CSF health promotion is a value-based, goal-oriented activity for attaining human health and well-being and preventing cancer. The CSF conducts health promotion work in many fields. It seeks to influence social policy, general attitudes, social and health care practices, and individual choices. Target groups are children, young people and adults. Where appropriate, activities are aimed at selected special groups. The CSF increased its health promotion work in regional associations in 2018 by hiring three health promotion experts (2.5 person-years) for the regions of North Finland, North Savo, North Karelia, Saimaa and Central Finland. In addition, regional associations were supported in health promotion work by participating in their various development projects. The CSF was active in the organisations’ nicotine-free Finland (JäNiS) and Smokeless Finland, Smokeless Helsinki and Hyvä kierre networks established in 2016. Cooperation continued with the Finnish Olympic Committee to reduce the use of snuff in sports. We also cooperated with, among others, the Finnish Heart Association, the Family Federation of Finland, the Finnish Diabetes Association, the Organisation for Respiratory Health in Finland, the Finnish Association for Substance Abuse Prevention, the Finnish Association for Mental Health, the Youth Mental Health Association (Yeesi) and the Martha Organisation. Youth health promotion Reinforcing healthy lifestyles among the young has been a key project for the CSF ever since 2016. For more than 15 years, the focus of youth health promotion has been on a project that aims to prevent young people from starting smoking and using nicotine (NuoTup), funded by STEA, the Funding Centre for Social Welfare and Health Organisations (formerly the Finnish Slot Machine Association). 2019 was the second year of the three-year STEA-funded Fressis project that aims to improve young people’s health knowledge by digital means. The Good Day (Hyvä Päivä) project, which promotes the health of young people un-der the age of 29 outside work and education, has been running since 2016. The funding for Good Day activities comes from STEA and through the Cancer Foundation’s business coop-eration with LähiTapiola. Reducing young people’s use of nicotine products Fressis. Started at the end of 2016, Fressis, a communications package that encourages and supports health lifestyles among youth, was started at the end of 2016, providing young people information and encouragement in leading a nicotine-free life and healthy lifestyles. Nicotine products cover cigarettes, snuff and e-cigarettes. Snuff was highlighted in particular in 2019. Fressis includes the website Fressis.fi, which is supported by social media channels and Fressis magazine. In 2019, Fressis provided young people with databanks, articles, knowledge tests and campaigns. Young people participated in Fressis’ content production, evaluation and develop-ment through volunteering, youth councils and collaborations with influencers popular among youth. Instagram is the main social media channel for Fressis for young people. The campaigns also made extensive use of other social media channels. Youth health questions are answered by the Ask an Expert service. In 2019 the service answered 100 questions about tobacco and nicotine products. Young people in particular were concerned about the risk of snuff and about stopping snuff use. In the spring, young people could use the Nicotine-Free chat, designed to provide support and guidance in stopping the use of nicotine products. The target group of Fressis magazine in 2019 was high school students and the magazine was produced for the first time in Swedish, in addition to Finnish. The Finnish-language magazine had a print run of 50 000 and the Swedish-language magazine 4 000. According to the evaluation received from young people, most of them found the content interesting and useful. An article in Fressis magazine also won a bronze medal in the Alternative Storytelling category of the International Creative Media Award. During 2019, two stakeholder collaborations took place in which influencers popular with youth encouraged quitting the use of tobacco products use and persevering without nicotine products. In addition, a campaign was prepared for 2020 to encourage young people to stop using tobacco and nicotine products. In 2019, the Fressis website had nearly 365 000 users and more than 430 000 sessions. User traffic increased by 94% over 2018. Online tests were answered almost 29 000 times. Fressis’ Instagram account had more than 2 000 followers. Tobacco body. The Tobacco Body website was revamped in 2018 and launched in 2019. The website contains information not only about cigarettes but about snuff, and meets current digital needs. Tobacco Body closely supports the Fressis and NikEdu services. Tobacco Body comes in Finnish, Swedish, English, Danish, Estonian