second-hand smoke. Many smoking-related dis-eases cause not only personal suffering,but also impose huge costs on the health-care system and the whole economy.

Tobacco smoke is by far the most signifi-cant and most hazardous indoor air pollu-tant. More protection from passive smok-ing and less tobacco consumption is apublic health priority that will be imple-mented by a whole range of preventiveand legislative measures. It comprisesthree aspects:

To prevent people from starting smok-ing; To support people in quitting smoking; To support the right of nonsmokers to asmokefree environment.

There are various ways to support andpromote the decision to stop smoking.Alongside intervention and treatment bydoctors as well as price increases andsmoking bans, population-wide massmedia campaigns are needed. Such cam-paigns help to lower the prevalence ofsmoking. Although the success of popula-tion-wide campaigns per individual issmaller compared to medical interven-tions, it becomes substantial and, thus,more valuable in view of the huge numberof people reached. Moreover, the costs forone abstinence case achieved by a massmedia campaign are many times lowerthan for cessation treatment by a doctor(MÜLLER MJ, 2005).“Smokefree” is the largest smoking cessa-tion campaign in Germany. The highestparticipant rates could be achieved in 2002and 2004: Over 90,000 smokers took partin each of the campaigns. Looking at parti-cipation numbers in “Smokefree” cam-paigns between the years 2000 and 2006,we observe a heavy fluctuation in totalnumbers. Nevertheless, participation in

10 Smokefree 2006

2006 was almost twice as high as in thefirst campaign in 2000 (Fig. 4).

According to all scientific evaluation of theGerman campaign, the measure has beensuccessfully implemented (SCHULZE et al.

2005; MONS et al. 2006) and has been able toconvince 0.5 percent of smokers inGermany to stop smoking for (at least)four weeks (SCHULZE et al., 2005). By the endof each “Quit and Win Campaign” be-tween 2000 and 2004” about 70% of theparticipants stayed smoke-free during thefour-week-period. The continuous 12-months abstinence rate in the year 2000constitutes 30% and in the year 2002about 22%. 12 months after the campaignin the year 2004 about 32% of the partici-pants were continuously smoke-free. Evenwith a conservative calculation of the con-tinuous abstinence rates („worst-case“scenario), that assumes that all non-respondents at the time of evaluationwere smokers, yielded in respectableabstinence rates 12 months after the cam-paign: from 20% in 2000 and 14% in 2002to 19% in 2004.

Overall, older and married people have agreater probability of a successful absti-nence. The number of the previous yearsof smoking and the number of previousunsuccessful quit-attempts reduce theprobability of success. Heavy smokers aremore successful than the lighter smokersand participants with a lower educationwere as successful as participants with ahigher school education. Substantially moreparticipants, who had received supportfrom either family members, friends orcolleagues, had abstinence rates abovethe average.

In addition to the evaluation of the adultparticipants of the 2004 campaign, a studyon the abstinence of the adolescent parti-cipants was conducted (SCHNEIDER et al.

2006). 61% of young adults questionedstated that they were abstinent at the endof the competition, i.e., at least for 4 weeks.1 year later, 19% of juvenile participantsstated to be nonsmokers. 12% of themstated to have been continuously absti-nent for 12 months after the start of the

competition. Therewith the abstinencerates are in fact lower than those of theadult participants but the results can stillbe considered quite successful.

When we take a look at Finland, wherethe “Quit&Win” campaign has beencarried out continuously over the past 20years, we can examine the long-term suc-cess of the campaign. Smokers in Finlandwere invited for the first time to attemptsmoking cessation back in 1986. The par-ticipation rate was 1.6 percent. Over theyears, participation numbers have fluctuat-ed considerably: After an initial drop, par-ticipation had then grown again continu-ously. In 1997, i.e. 11 years after the cam-paign was launched, the participation ratewas higher than in the first campaign(KORHONEN et al. 1999; cf. fig. 5).

However, according to Korhonen et al.(1999), the long-term character of the“Quit&Win” campaign in Finland has hadnot only positive effects on participation inan ongoing campaign. As a result of thehigh media presence, many more smokershad become aware of the campaign thanhad actually signed up to take part.According to the authors, these smokerswere unable to decide to quit smokingimmediately and some of them waiteduntil subsequent campaigns to participate(KORHONEN et al., 1999).

In Germany, too, efforts to awaken abroad public interest in the topics of “non-smoking” and “smoking cessation” havebeen successful (SCHNEIDER et al. 2006). Thismeans that in Germany, too, previous“Smokefree” campaigns may have beennoticed by smokers who have not yettaken part. As the results from Finlandsuggest, these smokers were unable todecide immediately to quit smoking and,thus, may be potential participants offuture smoking cessation campaigns. Theresults from Finland support the continua-tion of the “Smokefree” campaigns inGermany.

Smokefree 2006 11

Year 2000 2002 2004 2006Participants 24.925 90.458 90.184 44.636

Fig. 4:

Development of participation

numbers in “Smokefree”

campaigns in Germany

Furthermore, in the discussions at thisyear’s World Conference on Tobacco ORHealth (WCOTH) in Washington, massmedia campaigns were regarded as anindispensable means of motivating asmany smokers as possible to attemptsmoking cessation. Provided that the cam-paigns – like “Smokefree 2006” inGermany – transmit a positive message.This is the only way to increase the num-ber of smokers who succeed in quittingpermanently. According to Professor Shu-Hong Zhu from the U.S., more important

for society as a whole is an increase in thenumber of cessation attempts than thenumber of support programs. While eachyear 60 percent of smokers in the U.S.make a cessation attempt, it is still nomore than 30 percent in the U.K. andGermany. Mass media campaigns have alasting positive impact on the cessationclimate and the readiness to stop smokingamong the smoking population – thisconclusion of the WCOTH corresponds tothe trends observed in Finland.

12 Smokefree 2006

SCHULZE A, EHRMANN K, SCHUNK S,

PÖTSCHKE-LANGER M. Ergebnisse aus zwei

bundesweiten „Rauchfrei“-Kampagnen.

Gesundheitswesen 2005; 67 (12): 872–878

KORHONEN T, URJANHEIMO EV, MANNONEN P,

KORHONEN HJ, UUTELA A, PUSKA P. Quit

and Win campaigns as long-term anti-

smoking in North Karelia and other parts of

Finland. Tobacco Control 1999; 8: 175–181

MONS U., SCHULZE A., „Rauchfrei 2004“–

Bedingungsfaktoren eines erfolgreichen

Rauchstopps. Prävention und Gesundheits-

förderung, 2006, 1, 255–261

MÜLLER MJ. Maßnahmen zur Prävention am

Beispiel „Rauchen“. In: Müller MJ, Traut-

wein EA. Gesundheit und Ernährung –

Public Health Nutrition. Verlag Eugen

Ulmer, Stuttgart, 2005, p. 220–230

SCHNEIDER S, MOHNEN SM, TÖNGES S,

PÖTSCHKE-LANGER M, SCHULZE A.

Sind Wettbewerbe zur Tabakentwöhnung

von Jugendlichen geeignet? – Ein-Jahres-

Follow-up der bundesweiten „Rauchfrei

2004“-Kampagne. Medizinische Klinik 2006;

101:711–717. English: Are Competitions an

Appropriate Instrument for Youth Smoking

Cessation? A One-Year Follow-up of the

Germany-wide “Smokefree 2004” Campaign

Literature

Fig. 5:

Participation rates of “Quit &

Win” in Finland in the years

from 1986 to 1997

Source: Korhonen et al., 1999,

Edited by: German Cancer

Research Center, Unit Cancer

Prevention, 20061986

Part

icip

an

ts (

%)

1989 1994 1996 1997

Activities of the Coordinating Office at the DKFZ 13

2.1 Communication with theMedia

The “Smokefree 2006” campaign waskicked off at a press conference on March1, 2006 in the presence of its patron,Health Minister Ulla Schmidt. Forty-oneeditorial teams and journalists attendedthe event. In early March, the mediadebate about bird flu was at its peak andthe interest of the attending journalistswas very much focused on this topic. Inaddition, on March 1, 2006 first results ofan agreement between the HealthMinistry and the German Association ofHotels, Bars and Restaurants about thestep-by-step introduction of non-smokingareas were also presented. A number ofquestions for Health Minister Ulla Schmidtwere about this topic.

A press conference with the Federal DrugCommissioner, Sabine Bätzing, held onMay 30, 2006 in Berlin concluded the“Smokefree 2006” campaign. Sixteen edi-torial teams and journalists attended theevent in Berlin and reported about theprize presentation, which was part of it.Once again, journalists focused theirquestions on the agreement between theHealth Ministry and the GermanAssociation of Hotels, Bars and Restau-rants. In view of the upcoming World NoTobacco Day, they also took advantage ofthis opportunity to enquire about legisla-tive changes concerning the protection ofnonsmokers.

