7.4 Healthy lifestyles and healthy nutrition
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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). Smoking and alcohol consumption are central issues of the National Cancer Plan 2020-2024 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 fight against nicotine addiction had already been addressed by the government in 2016 by the national tobacco plan (Plan National de Lutte contre le Tabagisme - PNLT 2016-2020). It was drafted by a 'tobacco working group' ('groupe tabac') composed of representatives of 17 ministries, administrations and agencies.
The four main objectives of the plan were 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 set 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 set quantitative objectives until 2020, aimed 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%.
The national tobacco plan was supposed to be evaluated regularly with regard to the implementation of the individual phases and also the achievement of the goals. However, no public evaluations are currently available.
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.
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 (2021-25)) and aims at increasing health protection, public security and social cohesion. The strategy relies on who policy areas, aiming at:
- Reducing drug supply
- Reducing drug demand.
Cross-cutting themes and corresponding strategic priorities are:
- Addressing drug related harm
- International cooperation
- Research, innovation and foresight
- Coordination, governance and implementation.
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) 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 2023 amounts to € 630 845).
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.
''Mission Non-Smoking' (Mission Nichtrauchen)' is an information campaign and school competition of the Fondation Cancer, which is part of the European programme 'Smokefree Class Competition'. The campaign aims at raising young people's awareness of the dangers and negative effects of smoking and to encourage school classes to take part in a competition in which they do not smoke for six months. 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. At the en of the no-smoking competition, the participating classes are invited to a joint celebration and rallye where they can win prizes.
Furthermore, the Fondation Cancer provides support to help people to stop smoking in the form of information leaflets and runs a helpline to offer consultation for interested people.
Due to increasing numbers of people who smoke, the Fondation Cancer launched a national strategy 'Generation without Tobacco' ('Generation sans tabac') in March 2023. The aim of the strategy is to enable children and young people to be the first generation to grow up in a tobacco-free environment by 2040. Six measures are at the heart of the strategy:
- significantly increase the price of tobacco and related products annually
- prevent young people from taking up smoking and conduct regular prevention campaigns
- prohibit all forms of advertising and misleading advertising
- reduce the availability of tobacco products
- to effectively protect the population from passive smoking
- promote smoking cessation and establish an effective cessation pathway.
Alcohol prevention campaigns usually target a general audience, but try to reach young people in particular through their visuality. The Fondation Cancer launched the Sober Buddy Challenge for the third time in 2023. Participants are asked to go without alcohol for the whole month of January, alone or with friends or family. The campaign is run mainly via a facebook page that provides both information and support. The Institute for Road Safety (Sécurité routière) regularly campaigns to raise awareness of the dangers of alcohol while driving. Some campaigns particularly targeted young people, e.g. Raoul or 'Chauffer fir den Owend', which called on young people to designate a driver in their group who would not drink alcohol that evening in order to be able to drive the others home.
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 National 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 National 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 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.
In its Competence Unit for pedagogical and technological innovation, the Coordination service for educational and technological research and innovation (SCRIPT; Service de Coordination de la Recherche et de l'Innovation pédagogiques et technologiques) 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, the Fondation Cancer, the positive pressure of peers is a main element explaining the success of this campaign.
With regard to sex education in schools, the 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) published a guide to young people's affective and sexual health for professionals in 2020, which was largely distributed in secondary schools. Since 2006, all secondary schools in Luxembourg distribute condoms at a reduced price and offer information sessions on sexual health for pupils. In 2023, the Ministry of Education, Children and Youth launched a campaign on 'My Menstruation - My Body' ('Meng Reegel - mäi Kierper'). In parallel tampon dispensers are installed in all secondary schools.
The project 'S-Team: get involved!' ('S-Team: Setz dech an') addresses all Luxembourg primary and secondary schools as well as childcare centres. The aim is to contribute to the improvement of living together and school climate by making children and young people aware of their role in preventing violence. It is provided by the National Youth Service in collaboration with 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) and the Psychosocial and Scholastic Assitance Centre (CePAS; Centre psycho-social et d'accompagnement scolaires). In project groups, children and young people will be encouraged to think about and carry out awareness-raising activities for their peers with the help of a support team. The project can be completed by a "peer-mediation" training for children or young people.
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: 7.4.2 Encouraging healthy lifestyles and healthy nutrition for young people).