and Russian. The new Tobacco Body site was launched with a marketing campaign for young people as well as teachers who can use Tobacco Body in their teaching work. In 2019, Tobacco Body had more than 95 000 visitors and almost 126 000 sessions. NikEdu. Launched in 2017, the site for adults working with children and young people was developed in terms of both content and usability based on user ratings received. The site was marketed to target groups at events, in networks, newspaper advertising and digital marketing. In 2019, the site had more than 33 000 users. The Nuuska ei näy (Snuff Not Visible) campaign was carried out for parents of high school-aged youngsters, calling on parents to notice the phenomenon of snuff use by young people and to discuss the use of snuff with them. The campaign was conducted on social media and the campaign content redirected users to the Nikedu site for further information. The cam-paign reached more than 182 000 people through social media advertising and brought 14 400 visitors to NikEdu. A native article published in the daily paper Ilta-Sanomat had 12 500 readers. A total of 5 300 online tests were conducted as part of the campaign. The Tarmo health board game was produced for educational institutions and youth activities in cooperation with the Cancer Society of Southwest Finland’s NIKO project. Nikotiiniton amis (nicotine-free vocational school) project started at Savo Vocational College in Kuopio. The aim of the project is to help vocational schools develop operating models and learning environments that support a nicotine-free approach, and strengthen staff capacity to support the students in becoming nicotine-free. In the second year of the project, the planning of concrete actions was continued and the implementation of measures was started. The project will continue in 2020, when the developed models will be disseminated to the various sites of the vocational college and will also be developed more widely for utilisation in various vocational educational institutions. In addition to Savo Vocational College, the partners in the project are the Cancer Society of North Savo and the City of Kuopio’s substance abuse prevention work. Nicotine-free youth work. Nicotine-free youth work was carried out in 2019 in Ikaalinen, Keuruu and Siuntio for a total of 44 youth workers. The training aims to strengthen activities in youth work that support young people in a nicotine-free lifestyle. In the sports environment, work aimed at reducing snuff use was continued in cooperation with the Finnish Olympic Committee. The main focus in 2019 was on piloting snuff-related lesson content for sports colleges. Work on reducing the use of snuff in the sports environment continued in cooperation with the Finnish Olympic Committee. Fressis – improving youth health literacy in topics other than nicotine The Funding Centre for Social Welfare and Health Organisations (STEA) granted the CSF funding for 2018–2020 to promote non-nicotine-related topics through Fressis. Fressis covers the following topics in this respect: nutrition, physical activity, alcohol, sexual health, sun protection, circadian rhythm, and good mental health from a life management perspective. Fressis now extensively covers all cancer-critical lifestyles and offers young people a comprehensive information package about health promotion. In 2019, we produced plenty of material on different topics for the Fressis website and for social media, including articles, videos, infographics, tests and in the form of social media content. The Ask an Expert service answered 256 queries on health matters, in addition to questions about tobacco and nicotine products. The 2019 Fast Food Made Tasty advocacy campaign targeted young people aged 15 to 20 and aimed to give them concrete tips and an understanding of why it is important to get nourishment from ordinary food. The campaign was run on social media channels and on the Fressis website. The campaign brought nearly 60 000 young people to the site. Campaign information tests were done more than 2 300 times. According to the evaluation, the cam-paign effectively increased respondents’ willingness to make changes to their own eating habits, most importantly to reduce the consumption of unhealthy snacks and to eat more vegetables. The 2019 influencer collaboration was conducted with five micro-influencers. The target groups are the followers of the influencers, especially on YouTube. Everyday rhythms, exercise, nutrition, alcohol, and mental well-being were selected as the topics for five separate videos. Young people participated in Fressis’ content production, evaluation and development in 2019 via youth panels, as summer employees and developers. A total of 50 young people were involved during the course of the year. Kesäkumi campaign. Kesäkumi (Summer rubber) is a campaign to improve