In addition to the joint press releases ofDKFZ and BZgA issued at the start andend of the “Smokefree 2006” campaign,another 16 press releases were published.

Examples:March 1, 2006 Deutsches Krebsforschungszentrum undBundeszentrale für gesundheitliche Auf-klärung – Gemeinsame Pressemitteilung:"Rauchfrei 2006 – 10.000 e zu gewinnen" -Start der bundesweiten Kampagne zumRauchstopp

(German Cancer Research Center andFederal Center for Health Education –Joint press release: “Smokefree 2006 –10,000 euros prize money” – Launch ofnationwide smoking cessation campaign )

Ulla Schmidt: „Wer aufhört zu rauchen,gewinnt an Lebensqualität"(German Health Minister Ulla Schmitt: “Ifyou quit smoking, you gain quality of life”

Rauchfrei 2006 – AOK beteiligt sich anweltweit größter Nichtraucherkampagne(Smokefree 2006 – AOK supports theworld’s largest quit smoking campaign)

Rauchverzicht für ein gesünderes, besse-res, längeres Leben - Barmer unterstütztzum vierten Male "Rauchfrei"-Aktion(Smoking cessation for a healthier, better,longer life – Barmer supports “Smokefree”campaign for the fourth time)

Rauchfrei 2006: Apotheken machen mit!GEHE verteilt Aktionspakete an Apotheken(Smokefree 2006: Pharmacies take part inthe campaign! GEHE distributes campaignpackages to pharmacies)

April 4, 2006Deutsches Krebsforschungszentrum undBundeszentrale für gesundheitliche Auf-klärung – Gemeinsame Pressemitteilung:Schon über 20.000 Teilnehmer bei„Rauchfrei 2006“ – Anmeldung zur bun-

2 Activities of theCoordinating Office at the DKFZ

14 Activities of the Coordinating Office at the DKFZ

desweit größten Nichtraucherkampagne„Rauchfrei 2006“ bis zum 1. Mai 2006möglich

(German Cancer Research Center andFederal Centre for Health Education –Joint press release: More than 20,000 par-ticipants in “Smokefree 2006” already –Entry for Germany’s largest quit smokingcampaign ongoing until May 1, 2006)

April 20, 2006Bundesgesundheitsministerium für Ge-sundheit und Deutsches Krebsforschungs-zentrum – Gemeinsame Pressemitteilung:Ulla Schmidt: Mit "Rauchfrei 2006" gesün-der leben – noch 11 Tage bis zum An-meldeschluss(German Health Ministry and GermanCancer Research Center – Joint pressrelease: Health Minister Ulla Schmidt:With “Smokefree 2006” to a healthier life– 11 days till sign-up deadline)

May 30, 2006Gemeinsame Pressemitteilung DKFZ undBZgA „Rauchfrei 2006 – 10.000 Euro zugewinnen“: Über 44.000 Teilnehmer beider größten deutschen Aktion zum Rauch-stopp

(Joint press release of DKFZ and BZgA:“Smokefree 2006” – 10,000 euros prizemoney: More than 44,000 participants inGermany’s largest smoking cessationcampaign)

Die Drogenbeauftragte der Bundesregie-rung: Über 44.000 neue Nichtraucherinnenund Nichtraucher zum Weltnichtraucher-tag 2006(The Federal Drug Commissioner: Over44,000 new nonsmokers on World NoTobacco Day 2006)

In Fall 2005, six months before the firstpress release was issued, the CoordinatingOffice at the DKFZ started activelyapproaching the media. Approximately2,000 personal contacts with journalistsfrom print media, television, radio andInternet were actively undertaken. In talks,letters and emails, the office informedabout the renewal of the campaign and itsgoals. Special emphasis was placed onthe strength of “Smokefree 2006”: thefact that it is a campaign for both smokersand nonsmokers. Mass print media suchas all women’s magazines were contactedby telephone several times. In order toachieve nationwide coverage, approxi-mately 200 editorial offices of local ad andweekly newspapers were separatelyinformed about the campaign. The interestof companies in “Smokefree 2006” wasdiscussed in personal talks with 22 editorsof business newspapers and magazines.Special texts were produced for this pur-pose.

Upon a telephone call by the CoordinatingOffice, the daily newspaper “BILD” men-tioned the campaign in its national editionwithin its health advice series entitled“Die große BILD-Sprechstunde”. Twoweeks before entry deadline on May 1,2006, all 22 regional editorial offices of“BILD” were sent information aboutregional activities relating to the campaign.

All the big TV and radio stations wereinformed about the “Smokefree 2006”campaign. The Coordinating Office at theDKFZ held more than 150 conversationswith editors of medical advice programs.At the local level, radio interviews provideda particularly good opportunity to encour-age listeners to take part in “Smokefree2006”. On the occasion of the campaign

Number of Smokefree Participants Accounts Circulation TV Radio Internet Internet Site

Print Print Visits2006 44,636 574 66,197,700 58 43 465 1,038,9112004 90,184 641 95,136,900 159 101 365 1,150,0002002 90,458 456 105,224,700 9 40 43 unknown2000 24,925 130 unknown 30 45 unknown 20,000

Fig. 6:

Media Coverage of

“Smokefree” at a Glance

Source: German Cancer


Prevention, 2006


and on behalf of the Coordinating Office,psychologist Peter Lindinger repeatedlyacted as a studio guest with viewer call-in on the TV show “ARD-Buffet” onGermany’s channel one, ARD. The Frenchradio station “Europe 1” interviewedGerman participants of “Smokefree 2006”in order to give an example in France of asuccessful implementation of a quit smok-ing campaign.

In addition, more than 100 inquiries byjournalists to the Coordinating Office atthe DKFZ were answered. Contacts toparticipants in this year’s and prior cam-paigns were facilitated and participationmodes and chances of winning wereexplained.

Besides target-group specific draft texts,topic suggestions were provided to jour-nalists from all media. Background materi-al for research was also prepared andmade available. The following suggestionswere particularly in demand (available inGerman only):

Nichtrauchen und trotzdem schlank(Not smoking and still slim)Am Abend ins rauchfreie Restaurant –Ausgehtipps(Evenings in a smokefree restaurant –tips for going out)Rauchfrei leben – Blick zu den euro-päischen Nachbarn(Living smokefree – a look at ourEuropean neighbors)

Gemeinsam in ein rauchfreies Leben -ein Unternehmen startet durch(Together towards a smokefree life – anenterprise lifts off)Das schlägt mir aufs Gemüt – Tricks beiStimmungsschwankungen während desRauchstopps(It really gets me down – tricks for cop-ing with mood swings while quittingsmoking)Ich will nicht mehr – ein Leben ohneBlauen Dunst (Erfolgsgeschichte einesTeilnehmers).(I don't want to anymore – life withouttobacco (a participant's success story))

2.2 Communication withMultipliers

An Access address database created in2004 was refined for the “Smokefree2006” campaign to optimize the quality ofthe address inventory. In addition, newmailing lists were acquired and fed intothe database. In the course of the cam-paign, the address inventory grew from17,658 to 25,222 addresses.

Moreover, the “Smokefree 2006” teamprovided all interested parties with free-of-charge campaign packages containing 50entry cards, one “Smokefree 2006”poster, one display stand and one C4 sizesticker. The team produced target-groupspecific project descriptions with sugges-

Fig. 7:

Active print media contacts

(N = 1,350), Source: German

Cancer Research Center, Unit

Cancer Prevention, 2006

Active print media contacts (N = 1,350)


tions on how to implement the initiativefor companies, hospitals, universities, asso-ciations, pharmacies and educational facili-ties. Texts and photos for use in staff andpatient newsletters, intranets and schoolmagazines for students or teachers wereindividually tailored and sent out. Muchemphasis was placed on meeting differentneeds and developing individual materialsin order to maximize participation.

The total number of campaign packagesdistributed was 75,000. Of these, 35,700were shipped via the Deutsche Vertriebs-gesellschaft (DVG). 41,300 were dissemi-nated through the cooperation partners,GEHE, AOK, BKK and BARMER.

As shown in the chart, a large proportionof the campaign packages was sent

directly to the cooperation partners,GEHE, BKK, BARMER and AOK. Thesethen undertook the logistics and, thus,took over the costs for distribution to theircustomers. Using these multipliers it waspossible to reach all BARMER and AOKoffices as well as all GEHE customers(= pharmacies). 2,000 campaign packagesand an additional 500,000 entry cards,4,000 information letters, 6,000 postersand 2,000 stickers were shipped by theCoordinating Office at the DKFZ.

