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There are different strategies or plans that focus on specific health issues (e.g. tobacco use, drug abuse, emotional and sexual health, healthy nutrition). The national tobacco plan (Plan National de Lutte contre le Tabagisme - PNLT 2016-2020) is the national action plan that aims at reducing tobacco consumption. It was drafted by a 'tobacco working group' ('groupe tabac') composed of representatives of 17 ministries, administrations and agencies. The tobacco plan was launched in 2016 under the authority of the ministry of Health. Specific actions of the plan will be funded by a health fund (Fonds pour la Santé), which is going to be established in the near future. The four main objectives of the plan are to:
- Provide the public with a favourable environment for preventing smoking and achieving a long-term smoking cessation
- Protect young people and prevent tobacco use
- Help people who want to quit smoking to wean themselves from tobacco on a long-term basis
- Reduce morbidity and premature mortality related to smoking.
With regard to the protection of young people, the plan defines specific objectives:
- Raising awareness and motivate young people not to smoke
- Reducing the demand for tobacco of young people
- Denormalising the image of the smoker
- Making tobacco products less attractive and less accessible
- Regulating electronic vaporization devices
- Increasing price and improve tax policy on tobacco products.
The scheme also sets quantitative objectives until 2020, aiming to:
- Reduce smoking in people between 15 and 17 years of age from 17% (2014) to 10%
- Reduce smoking in people between 18 and 24 years of age from 24% (2014) to 20%
- Reduce smoking in people between 25 and 34 years of age from 29% (2014) to 25%
- Reduce the use of hookah in youth between 15 and 24 years of age to under 3%.
Professionals (teachers, youth workers, trainers) are an important target group of the national tobacco plan. The actions defined in the plan aim at increasing the awareness of education professionals with regard to their role as promotors of health issues, training in 'tabacology' (a relatively new academic discipline, originating from France and Belgium, that focuses on mechanisms of tobacco use and cessation) and teaching tabacology in technical secondary education.
The related actions are implemented by different administrations and organisations such as the Ligue Médico-Sociale, the Centre for the Prevention of Substance Abuse (CePT; Centre de Prévention des Toxicomanies) and the Fondation Cancer. A national alcohol plan (PALMA, Plan d’Action Luxembourgeois de réduction du Mésusage de l’Alcool) was launched in 2020. The plan reflects three priorities, aiming to:
- Reduce the misuse of alcohol and its harmful effects in Luxembourg
- Create favourable environments enabling the population to adopt healthy and reasonable alcohol consumption at any age of life, by protecting young people in particular
- Organise coordinated therapeutic and rehabilitative care for people with alcohol misuse, while providing support for their relatives and friends.
The expected effects of the plan in the medium and long term are as follows:
- Reducing alcohol-related morbidity and mortality
- Reducing the societal impacts related to alcohol misuse
- Developing a joint responsibility of the public authority and civil society to prevent alcohol misuse.
Smoking and alcohol consumption are central issues of the Plan National Cancer Luxembourg. This plan aims at reducing smoking among young people under 30 years of age and introducing prevention measures focusing on preventing alcoholism in adolescents. It was elaborated in joint collaboration of the ministry of Health and other relevant organisations and administrations. The 2020-2024 national action plan on drugs and drugs addiction (Stratégie nationale en matière d’addictions et plan d’action gouvernemental 2020–2024 en matière de drogues d’acquisition illicite et de leurs corollaires) is a national policy strategy on drug addictions. It is oriented towards the strategy on the European level (EU Drugs Strategy (2013-20), EU Action Plan on Drugs 2017-2020) and aims at increasing health protection, public security and social cohesion. The strategy relies on six fields of action, aiming at:
- Reducing the demand for drugs
- Reducing the offer of drugs
- Reducing the risks, harm and nuisances associated with drug use
- Providing information, research and evaluation
- Fostering international relations
- Establishing mechanisms of coordination.
With regard to emotional and sexual health, a national action plan on emotional and sexual health was elaborated and implemented by the different ministries, namely the ministry of Education, Children and Youth, the ministry of Equal Opportunities, the ministry of Family Affairs, Integration and the Greater Region, and the ministry of Health. The action plan mainly addresses children and young people and aims to achieve the following objectives:
- Developing respect and personal integrity
- Accepting particularities of genders
- Recognising the right to one's identity and sexual orientation, pleasure, intimacy and reproduction
- Preventing unwanted pregnancies, sexually transmitted diseases and sexual abuse.
For this purpose, the plan focuses on five fields of action:
- Good governance
- Information, sensitisation and education on emotional and sexual health
- Improvement of skills
- Equal access for everybody: diversification and sustainability of the offers
The responsible public authorities are the ministry of Health, the ministry of Equal Opportunities, the ministry of Education, Children and Youth and the ministry of Family, Integration and the Greater Region. Sexual education of young people in formal (schools) and non-formal (e.g. youth centres) education settings are important elements of the action plan.
In order to reach the objectives of the national programme and action plan, a National Reference Centre for the Promotion of Emotional and Sexual Health (Cesas; Centre national de référence pour la promotion de la santé affective et sexuelle « Cesas ») was created in 2017. This centre is a platform for compiling, harmonising and creating networks of national contacts, skills and expertise on the subject of sexuality in Luxembourg. In this sense, the centre will invest into spreading awareness and information and responding to individuals and groups according to their situation. The promotion of emotional and sexual health also extends to other sectors of life for general well-being. Children and young people are the main targets of this new centre and programme, with talks to be given in schools and educational materials on the subject to be available at school libraries (the budget for 2017 amounts to € 140 000).
