7.6 Mechanisms of early detection and signposting of young people facing health risks
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With the help of the Act CXXXIV of 2012. on the suppression of underage smoking and on the retail trade of tobacco products (2012. évi CXXXIV. törvény), the government radically altered the structure of the tobacco market in Hungary by reallocating concessions of tobacco selling rights and introducing strict regulations on young people's access to tobacco.
Tobbacco Control in Hungary Programme
The since defunct Ministry of Human Capacities launched a programme called Tobbacco Control in Hungary (Dohányzás Visszaszorítása Magyarországon) which is a comprehensive prevention programme for pre-school and school-aged children. Their organisation is the Hungarian Focal Point for Tobacco Control (Dohányzás Fókuszpont). The aims of the organisation includes:
'Implementing smoking prevention activities targeting youth and working out prevention programmes, collecting best practices, preparing cadastres and advising programmes for education institutions. Developing methodologies of national dissemination and participating in the implementation of these.'
They have developed several programmes to make school-age youth aware of the importance of a healthy, smoke-free lifestyle. These include a gaming software, portable touchscreen computers (PTSC) and a homepage called 'Smoking is sticky' ('Ciki a cigi'), which contains information about the harmful effects of smoking. They also provide a smoking prevention guide, a training programme and an interactive tool pack that can be used free of charge in formal education in grades 3-5 and 6-10.
Smoking prevention programmes
According to Ministry information in 2022, in order to reduce smoking among young people, the Ministry of the Interior (Belügyminisztérium) operates and distributes complex prevention programmes at the national level (in kindergartens and schools) and supports the institutional smoking cessation system to further reduce the proportion of young people who smoke and are exposed to passive smoking.
The National Koranyi Institute of Pulmonology (Országos Korányi Pulmonológiai Intézet) coordinated the smoking prevention programmes in 2022, with the professional assistance of the Hungarian Focal Point for Tobacco Control.
In 2021, the Institute launched a campaign to encourage the Hungarian population, including young people, to quit smoking. The campaign had two pillars. One of them called 'Live with clean lungs' ('Élj tiszta tüdővel'), which was aimed mainly at the urban, health-conscious young and middle-aged adult smoking population. In the campaign, they introduced life situations that can be familiar to those who smoke regularly and they launched a website to provide information and support. The other campaign aimed at warning influenceable young people of the danger of nicotine addiction. The Institution published press releases, made citylight campaigns, made online advertisements and social media campaigns (HVG, 2021)
Use of alcohol
The Act CLV of 1997 on customer protection (Fogyasztóvédelemről szóló 1997. évi CLV. törvény) states that it is forbidden to sell or serve alcoholic beverages to persons under 18 years of age, except for medicines prescribed by a doctor.
Use of drugs
The distribution of designer drugs through dealers and efficient online channels could be seen as a more serious problem for which there is little empirical research on young people and on the general population. Their popularity is due to their relatively low prices and easy access. In socially excluded communities (among marginalised urban youth and young people in underprivileged rural communities), there is also a growing trend towards the use of homemade drugs.
Research among young people indicates an increase in the intensity of lifetime or monthly cannabis use. According to the Health Behaviour in School-aged Children 2018 survey, 15% of boys have tried cannabis once in his life (it was 12% in 2014) and 8% of them tried it in the last 30 days (it was 5% in 2014).
Prevention programmes in schools
The State Secretariat Responsible for Healthcare and the State Secretariat Responsible for Public Education launched a programme called 'Comprehensive health and mental development and addiction reducing programmes in schools' ('MDSZ, Projektek').
The overall aim of the programme is to reduce aggressive behaviour in schools and prevent addiction through training and physical, mental and methodological support for teachers. It consists of four sub-programmes and the Hungarian School Sport Federation (Magyar Diáksport Szövetség) is responsible for the implementation. The timeframe of the programme is 1 November 2021 - 30 June 2023.
One sub-programme is the 'Comprehensive health development in schools through prevention programmes' ('MDSZ, Projektek'). The aim is
- to develop the physical and mental health of students,
- to prevent behavioural addiction,
- to prevent substances addiction,
- to prevent bullying and school violence.