Several AOK offices, particularly in thestates of Mecklenburg-Vorpommern andSaxony, requested another approximately25,600 entry cards. The AOK counselorsactively used the “Smokefree 2006” cam-paign in their communication with compa-nies and schools.

Fig. 8:

Distribution channels for cam-

paign packages (N = 75,000),



Prevention, 2006

Fig. 9:

Distribution of campaign

packages including coopera-

tion partners (N = 75,000),



Prevention, 2006

Distribution channels for campaign packages (N = 75,000)

Distribution of campaign packages

including cooperation partners (N = 75,000)

DVG

BARMER

AOK

BKK

GEHE

DKFZ

Public facilities

Counseling centers

Health insurances

Hospitals

Companies

Doctors’ offices

Pharmacies

Others

Number of campaign packages containing 50 entry cards each


2.2.1 Companies

In total, more than 4,000 companies haveparticipated in “Smokefree 2006”. This in-cluded everything from a joint start into asmokefree life in a 2-man law office togroup-wide initiatives in big companies. Morethan 200 companies published the texts pre-pared by the Coordinating Office at the DKFZin their staff newsletters and intranets.

Like in previous years, the focus of firstcontacts with companies was on providinginformation to company physicians, whowillingly used the campaign as an opportu-nity to talk to staff members. This year’swinner, Jakob Heinz, learned about thecampaign during a routine visit at the com-pany physician and decided to quit smok-ing then and there.

Examples:In cooperation with the Textil- und Beklei-dungsberufsgenossenschaft (ProfessionalAssociation for the Textiles and ClothingIndustries), campaign packages were sentto 1,600 company physicians. Prior tothat, the physicians had been sent lettersby the Professional Association for theTextiles and Clothing Industries to informthem about “Smokefree 2006”.

The Bezirksregierung Köln (Cologneregional government), jointly with theGovernmental Agency for OccupationalHealth and Safety in Cologne and Aachen,carried out a campaign for the protectionof nonsmokers in companies in 2006. Inthis context, the Coordinating Office atthe DKFZ was able to directly inform themanagement of 80 companies about“Smokefree 2006”.

The Deutsche Bahn AG (German Railways)informed their operational units about thecampaign and provided the CoordinatingOffice at the DKFZ with their addressesfor direct shipping of the campaign pack-ages. Thus, information material was sentto 70 DB Service Points, 87 DB CateringCompanies, 72 railroaders’ sports clubsand 9 health centers of the DB Gesund-heits-Service GmbH (Health Service)throughout Germany. The different unitsimplemented the “Smokefree 2006” cam-

paign in individual ways. Thus, additionalprizes were offered, such as by the EasternBavaria section of DB Regio AG. In Kassel,posters were placed in every signal towerto draw attention to the campaign.

Thanks to the good collaboration duringprevious campaigns, the management ofthe Company Medical Service of DaimlerChrysler AG was immediately willing tosupport “Smokefree 2006” again. Itinformed all employees in Germany andthe heads of the German plants. Thesewere sent information material by theCoordinating Office at the DKFZ accordingto their individual orders.

Fraport AG (owner and operator ofFrankfurt Airport) distributed 6,500 entrycards among its 13,000 staff members.The Coordinating Office at the DKFZ pre-pared texts for the Intranet and provided280 posters for Frankfurt Airport.

A two-week art exhibition and informationbooths with the Fagerström test for nico-tine dependence accompanied the“Smokefree 2006” campaign at two SAPAG sites with nearly 10,000 employees.The goal was “to wake people up anddraw attention to the topic of smoking.”The pictures in the exhibition entitled “Artworks – it is not an art to quit smoking”were very positively received. In additionto “Smokefree 2006” entry cards thatwere displayed, interested persons wereoffered individual smoking cessation coun-seling by the company physician and par-ticipation in a quit smoking seminar. Allinformation about the campaign, also pro-vided in English by the Coordinating Officeat the DKFZ, was simultaneously pub-lished in SAP’s Intranet and via the HealthNewsletter.

At Audi AG, protection of nonsmokers is avery important topic. In addition to inform-ing its 43,000 employees about the cam-paign, the company has implemented awhole range of initiatives for smokers whoare willing to quit. Around the “Smokefree2006” competition, Audi has offered lec-tures, consulting services of the companyphysicians and an in-house hotline.

The Hamburg Fire Brigade invited theirstaff members to attempt a four-weeksmoking cessation and distributed 5,550entry cards for the competition. TheCoordinating Office at the DKFZ, jointlywith the Press Office of the HamburgFire Brigade, produced a press releaseto inform the local press about thisinitiative.

“Smoking at the Workplace” was a topicat the Day of Research held at the Medi-zinische Hochschule Hannover (HanoverMedical School) on April 22, 2006. TheCoordinating Office at the DKFZ providedinformation material on the topic, thebrochures “Ärzte in Prävention” (Doctorsin Prevention) and “Die Rauchersprech-stunde” (Smoking Cessation Counseling)as well as “Smokefree 2006” entry cardsto enable future doctors to set a goodexample.

2.2.2 Pharmacies

“Smokefree 2006” is ideally suited toaddress the topic of smoking cessationwith pharmacy customers. All mediainformation contained the note that entrycards are available primarily in pharmacies.Many pharmacists who had already partici-

pated actively in the campaigns in 2000,2002 and 2004, were pleased to supportthe plan of all those who decided toattempt to quit during the campaign peri-od in 2006. To this end, it was necessaryto decorate showcases and shops accord-ingly and also to brief all employees sothat these could address the topic withcustomers on their own initiative.

Examples: Pharmacy wholesaler GEHE automaticallysupplied each customer (pharmacy) with acampaign package and offered easy order-ing of more packages using the pharma-ceutical central number of 5750941, whichwas specially issued by the Informations-stelle für Arzneispezialitäten (InformationAgency for Pharmaceutical Special Pro-ducts). In total, 20,000 campaign packageswere disseminated – 4,000 more than inthe previous campaign of 2004. In addi-tion, pharmacy customers were informedin the Internet consumer portal with a linkto the competition.

The “Smokefree 2006” poster usuallywelcomed pharmacy customers right atthe entrance door. Pharmacies, such asthe Eichwald-Apotheke in Frankfurt-Born-


Fig. 10:

Information on the Occasion

of “Smokefree 2006” on the

homepage of the Eichwald

pharmacy in Frankfurt-

Bornheim, Source:

www.eichwald-apotheke.de,



Prevention, 2006


Fig. 11:


of “Smokefree 2006” on

the homepage of the health

and nursing care insurance

Fortisnova, Source:

www.fortisnova.de, Edited by:


Center, Unit Cancer

Prevention, 2006

Fig. 12:


of “Smokefree 2006” on the

homepage of the company

health insurance Dr. Oetker,

Source: www.bkkoetker.de,



Prevention, 2006

Examples:

heim, also invited customers on theInternet to take part in the competition.

In the pharmacy Apotheke Dr. Hardt in St.Augustin, the interest in “Smokefree2006” by the neighboring tax and revenueoffice was so great that the pharmacyemployees spontaneously decided toorganize an information day at the taxoffice. The Coordinating Office at theDKFZ provided a PowerPoint presentationfor this purpose.

2.2.3 Health Insurances

Besides the big cooperation partners,other health insurances also used the“Smokefree 2006” campaign as an oppor-tunity to motivate their members forsmoking cessation. Some published theirown press releases, offered additionalprizes and organized theme days jointlywith partners.

2.2.4 Doctors

Doctors are an indispensable link in thechain of multipliers of the “Smokefree2006” campaign. Upon request by theCoordinating Office at the DKFZ, the

National Association of Statutory HealthInsurance Physicians (KassenärztlicheBundesvereinigung) published a noteabout the campaign in its periodical publi-cations so that the Regional Associationsof Statutory Health Insurance Physicians,professional associations and individualdoctors among the readers were able toorder campaign packages.

A suggestion was made to the chairmenof eight medical specialist conferencesthat took place during the campaign periodto hold their events as “non-smoking con-ferences”. They agreed to inform confer-ence participants and to hand out materialabout “Smokefree 2006”. This was usual-ly done by displaying information letterswith campaign package order informationat a central place or including these in theconference documents.

Examples: The Association of Pneumologists sent arecommendation letter produced by theCoordinating Office at the DKFZ to 1,170members in order to encourage theirpatients and employees to participate in


Fig. 14:


of “Smokefree 2006” on

the homepage of the clinic

St. Camillus, Quelle:

www.camillus-duisberg.de,



Prevention, 2006


“Smokefree 2006”. The members wereautomatically sent a campaign package atthe same time.

