CSF health promotion by cancer organisations is a values-based, goal-oriented activity for attaining human health and well-being and preventing cancer. The CSF carries out health promotion work in many areas. It seeks to influence social policy, public attitudes, social and health care practices and individual choices. The target groups are children, young people and adults. Where appropriate, activities are targeted at selected specific groups. In 2018, health promotion work in the regional associations was increased by recruiting three health promotion specialists (2.5 person-years) for the regions of Northern Finland, North Savo, North Karelia, Saimaa and Central Finland. In addition, the regional associations were supported in their health promotion work by participating in their various development projects. This temporary activity ended at the end of 2020. The experience was very positive. The CSF was active in the organisations’ nicotine-free Finland (JäNiS) and Smokeless Finland, Smokeless Helsinki and Hyvä kierre networks. Cooperation continued with the Finnish Olympic Committee to reduce the use of snuff in sports. We also cooperated with 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 Strengthening health-promoting lifestyles among young people has been a priority for the CSF since 2016. For more than 15 years, the focus on youth health promotion has been the Youth Tobacco and Nicotine Products Reduction Project (NuoTup), funded by STEA (formerly RAY). 2020 was the final 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 under the age of 29 outside work and education, has been running since 2016. The Good Day activities are funded by STEA and, through the Cancer Foundation’s business partnership, LähiTapiola. Reducing young people’s use of nicotine products Fressis. Fressis is a communication package aimed at young people to provide information and encourage a nicotine-free and healthy lifestyle. Nicotine products include cigarettes, snuff and e-cigarettes. Fressis includes the website fressis.fi, which is supported by social media channels. In 2020, Fressis provided young people with databases, articles, knowledge tests and campaigns. Young people participated in the content production, evaluation and development of Fressis as summer interns, content producers, in youth roadshows and through collaboration with influencers popular among youth. Instagram was the main social media channel, but other channels were also used widely in the campaigns. Young people’s health questions are answered through the Ask the Expert service. In 2020, 76 questions on tobacco and nicotine products were answered. Young people in particular were concerned about the risk of snuff and about stopping snuff use. For adolescents and young adults, the Erovirasto app (Quitting Administration) was developed to help youth quit snuff and tobacco through a 30-day programme, providing information on the harm caused by of smoking and snuff use, as well as tips and support for quitting. The free app will be available in 2021. Two influencer collaborations were carried out during the year on the hidden advertising of smoking and snuff and their environmental impact. The YouTube videos produced received a total of 119,000 views during the campaign period, with over 1,000 comments. Of those who responded to the feedback survey, 99% felt that after watching the video they had a better idea of why they should stop smoking or using snuff. The Fressis website had 632,000 users and over 756,000 sessions in 2020, an 87% increase in traffic over the previous year. Nearly 37 400 responses to online tests were received. The Fressis Instagram account had 1,955 followers. The videos on the fressis.fin YouTube account were viewed more than 82,600 times. Tobacco body. The revamped Tobacco body website was launched in 2019. Tobacco body contains information not only about cigarettes but also about snuff and is available in six languages (Finnish, Swedish, English, Danish, Estonian and Russian). During the year, tobaccobody.fi had 67,000 users and more than 83,000 sessions. NikEdu. The NikEdu website for adults working with children and young people was developed in terms of content, usability and accessibility. New content included lesson plans for secondary school health education and a model for adults to talk to young people about tobacco and nicotine products. The content was marketed to target audiences through networks, newspaper advertising and digital marketing. Nikedu.fi had over 18,700 users and 23,000 sessions. The materials on the site were viewed 3,105 times. The Tarmo health board game, developed in cooperation with the NIKO project of the Cancer Society of Southwest Finland, was distributed to educational institutions and through youth work. A training course on substance abuse in health teaching was carried out for 61 health teachers and trainee teacher in cooperation with Finnish Association for Substance Abuse Prevention (EHYT). At the end of the year, preparations were made for the rebranding of the NikEdu website. Starting in 2021, the site will be known as FressisEdu, merging with the fressis.fi youth website f. Nikotiiniton amis – Namis (nicotine-free vocational college). This project was run at Savo Vocational College in Kuopio from 2018-2020. The aim of the project was to help the vocational collage develop nicotine-free practices and learning environments that support a nicotine-free