Large scale health promotion programmes using this approach are currently being attempted in at least six countries So far successes in modification of smoking using both the media and skills training have been reported from North Karelia in Finland and Stanford University in California In Finland, after a study carried out over five years, reductions in smoking prevalence from around 50% to 40/' occurred in a test community, but these were confounded by major national legislative changes which contributed to similar reductions in a control community. There was, however, a net absolute reduction of around 9% in the numbers of cigarettes smoked in the test community duringthetrialperiod.