A therapeutic group of doctors, pharma-cists, psychologists, sports scientists andnatural practitioners took “Smokefree

2006” as an opportunity to organize asmoking cessation theme day in theBielefeld region. The event entitled “Ach,hör doch auf” (Hey, cut it out) presentedmethods of smoking cessation that haveproved successful in practice and offeredfree-of-charge health tests. Among the

Fig. 13:

Online report of the news-

paper Allgemeine Zeitung

Bad Kreuznach on 1 June

2006 about an extra prize of

the Burgen Clinic in Bad

Münster that was donated on

the occasion of “Smokefree

2006”, Source:

www.az-badkreuznach.de,



Prevention, 2006

partners of the event was the Universityof Bielefeld, which presented informationabout the prevention of nicotine consump-tion in young people and early inter-vention. The Bertelsmann BKK healthinsurance donated prizes in the form of 20 smoking cessation and movement ther-apy course places (see also “HealthInsurances”).

In a big radiological doctor’s office inHamburg, ten employees, together withpatients and “Smokefree 2006”, startedout into a smokefree life. To support theinitiative, lectures on the topic of smokingwere offered and activities around healthyeating as well as joint sports activitieswere planned.

2.2.5 Hospitals / Clinics

The Coordinating Office at the DKFZdirectly informed doctors in hospitals andclinics and published information in spe-cialist media of the medical and nursingprofessions. In addition, the CoordinatingOffice was able to convince the GermanNetwork of Smokefree Hospitals torepeatedly report about the campaign intheir newsletter. As a result, additionaltexts for staff and patient newsletterswere requested. Hospitals that were plan-ning to organize their own contestsamong employees inquired about the testpossibilities at the Coordinating Office atthe DKFZ.

Examples:The Drei-Burgen-Klinik in Bad Münsterdonated an additional prize of EUR 250.

2.2.6 States, Cities and Towns

The State Ministries of Social Securitywere asked for their support in a letterabout the “Smokefree 2006” campaign.The ministries passed the information onto the State Centers for Health Promotion.The campaign idea was particularly wellreceived in the State of Rhineland-Palatinewhere the Addiction Prevention Officecommunicated the idea, in close collabora-tion with the Coordinating Office at theDKFZ, in schools, companies and publicfacilities.

A project description of “Smokefree 2006”was developed for the State Ministries ofJustice in order to initiate that the cam-paign be carried out in correctional facili-ties, too. As a result, the Ministry ofJustice of the State of Baden-Wuerttem-berg recommended participation to theState Justice Administrations. Feedbackfrom all states was positive. Organizationof the campaign was partly supported bythe ministries, partly made a directresponsibility of facility managements.

The State Ministries of Education wereasked to help carry the idea of the“Smokefree 2006” campaign into schools.The states of Baden-Wuerttemberg,Rhineland-Palatine, Saxony, Saxony-Anhalt,Brandenburg and Bavaria, in particular,supported the initiative by repeatedly pub-lishing information in their specialistmedia.

The press officers of 84 big cities invitedcity government employees to take part in“Smokefree 2006”. They were additionallyprovided with background material for thelocal media.

Examples:As a measure to protect nonsmokers atthe workplace, smoking has been prohibit-ed, except in a designated smoking room,in the offices of the Bavarian StateMinistry of the Environment, Health andConsumer Protection since January 2006.The ministry had already participated inthe “Smokefree 2004” campaign anddecided, in an early exchange with theCoordinating Office at the DKFZ, to use“Smokefree 2006” to encourage its staffto stop smoking. They were informedabout “Smokefree 2006” by campaignpackages, on the Intranet and through anarticle in the staff journal by the addictionofficer.

The Frankfurt City Board of Health organ-ized a theme day on the “Smokefree2006” campaign in cooperation with AOK,BARMER, TK and DAK. Prior to the event,the health insurances mailed letters totheir members in and around Frankfurt toinform them about the theme day. More



Fig. 15:

Information about

„Smokefree 2006“ on the

homepage of the

Caritasverband Rhein-Sieg-

Kreis e.V., Source:

www.caritas-rheinsieg.de,



Prevention, 2006

than 250 visitors attended the event. Thegoal of this event was to inform attendeesabout different smoking cessation methodsand programs. The Coordinating Office atthe DKFZ presented “Smokefree 2006” ina lecture series. In addition, campaignpackages were provided for the event.

Various partners in the German capitalused the “Smokefree 2006” campaignmaterial for the ongoing “BerlinSmokefree” initiative. Right at the start ofthe campaign, a press release was issuedjointly by Health Senator Dr. Heidi Knake-Werner and Berlin Patients’ Officer, KarinStötzner, to advocate participation. 2,710campaign packages were supplied toBerlin facilities. 100,000 entry cards wereadditionally distributed in the districts ofSteglitz-Zehlendorf and Friedrichshain-Kreuzberg through the Health Planningand Control Office (Plan- und LeitstelleGesundheit) at the Friedrichshain-Kreuz-berg District Office.

Twenty-one days before entry deadline,the Chemnitz City Board of Healthpublished a press release in coordination

with the DKFZ office to support the“Smokefree 2006” campaign. A livelyexchange had preceded. The CoordinatingOffice at the DKFZ had approached theboard, because more than 100 facilities inthe city had ordered campaign material.

Following intensive talks with the Coordi-nating Office, the Duisburg City Govern-ment requested 400 campaign packagesand organized the distribution of the20,000 entry cards throughout the city inadministrative buildings, schools, youthfacilities, and businesses. City employeeswere informed about the competition onthe Intranet and in the staff journal. TheCoordinating Office at the DKFZ informedthe local press about this commitment.

Ingrid Heckner (CSU), Member of theBavarian State Parliament, hosted anexpert talk on the topic of smoking duringthe “Smokefree 2006” campaign. TheCoordinating Office at the DKFZ sent outinvitations to the event in the Altöttingregion to all doctors, companies, schoolsand institutions that had been sent entrycards for “Smokefree 2006”.

2.2.7 Associations, Organizations, Clubs

It has proven useful in the “Smokefree”campaigns to approach umbrella organ-izations as multipliers and to provide thesewith specially prepared material. Althoughduring talks the big commercial umbrellaassociations were interested in the topics of protection of nonsmokers and“Smokefree 2006” as an initial step, manydid not decide to support the campaignactively. The professional associations, onthe other hand, actively supported thecampaign by issuing circulars, articles onthe Internet and in journals of the associa-tions in collaboration with the CoordinatingOffice at the DKFZ. Response frommedium-sized companies was excellentand was reflected in a rise in orders ofcampaign packages each time after publi-cation of information.

Examples: There was a close collaboration with theVerband Deutscher Verkehrsunterneh-men (Association of German TransportEnterprises). In a circular comprising ex-tensive material specially prepared by the

Coordinating Office at the DKFZ, 600member enterprises throughout Germanywere informed about “Smokefree 2006”and encouraged to participate. In addition,the campaign was covered several timesin the association’s periodical, “Nahver-kehrs-Nachrichten”, which comes outevery 10 days.

The support by the Bundesverband derVerbraucherzentralen (Federal Associationof Consumer Centers) deserves specialmention. One line of action was to sendletters to the consumer centers at thestate level, asking them to use the“Smokefree 2006” campaign for con-sumer information. As a result, fifty-threeoffices ordered campaign material. In addi-tion, the association informed its memberassociations about the campaign in orderto pave the way for further active contactby the Coordinating Office at the DKFZ.Subsequently, 22 associations and organi-zations such as the Deutscher Mieterbund(German Tenant Association) and theDeutscher Caritasverband (German CaritasAssociation) were informed and asked to


Fig. 16:

Information about


homepage of the German

Association of Metal

Industries., Source:

www.metallhandwerk.de,



Prevention, 2006


communicate the “Smokefree 2006” ideato its members.

2.2.8 Schools

Unlike in the other countries participatingin “Quit&Win”, the German campaignwas also open for youth under 18 years,i.e. young adults and their helpers also hada chance of winning a prize of EUR 2,500.Therefore, headmasters were informedabout “Smokefree 2006” using variouschannels such as the State EducationMinistries and the State Agencies forHealth Prevention. In addition, the Co-ordinating Office at the DKFZ used variousteacher information media on the Internetand published the competition idea in thestate youth networks.

Already in the planning phase in spring2005 there had been extensive discus-sions about the question whether“Smokefree 2006” should be implement-ed in schools all over Germany. Finally itwas decided to inform schools withoutautomatically providing all of them withcampaign packages at the same time. Inview of the limited funds of the campaignthis would only have been possible byneglecting other cooperation partners.

Nevertheless, schools received campaignmaterial via several distributors. Besidesstate facilities, health insurances used“Smokefree 2006” for offering tobaccoprevention programs in schools. TheCoordinating Office at the DKFZ directlysupplied more than 1,200 schools withcampaign material. Entry cards were madeavailable in classrooms, entrance halls orschool offices. Project days on the topic ofnon-smoking were organized. “Smokefree2006” also found its way into studentmagazines. For this purpose, theCoordinating Office at the DKFZ had pre-pared two text proposals aimed at youngreaders.