awareness of STDs and protection against them and to increase condom use. The campaign was run in cooperation with the Family Federation of Finland, the Finnish Red Cross, the radio station YleX, and the Soldiers’ Home Association. The campaign is takes place at music festivals and other youth events. The campaign includes an extensive communication cluster aimed at young people through YleX and the social media channels of various organisations. During the campaign, thousands of condoms are distributed and young people can take the Marriage Master test both at events and as an online exercise. The online version, on the Fressis website, was performed more than 12 000 times in 2019. In addition, the young men who started military service received a ‘holiday rubber’. The CSF foregrounds campaign content on Human papillomavirus (HPV) and how to protect against infection and on promoting condom use. The Good Day project Good Day (Hyvä Päivä) project activity has been carried out since 2016 in cooperation with municipal youth services. The aim of Good Day is to increase the knowledge, skills and ability of young people under the age of 29 who are outside work and education to manage their lives in a healthy way. In 2019, Good Day activities were actively taken to the citizen infor-mation bureaus and group activities were continued in cooperation with the municipal youth services. In 2019, Good Day groups were run in Vantaa, Lohja, Rovaniemi, Kajaani, Varkaus, Seinäjoki and Joensuu. A total of 13 groups were set up and 67 young people outside work and education took part. Five Good Day instructor training courses were held: two trainings Helsinki and one each in Kuopio, Tampere and Turku. A total of 54 new professionals working with young people were trained as instructors for the Good Day groups. The Good Day instructor website was developed and an information package related to food and nutrition was added. In order to increase the visibility and awareness of the Good Day operating model, Good Day Instagram and Twitter accounts as well as a Facebook page, which was opened in 2019, were actively utilised. Activities were incorporated in, among other things, regional workshop days for Good Day group instructors. Reporting on the campaign work was done for the project funders STEA (interim report) and LähiTapiola. The continuation of the Good Day activities, which are incorporated in local service menus, was secured when STEA targeted funding for activities from 2020–2022 was obtained in late 2019. Social advocacy and reports Nicotine-free vocational schools. In 2018, the CSF commissioned a qualitative study from e2 Research about smoking prevention at vocational schools. The study examined current practices, guidelines and tools as well as current challenges and what needs to be done to solve them. The study was published in 2019 on the Savupilvi portal as part of the online publications series of the Finnish National Agency for Education and was publicised in a joint press release. In addition, advocacy meetings were initiated on networks related to vocational training. Snuff in sports. The CSF commissioned a study on the use of snuff in sports from Kuuskulman Tapaustoimisto research agency. The results of the study, which looked at snuff use among youth in everyday sports settings was published in spring 2019. The findings will be used in cooperation with the Olympic Committee. E-cigarettes. In 2019, the investigative work continued on the control of e-cigarettes. A scientific article on the results was published in the prestigious journal Tobacco Control. The main finding was that e-cigarette traders sell prohibited flavours popular among youth in an effort to circumvent the law and make coordinated appeals to the courts against tobacco control decisions. The supervisory authorities in Finland, the EU and in other EU countries were informed about the results of the study, a press release was issued and it led to several articles being published in the national media. In October, a seminar on New Research on Tobacco Policy was also held, which presented the above-mentioned studies by the Finnish Cancer Society, e-cigarette research and other current tobacco policy research. General health promotion General health promotion focuses on primary, secondary and tertiary prevention, targeting adults and pre-school children. UV-protection The main target group in 2019 was women aged from 25–40. Women make an effort to protect themselves in the sun but tanning is still important to many women. The female target group was reminded of sun safety. A video (Iho kertoo tarinoita) was distributed on social media channels, and aimed at the target group. A video made in 2018 for men (Lomakuvia) continued to be shared on social media. The well-received promotional work for children in daycare centres on self-applying sunscreen continued. There