1. Did Finland’s Tobacco Control Act of
1976 have an impact on ever smoking?
An examination based on male and female cohort trends
Satu Helakorpi, PhD, senior researcher

2. Background
• The aim of the study was to examine patterns of ever-
smoking among Finnish adults by gender and birth
cohort with special emphasis on the possible effects of
the 1976 Tobacco Control Act (TCA)
Source: Helakorpi S, Martelin T, Torppa J , Patja K, Vartiainen E and Uutela A:
Did Finland’s Tobacco Control Act of 1976 have an impact on ever smoking?
An examination based on male and female cohort trends. Journal of
Epidemiology and Community Health 2004;58:649-654
Impact of Finland's Tobacco Control Act of 1976 on ever-smoking 2

3. The 1976 Tobacco Control Act (TCA)
in Finland
One of the strictest tobacco control acts in Europe
The Act:
• Prohibited smoking in most public places and on public
transport
• Restricted tobacco advertising (a total advertising ban was
enforced in 1978)
• Set a 16-year age limit for tobacco buying
• Health warnings became obligatory on tobacco packaging
Impact of Finland's Tobacco Control Act of 1976 on ever-smoking 3

4. Material and methods
• The study based on data from annual cross-sectional
postal surveys from 1978 to 2001 (Health Behaviour and
Health among the Finnish Adult Population –surveys)
• subjects were 15–64-year-old men and women
(n=91 342)
• for the analyses 13 five-year birth cohorts were formed
(oldest birth cohort were born in 1916–20, the youngest
one in 1976–80)
• those who reported smoking regularly/daily for at least
one year in their lifetime were regarded as ever smokers
• logistic models were used to test the impact of the TCA
Impact of Finland's Tobacco Control Act of 1976 on ever-smoking 4

5. The impact of TCA
• In the study we assumed that any impact of the TCA
would manifest as a lower smoking rate than could
otherwise be expected in birth cohorts that entered the
critical age to start smoking after the TCA became
effective
=> In the models no effect of the TCA was assumed for
the cohorts that had already passed their 21st birthday
in 1976 (born 1955 or earlier), and an impact for those
born in 1956 or later
Impact of Finland's Tobacco Control Act of 1976 on ever-smoking 5

6. Male and female ever smoking by birth cohort
Post-war ‘Baby-
TCA 1976
War (WW II) (WW II) boomer’
generation depression
generation
generation
100
90
80 Separate dots = observed
prevalences for age groups
70
60
Solid lines = logistic model
estimated prevalences
%
%
%
% 50
The dotted lines =
40
prediction where the impact
30
of the 1976 Tobacco Control
Act (TCA) was assumed to
20 be zero
10
Source: Helakorpi S. et al. Did Finland’s Tobacco
0 Control Act of 1976 have an impact on ever
1916- 1921- 1926- 1931- 1936- 1941- 1946- 1951- 1956- 1961- 1966- 1971- 1976- smoking? An examination based on male and
20 25 30 35 40 45 50 55- 60 65 70 75 80
female cohort trends. J Epidemiol Community
birth cohort Health 2004;58:649−654
Men
19-34 35-49 50-64 25-49 25-49
Women 19-34 35-49 50-64 25-49 25-49
Impact of Finland's Tobacco Control Act of 1976 on ever-smoking 6

7. Results, men
• Among men ever smoking decreased from older cohorts
to younger ones
• The biggest decrease in male ever smoking was in the
birth cohorts born in 1961 or later
• Smoking was less common than expected according to
earlier birth cohorts’ trend in those cohorts which reached
the critical age to start smoking when the 1976 TCA was
in force (born in 1961 or later)
• Among men the prevalence of ever smoking based on
the final model was about seven percent points lower than
that based on the prediction
Impact of Finland's Tobacco Control Act of 1976 on ever-smoking 7

8. Results, women
• Among women ever smoking increased from one cohort to
the next in the birth cohorts born before 1956 and
decreased after that
• Smoking was less common than expected according to
earlier birth cohorts’ trend in those cohorts which reached
the critical age to start smoking when the 1976 TCA was in
force (born in 1961 or later)
• Among women born in 1961–65 the prevalence of ever
smoking based on the model was about 20 percent points
lower than that based on the prediction
Impact of Finland's Tobacco Control Act of 1976 on ever-smoking 8

9. Conclusion
• Results of this study suggest strongly that the
Finnish tobacco law of 1976 has contributed to the
decrease on smoking among Finnish men, and to
keeping Finnish female smoking on the lower level
• The present study proved that the examination of
smoking behaviour by birth cohort is a useful tool
when evaluating the impact of tobacco control policy
• This study is one example, how monitoring surveys
can be used when assessing the impact of public
health policy measures
Impact of Finland's Tobacco Control Act of 1976 on ever-smoking 9

10. Source:
Helakorpi S, Martelin T, Torppa J , Patja K, Vartiainen E and Uutela A: Did Finland’s
Tobacco Control Act of 1976 have an impact on ever smoking? An examination
based on male and female cohort trends. Journal of Epidemiology and Community
Health 2004;58:649-654
Helakorpi S. Impact of Tobacco Control Policy on Smoking and Exposure to
Environmental Tobacco Smoke. [Dissertation] Publications of the National Public
Health Institute 15/2008
e-mail: satu.helakorpi@thl.fi
Impact of Finland's Tobacco Control Act of 1976 on ever-smoking 10