Examples:The student council of the Ludwig-Erhard-School in Pforzheim distributed500 “Smokefree 2006” entry cards amongstudents and teachers within the frame-work of a project called “smokefree

weeks”. The Coordinating Office at theDKFZ provided additional gifts in the formof anti-stress balls.

“Vending machines, kiosks, moochedfrom a pal” – those were the sources ofcigarettes named by sixth graders at the Blumhardtschule in Boll and thePestalozzischule in Göppingen. Theirteachers used “Smokefree 2006” toencourage students to question theirsmoking behavior. For this purpose theyused the entry form and the cost calcula-tor provided at www.rauchfrei2006.de.

“Smokefree 2006” was the topic of a dis-cussion about smoking cessation during acareer planning seminar at the BSIBildung, Schulung, Information e.V. inHof. Twenty-four of the 100 young partici-pants decided to start a smokefree lifetogether on May 1. They were supportedby discussion sessions during the smoke-free month.

Fig. 17:

The Friedrich-Ebert-School in

Esslingen put up a large

poster to promote the cam-

paign. A box was provided to

collect students’ entry cards.



Prevention, 2006


Fig. 18:

Information about


homepage of the Stiftung

Warentest (German Con-

sumers Foundation), Source:

www.stiftung-warentest.de,



Prevention, 2006

Fig. 19:

Information about


homepage of the magazine

“Guter Rat”, Source:

www.guter-rat.de, Edited by:


Center, Unit Cancer

Prevention, 2006

Examples:


Fig. 20:

Information about



“Mädchen” (a magazine for

young women), Source:

http://maedchen.msn.de,



Prevention, 2006

Fig. 21:

Information about



“Focus”, Source:

http://focus.msn.de, Edited

by: German Cancer Research

Center, Unit Cancer

Prevention, 2006

2.3 Information by Internet

2.3.1 Publication of the “Smokefree

2006” Campaign Through External

Internet Services

The Coordinating Office at the DKFZscanned the Internet for publications onthe topic of smoking and smoking cessa-tion in order to actively gain partners whowould be willing to inform about“Smokefree 2006” on their sites and tooffer links to www.rauchfrei2006.de. Inaddition, many portals were encouragedto use the campaign as an opportunity toaddress the topic of smoking cessationand to implement it in a service-orientedway. Following extensive research, theCoordinating Office individually contacted200 online editors. The response wasexcellent. Within a few hours, the onlineservices of journals such as “Eltern”,“Guter Rat”, “Stiftung Warentest”, “Mäd-chen” and “T-Online” added informationabout the campaign.

2.3.2 Extension of Service at

www.rauchfrei2006.de

The internal transition of contents on thehomepage from static HTML pages to aneditorial system at the start of the cam-paign had the following goals:

Ability to add up-to-date contents morerapidlyModernizing the design while keepingthe CI Preparing search engine optimization.

After the technical changes had beenmade, the contents provided were extend-ed. In addition to information from sci-ence, participants in the 2004 campaignwere presented in order to encouragesmokers who had not made up theirminds yet. After the campaign had start-ed, participants of “Smokefree 2006”wrote about their motives for participationand their plans for their first smokefreeday. This was continued by participants’accounts of the smoking cessation experi-ence. At the end of the campaign, partici-pants shared the joy of success in a virtualsetting. The stories – which were oftenvery personal – reinforced the feelingamong participants that they were notalone. A column entitled “StammtischRauchfrei 2006: Wir treffen uns” (Groupof regulars 2006: We meet up) was exten-sively utilized to find like-minded people.The motto, “Gemeinsam aufhören gehtbesser” (Quitting together is easier), waswell received.


Fig. 22:

Homepage of „Smokefree

2006“ on 1 Juni 2006, Source:

www.rauchfrei2006.de, Edited

by: German Cancer Research

Center, Unit Cancer

Prevention, 2006

Moreover, participating companies weregiven the possibility to present them-selves at www.rauchfrei2006.de.

Questions that were frequently asked intelephone calls, such as about weight gain,mood swings or medical support, weredealt with in separate texts provided in the“Rauchstopp” (smoking cessation) col-umn. In addition, interested parties were

able to download logos and draft texts forthe campaign. There was a great demandfor the topic proposals provided in the col-umn “Presse” (press), particularly on theoccasion of World No Tobacco Day.

Between 11 December 2005 and 18 June2006, 312,137 visitors accessed the“Rauchfrei 2006” homepage and viewed1,038,911 pages.


Monthly report

Month

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May

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Week of

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Fig. 23:

Monthly report of the number

of accesses to the homepage

from December 2005 to June

2006, as on 4 June 2006

Source:

www.rauchfrei2006.de,


Center, Unit Cancer

Prevention, 2006.

Fig. 24:

Weekly report of the number

of accesses to the homepage

from 11 December 2005 to

28 Mai 2006, as on 4 June

2006, Source:

www.rauchfrei2006.de,


Center, Unit Cancer

Prevention, 2006.

The month with the most visitors(155,115) at www.rauchfrei2006.de wasMarch 2006. Together, they browsed on304,599 pages. The month with the great-est interest in information about the cam-paign was April 2006: 83,749 visitorsviewed 396,546 pages. On a monthlyaverage basis, 43,858 users accessed144,171 pages.

The graph illustrating the number ofInternet accesses on a weekly basisshows that the peaks of the “Smokefree2006” campaign were when entry startedand when the winners were announced. The graph illustrating the number ofInternet accesses on a weekly basisshows that the peaks of the “Smokefree2006” campaign were when entry startedand when the winners were announced.

2.4 Communication withParticipants

2.4.1 Newsletters for Motivation

Besides providing information on thephone to participants and interested per-sons, the Coordinating Office at the DKFZsent out eight motivating emails. Personalencouragement in this way started on 25April 2006, six days prior to the joint startinto a smokefree life, and ended on WorldNo Tobacco Day. Approximately 15,000participants received these newsletters byemail provided they had given their con-sent “to be sent regular information byemail from the DKFZ” when they signedup for the competition. Those who hadchecked “no” in the entry form or whohad signed up by regular mail, did notreceive any motivating mails. After send-ing the motivating mails, the tips werepublished on the Internet and, thus, madeavailable to all participants.

This form of support met with a very goodresponse. The “Smokefree 2006” teamreceived 4,500 emails in which partici-pants shared their experiences, troublesand difficulties relating to smoking cessa-tion. The senders were asked for theirconsent to present their personal experi-ences on the Internet. The aim was, on

the one hand, to constantly fuel the feel-ing of a big community working towardsthe common goal of smoking cessationand, on the other, to motivate undecidedsmokers to make their own quit attempt.

Besides sending in field reports, whichwere often of a very personal nature, par-ticipants also asked many questions. Forexample, a large number of participantsbelieved that they had to do a urine testbefore quitting. Another frequently askedquestion was how participation of non-smokers was excluded. Other topics par-ticipants and helpers were concernedabout included “involuntary smoking” andwhether the urine test would be influ-enced by secondhand smoke, and“smokefree workplaces” and how tointroduce smoking bans at work. Generalquestions about smoking cessation suchas weight gain and mood swings werealready covered, corresponding to thegeneral course of nicotine withdrawal, inthe motivating mails, as were symptomsof hay fever that were particularly strongin 2006.

All those who indicated during the cam-paign that they did not persevere weresent individual mails to encourage them tokeep trying or to make a new quit attemptat a later time with the aid of the smoker’squitlines of the BZgA and the DKFZ.

2.4.2 Groups of Regulars

For participants to share their experiencesdirectly and encourage each other to per-severe, the Coordinating Office at theDKFZ supported the formation of local“Smokefree 2006” groups of regulars.Under the motto, “Gemeinsam aufhörengeht besser” (Quitting together is easier),regular meetings were held in Bonn,Dresden, Hamburg and twelve other cities.

The Coordinating Office at the DKFZ firstsuggested the idea of groups of regularson the Internet and invited participants forthe first time to meet up in the thirdnewsletter on 4 May 2006. Participantsfrom 50 towns and cities indicated theirinterest. By searching the online registra-tions, the Coordinating Office at the DKFZ


determined the participants from 14 bigcities and sent emails to approximately500 participants per city to inform themabout the interest in a group of regulars intheir city. The response was overwhelm-ing. Answers spanned a wide range fromhappy acceptance over regret because ofa lack of time to attend through to numer-ous suggestions for meeting places or fur-ther joint activities. Many emails wereexchanged between interested partici-pants and the Coordinating Office at theDKFZ until place and time of the firstmeetings were scheduled in 15 cities andtowns.