Promotion of healthy lifestyles and healthy nutrition is a main objective of the National Action Plan of healthy eating and physical exercise (GIMB; Gesond iessen, méi bewegen) (see: 7.3 Sport, youth fitness and physical activity).
There are several projects and initiatives encouraging healthy lifestyles and healthy nutrition for young people. They range from more general information offers to specific campaigns, and most of them are part of the national strategies or action plans (see: National strategies). The youth magazine 'Den Insider' is published quarterly by the Fondation Cancer and deals with various health issues (such as healthy nutrition, sports, smoking, self-confidence, cancer, etc.). It is an important resource offered to young people to inform and encourage them about healthy lifestyles and healthy nutrition. 'Be smart, don't start' is an information campaign of the Fondation Cancer which informs young people about the dangers and negative effects of smoking. The Fondation Cancer provides interested persons and institutions with posters, leaflets and stickers to promote the message of the campaign and provide further information on the effects of smoking. The Fondation Cancer distributes information brochures on the negative effects of smoking ('I am smokefree') or provides support to help people to stop smoking in the form of a brochure ('Tabac-Stop') and also a helpline to advise interested people. The prevention week on alcohol consumption ('Alcohol? Less is better!') is a prevention campaign which was first organised in 2017 by the ministry of Health, together with the ministry of Sustainable Development and Infrastructure, and the Institute for Road Safety (Sécurité Routière). This prevention campaign is primarily based on citizenship and self-help. The core element of the campaign is the engagement of volunteers who spread the core statements of the week of action: in pedestrian zones and shopping malls, in their schools, in the workplace, during sporting or youth events, etc.. Their purpose is to inform about alcohol and stimulate discussions about alcohol consumption. The main issue of the 2019 edition was alcohol consumption at work. The nationwide campaign 'No alcohol under 16 years – We adhere!' (Keen Alkohol ënner 16 Joer – Mir halen eis drun!) was launched in 2007 by the Centre for the Prevention of Substance Abuse together with the ministry of Health. The campaign addresses all adults with the goal of sensitising them to behave responsibly with regard to alcohol, especially in the context of the healthy development of children and adolescents. The aim is to create a stronger awareness of the importance of the issue especially with regard to the sale of alcohol (in supermarkets, gas stations, bars, or festivities) to young people under the age of 16 (since 2006, the sale of or offering alcoholic beverages to minors under 16 years of age is prohibited). The campaign also provides stimulus materials and discussion material for youth workers and parents so that they can contribute to the implementation of the campaign. The Centre for the Prevention of Substance Abuse runs the service 'FRO NO' which provides information on psychotropic substances and aid or consultation institutions in Luxembourg both online and by phone. The 'Trampolin' service provides initial and continuing training courses for social, educational, psychological and medical professionals on addiction and addiction prevention.
The 'goodfoodloop' is an initiative of the National Youth Service. Its webpage www.goodfoodloop.lu contains healthy recipes and tutorials on freestyle sports.
The medical care at schools (médecine scolaire) is in charge of the supervision and promotion of health and well-being of children and adolescents in schools. It is provided by medical-socio-school teams which must be accredited by the minister of Health. The division of medical care at school, the health of children and adolescents is responsible for organisational issues in secondary education. The medical care at school is in charge of screening for diseases and deficits, including oral diseases, by establishing health check-ups on a regular basis.
The Competence Unit for Pedagogical and Technological Innovation (SCRIPT-INNO; Cellule de compétence pour l’innovation pédagogique et technologique) coordinates several activities in the field of youth health and well-being in schools (classroom interventions, projects, campaigns, national studies, conferences, etc.). Its activities in schools encompass the following topics:
- School climate and school culture
- Emotional and sexual education
- Nutrition and the promotion of physical activity
- Prevention of drug abuse.
The Fondation Cancer organises the campaign 'Mission non-smoking' in schools, which is implemented as a smoke-free class competition. Pupils of the participating school classes commit to not smoking over a period of six months, and those who succeed are invited to a final event. According to the organiser, Fondation Cancer, the positive pressure of peers is a main element explaining the success of this campaign.
With regard to sex education in schools, since 2006, all secondary schools in Luxembourg distribute condoms at a reduced price and offer information sessions on sexual health for pupils.
The project 'Peer-mediation in daily school life' addresses all Luxembourg primary and secondary schools interested in integrating peer mediation as a core element in the overall process of school (climate) development and prevention measures. It is provided by the National Youth Service and the coordinating service for educational and technological research and innovation (SCRIPT; Service de la Coordination de la Recherche et de l'Innovation pédagogiques et technologiques). The target group is the whole school community (teachers, educators, administrative staff, parents, and pupils) but especially pupils.
The different policy strategies and action plans are developed and implemented in close cooperation of the involved ministries, administrations and organisations.
Raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people
Raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people is promoted by initiatives and campaigns encouraging healthy lifestyles (see: Encouraging healthy lifestyles and healthy nutrition for young people).