were storytelling lessons in day care centres across the country, where children were explained the importance of protecting themselves from the sun and given instructions on how to apply sunscreen themselves. A brochure was sent to the children’s parents (Healthily in the sun — a brief guide for parents). Kindergartens received a poster about how can children self-apply sunscreen. In 2019, instruction sessions were done by students from vocational colleges in addition to those arranged by CSF employees. Guidance was given at 105 daycare centres to 3 700 children aged between 3 and 6. Due to the increase in the number of skin cancers and the increase in public awareness of the issue, there has been an increase in the number of applications to CSF for mole analysis. The CSF os C no longer able to meet this growing demand, so in 2019 we began mole examination training for health professionals. In 2019, 136 primary health care professionals were trained in mole examinations in Siun Sote and Kuopio provinces. Training will be continued in 2020. A press conference was held in cooperation with the Radiation and Nuclear Safety Authority and the Finnish Meteorological Institute. The media was interested in sun safety issues and numerous magazines and other media interviewed about healthy behaviour and sun expo-sure. Aattelepaite.fi website The aattelepaite.fi website, geared to men, has been devised on the basis of CSF studies concerning men. Several videos of interest to men have been produced for the site, tobacco, food, exercise, the sun, sex and alcohol. The site also has information, self-examination guidance and self-tests. Apart from giving solid information, issues have been dealt with humourously. In addition to ordinary men, the videos feature experts as well as celebrities popular among men, such as Bruce Dickinson of Iron Maiden. Testicular self-exam The aim of the testicular self-exam campaign, directed at young men (15 to 35-year-olds) is to raise awareness among young men about testicular cancer, its symptoms, and how to palpate your testicles. The campaign produced a brochure as well as a video (Katsasta kassis) that has been distributed on social media for young men. The video had 26 000 viewers. Ma-terial and guidance on testicular self-exams have also been provided to military conscripts. Exercise The CSF, in cooperation with other organisations, has been involved in the Liikkuva yhdistys project promoting physical activity, from 2017-2018 together with the Finnish Heart Association, the Organisation for Respiratory Health in Finland, the Finnish Diabetes Association and the Finnish Brain Association. With the end of the project, the collaboration continued in 2019 with the additional involvement by local branches, and included the organisation of 11 training courses. The CSF became a member of the adapted physical activity association (SoveLi) and of the Age Institute, also enabling active collaboration with other physical activity professionals. Reducing the use of alcohol and tobacco and nicotine products in adults Work to reduce the use of tobacco and nicotine products among adults was added to by ac-tivity targeted at people who already have cancer. Working together with hospitals, the CSF promoted the Stop Smoking before Surgery model and arranged ward classes and lectures for physicians and other health care professionals. The CSF sought, by various means, to promote the cessation of the use of tobacco and nicotine products by the adult population. Smoking and pregnancy The CSF has been actively involved in reducing smoking during pregnancy in cities and provinces. In 2019, the cancer associations in the Oulu region and the Joint Municipal Authority for North Karelia Social and Health Services conducted surveys of child health clinic nurses on the need for information and support. The surveys will be extended to other areas in the coming years. Training courses for child health clinic staff were held in 2019 in Joensuu and Turku, and at a Hyvä kierre health promotion seminar. The training will also be extended to other areas in the coming years. The aim of such training is to increase knowledge and skills and to launch targeted activities at child health clinics to reduce smoking and the use of other nicotine products. Alcohol In 2019, a target group analysis was conducted for women aged 25–35 years. Based on the results, three stimulating videos were made for social media. These gained 252,000 viewers in a month. Women and Alcohol website was launched. At the beginning of the campaign, a media release was sent out, on the basis of which numerous magazines covered the topic. Alcohol matters were also discussed on the aattelepaite.fi website. The CSF brochure on alcohol brochure was distributed on a number of occasions. The carcinogenicity of alcohol was also addressed at various cancer prevention lectures.