One week later, the newsletters were uti-lized to find partners for a local group ofregulars in the regions and cities. In orderto make it easier for participants to arrange

a meeting, they were asked for their con-sent to release their email addresses inaccordance with data safety regulations.Thus, the groups of regulars in 15 citiesarranged their own meetings. Nevertheless,there was a never-ending stream of emailsconcerning the groups of regulars.

The Coordinating Office at the DKFZ wasregularly informed about the dates andmeeting places so that these could imme-diately be published on the Internet atwww.rauchfrei2006.de. The CoordinatingOffice informed the “established” groupsof regulars about new people interested injoining. In addition, there was a dailyupdated column on the homepage whereparticipants could present their interest inattending a group of regulars in their hometown or city.


Fig. 25:

Greetings from the Bonn

group of regulars

Participants’ Comments 33

3.1 Incentive to Quit

“Knowing that thousands of other peopleare trying to become smokefree at thesame time will make it much easier forme. It's like with sport – it's only half asmuch fun on your own.” (Maria, 48,Bremen)*

“I've been smoking for seven years andI'm really glad that I heard about theSmokefree campaign: You regularlyresolve to stop, saying ‘That's it, enough,I'm giving up!’, but the incentive, the rightmotivation, often isn't there. I realize thatit doesn't work long-term: smokers get illmore often. I'd like to have children atsome point; I have to have stopped bythen, so why not now?!” (Elfi, 21,Münster)*

“I'm 45 years old now and I've beensmoking regularly for more than 20 years,usually more than a packet a day. I stum-

bled across the Smokefree campaign bychance while I was surfing the web a fewweeks ago and spontaneously signed upto take part. I didn't think about it toomuch, nor have I made any seriousattempts to stop smoking in all thoseyears, even though I was always, and stillam, very aware that smoking can onlyharm me. It looks as if the right time hascome. My mind is made up and I'm notgoing to touch another cigarette after May1.” (Ruth, 45, Bad Wildungen)*

“Thank you so much for this initiative! Itmight have saved my life, since every draghurt my lungs. The coughing was awfuland I was totally unfit. I signed up straightaway on March 1 and told everyone Iknow about it.” (Bärbel, 41, Bad Arolsen)*

”I think the campaign is really great andI've taken part because I finally want tostop smoking! I've tried several times, forexample, when I went to Iceland: no-one

3 “Smokefree 2006” –Participants’ Comments

Smoking Cessation Campaignfor Adults and Youth

commissioned by theFederal Centre for Health Education

Rauchfrei 200610.000 zu gewinnen!

34 Participants’ Comments

on the tour smoked and that really helped.Unfortunately, I started again after I gothome. I get tempted very easily. You think‘Just one’. But now I've got a challenge.That really stops me smoking. As far asthe money is concerned, I always tellmyself – you're not going to win it any-way. But in fact you win so much more.On the 12th day, a colleague tried to temptme. No! Although? … Perhaps ‘just one’wouldn't matter. But that's just cheatingyourself! I'm proud of every day I don'tsmoke.” (Rosi, 45, Meißen)*

“It's a good thing that you've organizedthis! It was finally a good reason to quitsmoking.” (Britta, 27, Frankfurt)*

”Thank you for an answer and just in gen-eral for this whole campaign. I don't thinkthat I'd have stopped smoking without'Smokefree 2006'.” (Frank, 18, Ulm)*

3.1 Motivation to Persevere

“I never thought that life without nicotinecould be so nice. My daughter is veryproud of me and praises me everyday.She's put a poster up in the kitchen full ofnonsmoker slogans and I get a surprisesticker on my poster for every day that Idon't smoke. It's great and really encour-ages me.” (Petra, 41, Hamburg)*

“Thank you for the Newsletters – theyhelp me get through the weak momentshere and there. My biggest wish is that I'llstick to it.” (Brigitta, 53, Weinheim)*

“You keep giving me encouragement. I'ma single mother, I work and have a lot ofstress situations. My husband also makesnothing but problems, which are timeswhen I'd most like to reach for a cigarette.But I want to stick to it for myself and formy children. Keep giving me the strength Ineed. Thanks.” (Rosi, 42, Berlin)*

“I get a lot of support to give up from myhusband, who used to be a heavy smokerhimself but stopped many years ago. Forexample, he gives me a reward and a cer-tificate for every week in May that I've

stayed smokefree. My 10-year-old son isgoing to make sure that there aren't anymore cigarettes in the house. They'veboth promised me to be understanding ifI'm moody.” (Vera, 45, Hanover)*

“My 'little helper' is my sister and she'sgiven me the most wonderful help in theworld. I was allowed to be with her in thedelivery room (which, as everyone knows,is smokefree) on the 1st of May when mygodchild was born. Being able to cuddlemy godchild smokefree gives me lots ofstrength.” (Carmen, 36, Celle)*

“Thank you! The last 10 days were hardfor me, I was completely finished: every-thing hurt, I couldn't sleep, I had loads ofproblems and I was tired. But it's gettingbetter everyday. I don't miss smoking asmuch as I did on the first day, even thoughI work in catering and everyone smokes.Thank you for giving me this chance.”(Ülo, 35, Leipzig)*

“Today is already May 26 and the cam-paign is almost over. I've made lots ofattempts in the past to stop smoking (e.g.,during pregnancy smoking was no issue).No-one really believed that I would man-age. But there's something completely dif-ferent about it this time. I don't have tostruggle anymore. I simply decided not tosmoke anymore – for myself and for mydaughter. I don't want her to grow up witha smoker for a mother. I signed up for the'Smokefree month’ and put my husbanddown as my helper. It's great how consid-erate he – a smoker himself – is. He spursme on, as well as praising, supporting andrewarding me. Before he just used to waittill I finally started again. Today, because ofme, he smokes much less and not at all inmy presence. But the best ‘present’ camefrom my 5-year-old daughter; she told mehow she thinks it's great that I don'tsmoke anymore and how good I smellnow.” (Maria, 22, Burgdorf)*

3.2 Enjoying Not Smoking

“I really like not smoking anymore. When Ithink about how I used to blow EUR 3,50

every-day into my lungs and into the air, Ifeel ill. So keep it up. This whole campaignis really great!” (David, 18, Mannheim)*

“I can't just see spring in the woods now,I can actually smell it. Due to the insidiousprocess of scent loss, you don't evennotice that fine scent particles exist. Onlyqueuing in a store, that’s the only placesmokers are at a slight advantage, sinceyou don't notice the 'odor' of the othercustomers. Just smelling lilies of the val-ley for the first time after 20 years of nico-tine made all the effort definitely worth-while.” (Bertram, 41, Ludwigshafen)*

“And I'm feeling better everyday.” (Tino,32, Riesa)*

“How good it is not to smoke. My hus-band is delighted; since he alreadystopped in October 2005 he's also enjoy-ing my smokefree time.” (Marianne, 54,Heilbronn)*

“I'm a very enthusiastic participant ofSmokefree 2006! My dad and I are bothtaking part and it's working out reallywell!” (Frauke, 21, Duisburg)*

“So far not smoking has worked out reallywell and I'm glad about it; why didn't I doit sooner?” (Timo, 23, Gaggenau)*

“The most important and best bit about itfor me: I'm smokefree! I'm finding it easy,easier than I've ever found it before in mylife. I wish all participants success thistime round! What a victory for us all! It'sbeen a long and difficult sickness, fromwhich I can now finally recover – I'mecstatic!” (Sylvia, 46, Eichwalde)*

3.3 Reasons to Participate

… Addiction

“Started at 14, stopped at 35. 7 yearssmokefree and then, unfortunately, start-ed again 4 years ago. At least 5 attemptsto stop in the last 2 years – mostly onlystuck it out 3 to 11 days. It's a real addic-tion. My cough and sputum are getting

worse and worse. My nostrils are like tar,the tissue is black when I blow my nose!My two fingers are yellow and my skinisn't very nice anymore.” (Edeltraud, 46,Bremerhaven)*

“I've tried to stop smoking numeroustimes in the last 23 years. Unfortunately Ialways went back to cigarettes and wasaddicted again. I tried with all sorts ofaids: nicotine plasters and chewing gum,acupuncture and addiction counseling. I'veeven read ‘The Easy Way to StopSmoking’ three times. But I think thatwhen you're not really convinced aboutwhat you're doing, no amount of aids canhelp. But now I'm ready. I'm going to stopsmoking, because I want to live an addic-tion-free life.” (Angelika, 42, Erpolzheim)*

“I'm already looking forward to May 1,because then I won't have to smoke any-more. Actually, I haven't wanted to for along time now and I find it really disgust-ing. I already stopped for a couple ofmonths. I felt really good, had loads ofenergy. But unfortunately I started againand was addicted really quickly. Knowinghow well I felt without nicotine in my bodymade it even worse. So I'm using theSmokefree competition as an opportunityto finally do what I've wanted to do foryears: beat nicotine addiction.” (Ilse, 39,Cologne)*

… Financial Aspects

“It just suddenly 'clicked' – I realized that Ididn't want to give my money to the tobac-co industry anymore. I'd rather not thinkabout how much money I've spent overthe last 32 years.” (Werner, 46, Rostock)*

“I just can't see why I should spend enor-mous amounts of money on NOTHINGanymore.” (Thomas, 50, Leipzig)*

“That's it, it's over, because I slowly can'tafford it anymore. I spend 120 Euro amonth just on cigarettes.” (Susi, 19,Bitterfeld)*

“I've had it with addiction and depend-ence. When I think how much it's cost….