The European School Survey Project on Alcohol and Other Drugs (ESPAD)
ESPAD is a collaborative effort of independent research teams in more than 40 European countries and the world's largest cross-national research project on substance use among young people. The overall aim of the project is to repeatedly collect comparable data on substance use among 15-16 year old students in as many European countries as possible.
According to ESPAD2019, in Hungary the most common drug was cannabis. After cannabis, the most commonly used drugs are legal or partially legal. The second was the pharmaceuticals, mainly tranquillisers/ sedatives.
Education institutions and child protection
The links between public education institutions and the system of child protection are set out in the Act CXC of 2011 on National Public Education (2011. évi CXC. törvény a nemzeti köznevelésről) and in a government decision [20/2012. (VIII. 31.) EMMI rendelet].
The prevention and elimination of vulnerability is the responsibility of every teacher in the educational institution. Ensuring this activity is primarily the responsibility of the head of the institution, for which there is a law enabling the institution to employ a child and youth protection advocate to assist the school's educators in child and youth protection work. The job descriptions of the child and youth protection advocates, the rules of procedure for the tasks to be carried out and the activities of prevention, disadvantaged children and children at risk are also regulated in this resolution.
Definitions of vulnerability
Vulnerability, defined in the Act CLIV of 1997 on Health (1997. évi CLIV. törvény az egészségügyről), includes only the threat to the optimal maintenance of the state of health. It does not contain any indications of causes, situations, risk factors or their severity. Since the law does not specify the cases of cooperation and reporting obligations, it often happens that medical confidentiality is also used by professionals who are otherwise subject to the reporting obligation.
The Act C of 2012 on the Criminal Code (2012. évi C. törvény a Büntető Törvénykönyvről) contains the definition of juvenile risk for the police and the related measures. The act states that the purpose of the punishment or measure applied to juveniles is to ensure that the juvenile develops in the right direction and becomes a useful member of society, taking into account the education and protection of the juvenile when choosing the measure or punishment.
The Tobacco Control in Hungary Programme
The main coordinator of the Programme is the Hungarian Focal Point for Tobacco Control (Dohányzás Fókuszpont) and they are in cooperation with the local offices of the Government Agencies and the Health Promotion Offices (Egészségfejlesztési Irodák).
Guidance to stakeholders
The legislative framework for the implementation of school-based prevention programmes is defined by a government decision [20/2012. (VIII. 31.) EMMI rendelet]. According to the regulation, the aim of health promotion is to ensure, that every child has a full-time health promotion activity that is effective in everyday life of the educational institution, which effectively develops the well-being and health.
The decree also defines behavioural addictions and the prevention of the use of addictive substances as defined tasks, so that drug prevention activities can be implemented as an integral part of school health promotion. The provisions of the decree concerning the development of physical and mental health, behavioural addictions and prevention of the use of addictive substances have entered into force on 1 September 2013.
The Hungarian Police (Magyar Rendőrség) has several local and national drug prevention programmes. Members of the organisation regularly give:
- drug-prevention lectures from primary school to universities,
- advertise drawing competitions,
- host thematic forums nationwide.
In 2013, the main directions of the drug prevention activity within the organizational framework of the Hungarian Defence Forces (Honvédelmi Minisztérium - Magyar Honvédség) were set out in:
- the Parliament Decision no. 106/2009. (XII.21.) on the national strategic programme for the management of the drug problem (106/2009. (XII. 21.) OGY határozat a kábítószer-probléma kezelése érdekében készített nemzeti stratégiai programról), adopted the
- 'National Strategy for Solving the Drugs Problem' ('Nemzeti stratégia a kábítószer-probléma visszaszorítására'),
- the Drug Prevention Commettee of the Hungarian Defense Forces (a Magyar Honvédség Drogprevenciós Bizottsága).
Drug prevention in the Catching-up Settlements programme
The overall aim of the Catching-up Settlements programme (Felzárkózó települések program) is the social inclusion of disadvantaged settlements and people living there, with a focus on children and youth.