approach, and to strengthen the capacity of staff to support students’ nicotine-free behaviour. In 2020, the models developed were disseminated to various points at the vocational college and the activities were incorporated structurally. In addition to the Savo Vocational College, the project partners are the Cancer Society of North Savo and the City of Kuopio’s substance abuse prevention work. The operating model for promoting nicotine-free vocational schools was developed by means of service design together with vocational school actors. This is based on the models and tools devised by the Namis project. It includes training and teaching materials, tools for student guidance, involvement and advocacy, and practical examples of rules and guidelines for the institution and the development of the institution’s environment. The roll-out of the model to educational institutions will start in 2021, together with five regional cancer associations. Nicotine-free youth work. Training was conducted in two distance learning sessions for youth workers in Laitila and Akaa. Due to the exceptional situation caused by the Covid pandemic, a remote delivery model was developed for the training, which can be used as an alternative to face-to-face training in the future. Ninety-four per cent of participants felt that they had benefited from the training and all would recommend the training to other youth workers. Snuff-free sport. In 2020, a service design method was developed in collaboration with the Finnish Olympic Committee, EHYT and sports stakeholders to develop a snuff-free sports model for sports clubs to promote snuff-free sports. The model is available on the website nuuskatonurheilu.fi. In 2021, it will be rolled out to sports clubs across Finland. Fressis – improving youth health literacy in topics other than nicotine 2020 was the final year of the three-year STEA-funded Fressis project. Fressis covers all the key lifestyle areas of cancer prevention and provides young people with a comprehensive health promotion package. The aim of the project has been to strengthen young people’s health awareness and skills in areas other than tobacco and nicotine products: nutrition, physical activity, alcohol, sexual health, sun protection, circadian rhythm, and good mental health from a life management perspective. A wealth of content was produced for both the Fressis website and social media channels in the form of articles, videos, infographics, tests and social media content. Of the respondents to the evaluation survey, 72% felt that they had received additional information, Forty-eight per cent had started to consider their own motivation to adopt a healthy lifestyle and 48% intended to implement or try out the tips and healthy lifestyle practices they had received. The popularity of the Ask an Expert service has increased year-on-year, with 561 health-related questions answered in 2020, in addition to questions on tobacco and nicotine products. Sexual health was the most popular issue among young people. Feedback showed that 95% of respondents felt that they had received the information they needed and that the answer was useful to them. The “Fressimpi fiilis” campaign was run for young people aged 15-18 in 2020-21, with three young influencers giving video tips on small everyday activities that can promote mental wellbeing. The videos were viewed by 2,255 young people. According to campaign feedback, 74% felt they had received good tips and 71% intended to try them. Four social media influencers collaborated to create content on nutrition, alcohol and HPV for YouTube and Instagram. The different content formats received a total of 588,000 views. Ninety per cent of respondents to the feedback survey felt they had received more information on healthy lifestyles. Together with the Radiation and Nuclear Safety Authority, the Finnish Meteorological Institute and the University of Eastern Finland, a pilot campaign was designed and carried out to encourage young people to protect themselves from the sun, which will be continued in the spring-summer period in the following years. Young people participated in the content production, evaluation and development of Fressis as youth panels, summer workers and content producers. Kesäkumi campaign (Summer rubber). The Summer Rubber campaign is to improve awareness of STDs and protection against them and to encourage condom use and oral protection. The campaign is run annually in cooperation with the Family Federation of Finland, the Finnish Red Cross, the radio station YleX, and the Soldiers’ Home Association. Due to the Covid pandemic situation, the campaign was carried out as a digital campaign making strong use of social media. Within the campaign, the CSF foregrounds campaign content on the human papillomavirus (HPV) and how to protect against infection and on promoting condom use. A total of 350,000 young people were reached via Instagram. The Fressis website’s Marriage Master’s test was completed 18,000 times by the end of autumn. Of those who responded to the campaign evaluation, 75% said they had learned something new about sexual health and 75% said they would use condoms in the future. The Good Day project The aim of the Good Day project 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. The project has been run since 2016 in cooperation with municipal youth services and citizen information bureaus. At the beginning of 2020, Good Day came