Between 1 and 1.5 months work everyyear just for an addiction. Shocking.”(Egon, 41, Magdeburg)*

… Health/Sickness

„I've been smoking for 10 years. This factalone is actually bad enough. On top ofthat I've been taking the contraceptive pillfor the last 6 years. Last month I wastaken to the university hospital in Düssel-dorf with a life-threatening thrombosis andhad to be operated immediately. This hasleft me with some big scars, I have towear support tights and take medicineswhich are turning me into a hemophiliac.It's all quite dangerous, but I've actuallybeen lucky. I would be ashamed of myselfif I didn't change something now. I don'twant to go through that again. That's whyI'm stopping smoking.” (Simone, 24,Eisenach)*

“After 39 years I finally want to stop,because there's just been the secondcase of lung cancer in my family, and formy young daughter's sake. I'm gettinglots of support and encouragement frommy daughters and of course my husbandthinks it's a good idea too.” (Traudel, 53,Bad Segeberg)*

“When you wake up in the night and can'tget your breath, you should stop. I didn'tsmoke for 5 years and then started againbecause of stress. But that's it now – fin-ished.” (Stefan, 35, Ahaus)*

“Every cigarette shortens your life by 15minutes, Granny!” (Simona, 54, Ingolstadt)*

“I want to stop worrying about the ‘packetfor the evening’ and save the money forsomething better. Of course, health is evenmore important. I'm so unfit I feel like anold man.” (Markus, 23, Ronneberg)*

“Up until 11 years ago, I smoked a packetof cigarettes a day for a period of 25years. After a heart attack I stopped smok-ing immediately and successfully. About ayear ago, I slowly started again and nowI'm back to around 20 a day. I want to andI must stop smoking, if only because of

the acute danger from the damage that'salready been done.” (Hilfried, 60, Hagen)*

3.4 Life After the Campaign

“After 35 years of nicotine consumption –two packs a day, and even more on week-ends playing skat and gin rummy – I neverthought that I could go without a cigarettefor even just 2 days. No tablets, no nico-tine plasters to help me, just like that. Ididn't even crawl round on my knees beg-ging for cigarettes. I didn't even get ‘thejitters’. On day 2 my morning cough wasjust gone. My sense of smell and tastewere much more intense than before.Even cycling 20 km in one go isn't a prob-lem anymore. I've got only positive thingsto report. Before your campaign every-thing seemed so difficult, but in actual factit isn't. You had the idea and I wanted totake part and not end up a loser giving uphalf way; that was it, really. Being a busdriver, I'm trying to have a good influenceon all the under-age school kids I seesmoking. I get the impression some ofthem even think about it. I'm going tostick to it, come stress or no stress.”(Wilhelm, 52, Dresden)*

“I've been very good up to now, eventhough it's been a really difficult time forme. I lost my job and then I had to getover this hurdle of not smoking. In similarsituations I've usually resorted to morethan just one cigarette. On the other hand,I used to work at a kiosk and had to sellcigarettes everyday – that wasn't easy.But when you know that thousands ofother people are also ‘suffering’, it's mucheasier than doing it on your own." (Bärbel,22, Dinslaken)*

“I want to say thank you for organizingthis campaign. It was really difficult at thebeginning, but thinking about the gainsmade it easier. I keep thinking about howI'm now smokefree just like my supporterwho I did the campaign with.” (Marcus,18, Seehof)*

“After nearly 30 long years it looks as ifI'm happily over my smoking years. Thanks


to you and my mother, who still can'tquite believe it. But you can see it in mynew weight, unfortunately I've put on 22pounds. My colleagues are very pleasedfor me, but tease me with things like‘You've grown into you wrinkles’. Nice,huh? Now I often ride an hour to work andan hour back. By bicycle! I'm very proudof myself! I've started noticing muscles Ididn't have before. If I win money, I'mgoing to buy myself a better bicycle sothat my charming colleagues don't keepsaying: Here comes the housewife who'sstill practicing!” (Marion, 43, Elmshorn)*

“The 29th day as a nonsmoker, the firstday after the official end of the cam-paign….. I would never have thought itpossible that I, who smoked so passion-ately, would be able to stop so 'easily'. Istill can't believe it, but I really haven'tsmoked for four whole weeks and nowI'm looking forward to the rest of my lifeas a nonsmoker! The concept is fantastic!First of all I was able to prepare myself forthe start calmly, then there was the count-down and I knew: very soon it'll be start-ing. I actually wrote a goodbye note on theevening before, which I'm sure I'll readagain sometime. Then there were theemails at regular intervals, which kept giv-ing me new motivation. I put 4 EUROaway everyday and with that moneybought myself a wonderful ring which willalways remind me that I managed it.”(Arianne, 33, Hanau)*

“Well, unfortunately, I haven't won anymoney, but nevertheless my friends and Ihaven't smoked since the beginning ofAPRIL already, which I – as a former smok-er with a tendency to chain smoke – foundparticularly difficult. But we've beenrewarded anyway with a ‘smokefree psy-che’. Greetings and congratulations to thesuccessful participants and winners.”(Johanna, 30, Nuremberg)*

“I started school at 5 and was on average1.5 to 2 years younger than my class-mates. On top of that, it wasn't very easyfor me to fit in. So it was practically a fore-gone conclusion that, by the age of 14, I'dbeen standing with the others in the

school yard finding it great that puffingaway on a cigarette made me finally'belong”. I smoked at least a pack a dayfor 26 years. On April 25, 2006 my hus-band had his fourth anniversary as aNONsmoker and I made him a congratula-tions card. Then, quite incidentally, we gotonto the subject of when I would stop.This conversation kept coming back to meand I remembered an acquaintance of minetelling me in 2004 about a Smokefreecampaign. On April 27, 2006 I looked inthe web and found the ‘Smokefree 2006’campaign, signed up spontaneously andput my husband down as my helper. I alsoordered the nonsmoker starter set andthen told my husband about it. 'Wow,that's very sudden,' was his reaction andhe wanted to know why I was doing it,which I couldn't really tell him. If I'dknown what I had coming to me from May1, I'm not sure if I would have signed up. Icried about everything. I got some helpfrom my family doctor and my husbandwrote me a personal dedication in my cal-endar every day. I think I've been in everypossible situation in the last four weeks:celebrations, happiness, frustration, love,pity, suffering and I still persevered. Idon't think I need cigarettes anymore, atleast not physically. Mentally it's a bit dif-ferent… every situation in which I wouldnormally have smoked I now have to getthrough without cigarettes. Some of thosemore than once, before my sluggish brainfinally got that it's just as possible withoutmy beloved 'fags'. That doesn't mean itwas easy. Every time I was just about togive up I said to myself: there will alwaysbe an excuse why now would be a goodtime to carry on smoking, and that's how Ikept myself strong. For a smoker, theresimply isn't a really good time to becomea nonsmoker. I'm happy to be a nonsmok-er.” (Manuela, 40, Ludwigshafen)*

“I used nicotine patches for the first 7days, but then stopped that because I hadreal problems sleeping. It was a bit diffi-cult without the patch when I got up in themornings or after eating because that'swhen I noticed a craving. After eating Inow go for a walk with my husband, whostopped smoking 16 years ago. Our dog is


happy about the extra walks he's getting.At first it was also difficult at work – goingout for a cigarette break and chattingabout this and that. Now I can join mycoleagues for a bit of a chat without havingany addictive thoughts. I think I'll keep itup and I'm really glad that I took part inthe ‘Smokefree 2006’ campaign.”(Angelika, 37, Erpolzheim)*

“I never believed that I could manage itbecause I started a new job on May 2 andso I'd been smoking even more than usualbefore that. This time I managed without.Even though I had problems in my privatelife where I would usually have smoked, Imanaged those without, too – eventhough the craving was there. I'm going tokeep it up because I really feel better.”(Heiner, 39, Potsdam)*

“Thank you for your helpful messages! Ifound one sentence particularly important:(the gist of it was) The craving for a ciga-rette wears off again quickly, you just haveto resist for this short moment. I reallymanaged that! In 2066 I'll be 120 yearsold, healthy, fit and happy.” (Laura, 58,Cottbus)*

“I'm proud of myself! I found the first twoweeks really difficult. I didn't know whatwas wrong with me. Is it the menopauseor is it withdrawal? I couldn't sleep, I wassweating heavily and I didn't have anyenergy. Although I'm in the restaurantbusiness, with guests who smoke ofcourse and a lot of stress at the weekend,I've stuck to it so far. I've set myself anew goal: I'm not going to smoke beforemy 50th birthday in October and, youknow what, I'm going to stick to it!”(Getraude, 49, Schwetzingen)*

“I've had just about every withdrawalsymptom you can have. Depression,insomnia, I just wanted to be alone andeven thinking was too much for me. If youhadn't described everything in the emails,I wouldn't have known that they werewithdrawal symptoms. I think I've man-aged it and I'll never smoke again. Thesmoke makes everything smell so awfuland I feel much better without smoking.