The programme has a comprehensive sub-programme on crime prevention, including drug prevention. They organize a complex drug prevention programme in schools where they provide information to disadvantaged children on addictions, drugs, alcohol and provide practices to healthy lifestyle and stress management. The programmes are implemented in the form of small working groups and not in frontal training ('Felzárkózó települések program - Bűnmegelőzés, drogprevenció').
In the frame of the programme, 10-12 addiction counsellors and 51 social workers were trained with the aim of teaching participants for the basic concepts of addictions in an interactive way. (For general information on the programme, see sub-chapter 4.3 Strategy for the social inclusion of young people.)
Hungarian National Focal Point
The Hungarian National Focal Point (NFP) (Drog Fókuszpont) is the national agency of the European drug information network. The NFP develops the national drug information system which has to be able to supply objective and reliable data to the professional and political decisions, arrangements and programmes according to the international standards. Their activity includes data collection on prevention activities in Hungary, also on 'selective prevention', which means specific sub-populations who is in higher risk than the average, such as young offenders, school drop-outs or students who have learning difficulties.
Drug Coordination Forums
According to the 2022 annual report of the Hungarian National Focal Point the Drug Coordination Forums [Kábítószerügyi Egyeztető Fórumok (KEF)] play an important role in the implementation of drug policy and consist of local-level professional consultation work groups that were created by local authorities and local professional collaborations. The members of the Drug Coordination Forums are representatives of state, municipal, NGO and church organizations that are active in the management of the drug problem
The forums aimed at handling the drug problem locally and to perform and participate in drug prevention activities such as interactive education programmes, theater productions for youth on drug prevention.
Currently, there are 135 KEF operating in Hungary, with capital, town, district, small region, county or regional competence. The members of the Drug Coordination Forums are representatives of state, municipal, NGO and church organizations that are active in the management of the drug problem (Hungarian National Focal Point, 2022).
Preventing addiction in child protection institutions
According to Ministry information in 2022, the responsible Ministry launched a pilot project in 2021 in cooperation with the National Association of Addiction Consultants (Addiktológiai Konzultánsok Országos Egyesülete). The aim is to support professional workers in child protection institutions to handle addiction problems of children and to raise health awareness. The development of emotional intelligence, social skills and coping strategies are also important in the project.
Church-based and civil spheres
Many actors in the church-based and civil spheres focus on young people with drugs, alcohol or other mental illness. Some of the most important organizations are the following:
- RÉV Addicts Assistant Service (RÉV Szenvedélybeteg-segítő Szolgálat)
- Blue Point Drug Counselling Centre and Drug Therapy Foundation (Kék Pont Drogkonzultációs Központ és Drogambulancia Alapítvány).
The church-based maintained RÉV Addicts Assistant Service (RÉV Szenvedélybeteg-segítő Szolgálat) helps those affected to free themselves from addiction and their relatives and environment to support the addict in recovery. Alcohol, drug, gambling, drug addiction, eating disorders and similar struggles and problems are treated by qualified social workers, psychiatrists, psychologists, chaplains or patients who have already recovered.
The Blue Point Drug Counselling Centre and Drug Therapy Foundation (Kék Pont Drogkonzultációs Központ és Drogambulancia Alapítvány) has been a public benefit organization since 1997. The aim is to prevent, treat and reduce the problems caused by addiction for the individual, the family and society. It currently operates two outpatient clinics in Budapest. In these two areas, the teams usually consist of social workers, addiction counsellors, doctors, psychologists, sociologists, lawyers and communication specialists as well as volunteers.
Vulnerable groups associated with institutions: school drop-outs and school children, children in childcare institutions and juvenile offenders, as well as vulnerable groups in communities such as families at risk, homeless youth, young people in disadvantaged neighbourhoods and minorities, especially Roma youth.
Food-related illnesses are treated as priorities in the budget. The objective of the Act CIII of 2011 on Public Health Product Tax. Act (a népegészségügyi termékadóról szóló 2011. évi CIII. törvény) is to impose special taxes on food products with high sugar, salt and certain methyl-xanthine (such as caffeine) content. The aim of the measure is to promote healthy nutrition, to encourage food industry to produce products with more favourable composition, and to improve healthcare services and public health programs. The collected tax provides funding for the National Health Insurance Fund (Egészségbiztosítási Alap).