[German Network for Tobacco-Free Hospitals & Health-Care Services]. / Das Deutsche Netz Rauchfreier Krankenhäuser & Gesundheits-einrichtungen (DNRfK).

The DNRfK (German Network for Tobacco-Free Hospitals & Health-Care Services) is based on the Code of the ENSH-Global Network for Tobacco-Free Health-Care Services. To evaluate the project, a total survey of network members using an online questionnaire (78 items) was carried out (n=181; 67.4% response rate). At the time of the recording period, 17% achieved the silver level of certification, 43% the bronze level and 40% had not been certified. Various smoking cessation methods are offered (motivational interviewing, 47%; brief interventions, 45%; individual counselling, 45%). Smokers received pharmacological support in 63% of the hospitals. Smoking cessation services are mainly carried out by physicians (63%), nursing staff (51%) and psychologists (51%). Guideline-oriented smoking cessation is offered by 36% of participants (69% silver level, 33% bronze level, and 32% in clinics without certification). The Code has been widely accepted and, consequently, well implemented by members. The quality of the tobacco control measures and evidence-based smoking cessation treatments increases with duration of membership and certification level or is validated through this. Some deficiencies were found with respect to training-the-trainer qualifications and follow-up measurements.

[From smoke-free to smoke-free PLUS. Why a ban on smoking in health facilities alone is not enough]. / Von Rauchfrei zu rauchfrei PLUS. Warum Rauchverbote allein in Gesundheitseinrichtungen nicht ausreichen.

"Smoke-free hospitals" are--at least in the public's perception--regarded as a matter of course since the laws to protect non-smokers came into effect. A professional understanding of addictive diseases treatment and clinical practice indicates that healthcare services must offer more than bans to fulfill their responsibilities. They must also systematically integrate smoking cessation, motivation, and counselling in their treatment program. In a pilot project, the Federal Ministry of Health supported the development of a "Network of Smoke-free Hospitals and Healthcare Services", so that these requirements could be achieved by silver-certified facilities on the basis of European standards.

[Women and smoking. A challenge for the tobacco control policy in Germany]. / Frauen und Rauchen. Herausforderung für die Tabakkontrollpolitik in Deutschland.

In Germany, smoking rates among women have been slightly declining since 2003. However, smoking rates among young women and girls are high and are reaching the smoking rates of their male counterparts. Only about half of pregnant smokers below the age of 25 stop smoking. Women and girls with low education and low level jobs, those who are unemployed, as well as single parents have the highest smoking rates. The tobacco industry promotes smoking behavior of women and girls through marketing campaigns, thus, systematically counteracting smoking prevention activities. Within the framework of the annual conference 2008 of the Federal Drug Commissioner on the theme of "Women and Smoking", recommendations for a gender-specific tobacco control policy in Germany were developed. The main demands relate to the necessity of a targeted policy approach which takes into account the needs and life circumstances of women and girls, the development of integrated prevention programs for pregnant women, improved medical and preventive care, the involvement of women from the media and culture, from health professions and politics to promote a smoke-free culture, gender-specific research, and the improvement of tobacco control legislation. FACT (Frauen aktiv contra Tabak e.V.) actively supports the implementation of these policy recommendations.