After 22 years with cigarettes I had almostforgotten how good everything tastes andhow lovely spring can smell. The flowersnever smelt so intensively. Never beforehad I been out on to the balcony a dozentimes to smell the flowers. Every time Ithink: what a miracle. I've been missingthis pleasure all these years! Food is alsotastier and better. The result is that I'veput on 2 kilos. But I'll allow myself that tostart with. I can lose weight anytime; I'mjust going to enjoy everything first. Lots ofother things have changed as well. I feelmore stable, more determined, I can con-centrate better and I've calmed down alot. I see things much more relaxed nowand I've even become more optimisticabout a lot of things. I've become a proudnonsmoker and it's 99.99% that it's goingto stay that way. I've won a prize, andthat's the experience and the feelings I'mhaving right now. And my health!” (Ilse,36, Tegernsee)*

“I didn't need some of the perseverancetips anymore and just thought: onceyou've flipped the switch in your head, it'srelatively easy. I mean, if you really wantit, you can do it. I'm also taking a lot morecare of my body: lots of sport and outdoorexercise, healthy food, sleep and relax-ation! What I find really nice is that mydaughter Gundula (25) and her fiancé havealso stopped smoking. They want to havea baby soon, perhaps next year.Smokefree – we're sticking to it!”(Natscha, 49, Neugersdorf)*

“First of all I want to thank my daughter,Isabel. She told me about the campaign.We looked on the Internet together. Wemade a deal about a year ago that I'd quitsmoking on April 30, 2006 for the confir-mation of my twins. I thought Isabelwould forget about it! But she didn't! DayX came and I have to say that I had imag-ined it would be worse. I smoked from1980 up to September 15, 1989 and thenstopped. Five years later I started again.Why? Stupidity?! I'm going to try it foreverthis time.” (Marianne, 41, Celle)*

“Yes, I can proudly say that I haven'tsmoked since May 1. I've got some circu-


lation problems and mood swings at themoment. But when you've been smoking50–60 cigarettes a day, what can youexpect from your body? But I think thesewill ease off soon. The numbers of cravingattacks are getting fewer and fewer. Icompare it in my mind to my victory overmy other addiction – I've been dry for 10years now – so it's really not so difficult tostick to it. If I'm not one of the winners,it's not the end of the world. I'm definitelyamong the winners – healthwise andfinancially. I'm not going to start smokingagain and I don't need any nicotinereplacement. The challenge on May 1 wasthe final impetus for me to quit smoking.”(Eberhard, 51, Greifswald)*

“Definitely an exciting, exasperating andnice time. Withdrawal on all levels. Youmeet yourself just as you are ...: clearerand more honest, not so fuzzy. Wouldhave been great to win the prize and goon holiday with my children – that wouldreally have been it. All the best to all ofus.” (Rita, 37, Bad Nauheim)*

“My wife made my life misery because ofmy smoking for nearly 40 years. She gaveup a year ago. Only after that did I reachthe decision to finally stop. Now, at theage of 54, I'm (finally) determined to putthe money to some better use.” (Siegbert,54, Königswinter)*

“I've smoked heavily for many years. Myjob as chairwoman of the board of a mediacompany is fast-paced, exciting, and notexactly conducive to no-smoking plans. Isuddenly went from 200 to 0 on April 30,2006 when I fell and knew immediately:I'd broken my leg. Within seconds I real-ized that this incident was going to put meout of action for weeks to come and Iwas, and still am, convinced of two things:first, God knew that it was going to takemore than a cold to bring me to my sens-es, but rather something that would 'slowme down' long-term. Second, if I'm evergoing to manage to stop smoking, it'snow. While we were waiting for the ambu-lance I enjoyed smoking what I knew wasgoing to be my last cigarette. After thefirst few days in hospital I started getting

the first cravings and I was tempted morethan once to go out on the smokers' ter-race with my crutches or in a wheelchair. Ihave to thank my room-mate, who alsohappened to be called SMOKE, that Ihaven't lost my self-control up to now.Mrs. Smoke gave up smoking herself 4years ago. She has become a real friend,even though there's a 20-year age gapbetween us. We'll both be staying in thehospital for a few more days together andone thing is for sure: after that we bothwon't be smoking.” (Rosi, 44, Mainz)*

“I'm proud of myself! And I really noticethat NOT smoking is healthier and givesme new energy – e.g. I haven't been tak-ing the lift recently but the stairs insteadand that with unusual ease – but it canalso be a strain in certain situations. That'swhen it's important to not be weak. Tostrengthen my resolve I keep tellingmyself how good it is for me and howgood it feels not to smoke anymore, andthen I tell myself that this craving for a cig-arette is only temporary and that it wouldbe stupid to give in to it when I've man-aged so many days ‘without’. It's notalways easy, but it's worked every time upto now. And the envy and admiration ofmy still smoking colleagues gives meextra motivation. If any of them take meas an example and stop, I'll give them mysupport. Even without the prize, I still wonfrom taking part in ‘Smokefree 2006’.”(Anna, 35, Sinsheim)*

“The previous week my partner and I hadsplit up – so the temptation was great. I'lladmit that I was actually on the way to thegas station, but turned around. I thought:No, no man is worth that! And I'm goingto stick to it, even though I'm sleepingbadly and the craving keeps coming back.I and my health are worth it!” (Berta, 47,Altenberg)*

“I'm doing a course at the moment at aprivate university, which I'm paying formyself. The money I'm saving from notsmoking is helping me achieve my goal.It's not easy not to smoke, though, whenI've got exam stress. But I'm never goingto give up the time I've already stuck to it.


I'm looking forward to a smokefree life.”(Saskia, 40, Lauenburg)*

“If I hadn't found the ‘Smokefree 2006’advert and signed up, I would probably stillbe smoking today. But yes, even I've beensmokefree since 1st May. It's not alwayseasy, but the physical changes are veryrewarding. For example, walking up to the2nd floor without having to gasp forbreath. Some of the people around me areastounded by my new appearance.” (Vera,45, Magdeburg)*

“Stopping smoking has been absolutelyworth it – in every way. I just feel muchbetter, I've put on a few kilos which simplymake me look healthier. No coughing orother morning complaints etc. It's great.Even though I get the odd craving, I canget over it. It is and will remain a questionof mental attitude. Yesterday I counted upthe number of UN-smoked cigarettes. Justthinking about it made me feel ill – howbadly have I treated my body over the last35 years.” (Roman, 50, Langebrück)*

“Me and four friends decided at the endof April to quit smoking. We found outabout the Smokefree campaign from theposters and so we smoked our last ciga-rettes in April. The first few days weretough, but since then the cravings haveworn off a lot. At parties, after a nice mealor having a coffee I still fancy a cigarette,but so far I've been able to resist. Actually,my boyfriend has been encouraging me togive up smoking all year. He gave me a'motivation calendar' at the New Year. Forevery day that I smoked max. 4 cigarettesI could stick a red dot on my calendar, forevery day with max. 2 cigarettes a yellowdot, and a green dot for days with no ciga-rettes. For 10 consecutive red dots or 5yellow dots or 2 green dots he gave me alittle present. Now I can look forward togetting a surprise from him every twodays.” (Katrin, 29, Ahaus)*

*Names changed for data protection


Anett KoscheDeutsches Krebsforschungszentrum,Heidelberge-mail: [email protected]

Dr. Martina Pötschke-LangerDeutsches Krebsforschungszentrum,Heidelberge-mail: [email protected]

Susanne SchunkDeutsches Krebsforschungszentrum,Heidelberge-mail: [email protected]

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