28:T432,

When comparing health administrative areas in Sweden the variation in death rates for 13 suggested indicators of avoidable mortality was analysed for the time periods 1974–79 and 1980–85. For most indicators the variation was significant. The level of systematic (nonrandom) variance differed between the sexes for certain conditions.

According to the theory of mass-significance it would be appropriate to use a sharpened significance test of high SMRs. For certain health policy indicators it was possible to detect areas accounting for nearly all the deviation above the national standard using a sharpened test (p < 0.001). For most medical care indicators, however, the high death rates had a lower level of significance. When sensitivity is given priority an ordinary test (p < 0.05) should be preferred. This means, however, dealing with potential false positive warning signals. Epidemiological surveillance of indicators of avoidable mortality should be the starting point for in-depth studies.

29:T43e,

The purpose of the study was to test the applicability of the modernization framework to changes and regional diversity in adolescent smoking. A biannual cross-sectional survey data from the Adolescent Health and Lifestyle Survey was used. A national sample of 14, 16- and 18-year-old Finns answered a mailed questionnaire every other year from 1977. The 1977, 1979 and 1981 data were pooled as were data from 1983 and 1985 (N = 8505, 9777). The 1987 sample was weighted in accordance with the province size (N = 11 374). Modernization trends found in the literature were apparent among adolescent smokers between 1977 and 1987. The use of hand-rolled cigarettes nearly stopped when the use of manufactured cigarettes increased. The use of low-tar cigarettes increased and that of other tobacco types decreased. Regional differences in tobacco types were associated with the structural modernization level of the regions. Snuff use was most prevalent in the most modern and the most traditional regions. The modernization framework proved useful in explaining changes in smoking.

2a:T496,

Smoking cessation is difficult to obtain, even among pregnant women who should be highly motivated to quit. Identification of predictors of unsuccessful smoking cessation may be of help in identifying pregnant smokers who need special attention in order to reduce or eliminate the intrauterine tobacco smoke exposure.

The study was done in two consequtive samples of pregnant women in Odense and Aalborg, Denmark. Altogether 13815 pregnant women participated in the study by reporting detailed information on their lifestyle during pregnancy and before pregnancy. Recruitment of pregnant women started in 1984 and ended in 1987. The study is based upon self-administered questionnaires filled out in the 36th week of gestation. Only those who were smokers prior to the pregnancy are included in the study (5724).

The study showed that the strongest predictors of unsuccessful smoking cessation were: the level of smoking prior to pregnancy, coffee consumption, and the partners smoking habits. Parity, school education, and social status also played a role but were less strongly associated with continous smoking in pregnancy.

2b:T458,

Sex education has been a requirement in Swedish schools for the past 30 years. The purpose of the study was to describe the opinions of 17- and 18-year-old Swedish students at the upper secondary school regarding the sex education they received at school as well as their knowledge about the anatomy and physiology of reproduction. A questionnaire concerning education about sex and relationships was answered by 421 students. The results of questions regarding human reproduction illustrated that the students have insufficient knowledge about men's and women's reproductive organs. Two-thirds of the students who had received sex education thought the instructions were insufficient. The students wanted to talk more about po