within the scope of targeted STEA project funding. The other source of funding is through the LähiTapiola-Cancer Foundation business partnership. Good Day group activities continued in cooperation with municipal youth services and citizen information bureaus. Good Day groups were organised in Vantaa, Lohja, Rovaniemi, Kajaani, Kuhmo, Seinäjoki, Joensuu, Huittinen, Janakkala, Kerava, Mäntsälä, Oulu, Ii and Espoo. A total of 21 groups were carried out, with 100 young people participating. The Covid pandemic moved the group activities for young people online, and some of the Good Day groups were also conducted remotely. In March, the project team developed a remote version of the Good Day group model. The regional “coffee mornings” led by the group instructors were transformed into two national remote coffee morning sessions, with good attendance from different parts of Finland. Good Day instructor training courses were organised in Vantaa, Oulu and Hämeenlinna, and as remote training in autumn 2020, where 66 new professionals working with young people were trained as of Good Day group instructors, as well as in separate municipal trainings. Cooperation was launched with the Salpaus vocational education and training centre to introduce the Good Day approach to vocational college students at risk of dropping out. The Good Day Counsellor website was developed and information texts on daily rhythm, mental well-being and physical activity were added. The Good Day Instagram and Twitter accounts and Facebook page were actively used to increase the visibility and awareness of the project. General health promotion The CSF’s general health promotion focuses on primary, secondary and tertiary prevention, targeting adults and pre-school children. UV protection Promotional work for children in daycare centres on self-applying sunscreen continued. Virtual storytelling lessons were carried out in daycare centres across Finland. Children were shown a new video, ‘Sunshine Helpers – Let’s Shine Together’, which explains the importance of sun protection, healthy picnic foods and the importance of a clean environment. A brochure was sent to children’s parents entitled ‘Healthy in the sun – a brief guide for parents’. Daycare centres received a poster on how children can self-apply sunscreen. In addition to CSF staff, the educational sessions were run by students from universities of applied sciences. Women were reminded about healthy sunbathing habits with the “Skin tells stories” video and men with the “Holidy photos” video on social media. 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 is no longer able to meet this increasing demand, so in 2019 we began mole examination training for health professionals. A press conference was held together with the Radiation and Nuclear Safety Authority and the Finnish Meteorological Institute. The media was interested in sun safety issues and did several interviews about healthy behaviour in the sun. Aattelepaite.fi website The aattelepaite.fi website, which is geared to men, was devised on the basis of CSF studies concerning men. Several videos of interest to men have been produced for the site, tobacco, food, exercise, 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 humorously. 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-examination The campaign, aimed at young men aged 15-35, aims to raise awareness of 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. Materials and guidance on testicular self-examination have also been distributed at army recruitment events. Exercise The theme of the Cancer Week, held in May, was cancer and exercise. The aim was to encourage people with cancer to exercise more. The CSF and Cancer centres worked together on this theme. Cancer and physical activity was integrated into teaching and thesis work at universities of applied sciences. The CSF worked with the Finnish Heart Association, the Organisation for Respiratory Health in Finland, the Finnish Diabetes Association and the Finnish Brain Association to run training courses and other activities at local chapters to encourage physical activity. Efforts were made to organise the trainings remotely. The CSF is a member of the Finnish Adapted Physical Activity Federation (SoveLi) and the Age Institute. Reducing the use of alcohol and tobacco and nicotine products in adults More work was done with people already affected by 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. A specialist video was made available for use by hospitals. Tobacco and pregnancy The CSF was actively involved in efforts in various cities and provinces to reduce smoking during pregnancy. In 2020, nicotine-free pregnancy training was conducted in the South Karelia Social and Health Care District, and in previous years numerous training courses were conducted throughout Finland. The aim of the training is to increase knowledge and skills and to launch targeted activities in clinics to reduce smoking and the use of other nicotine products. A video, brochure, posters and a PowerPoint presentation were produced to assist the work of the clinics. Alcohol The Women and Alcohol website was launched. Three videos were made to raise awareness among women about their alcohol use. Alcohol issues were also addressed on the Aattelepa ite website. The CFS’s brochure on alcohol was distributed at various events. The cancer risk of alcohol was also addressed by various lectures on cancer prevention.