Long-term effectiveness of behavioural interventions to prevent smoking among children and youth

Abstract

Objectives: To evaluate the long-term effectiveness of recent behavioural interventions in the prevention of cigarette use among children and youth and to compare the effectiveness of different school-based, communitybased and multisectorial intervention strategies. Methods: A structured search of databases and a manual search of reference lists was conducted. Randomised controlled trials published in English or German between August 2001 and August 2006 targeting youths up to 18 years of age were assessed independently by two researchers according to predefined inclusion criteria and with regard to methodological quality. Data abstraction was performed and crosschecked by two researchers. Where appropriate, pooled effect estimates were calculated and tested in sensitivity analyses. Results: Of 3555 articles, 35 studies met the inclusion criteria. The follow-up duration ranged from 12 months to 120 months. Although the overall effectiveness of prevention programs showed considerable heterogeneity, the majority of studies reported some positive long-term effects for behavioural smoking prevention programs. There was evidence that community-based and multisectorial interventions were effective in reducing smoking rates; in contrast, the evidence for school-based programs alone was inconclusive. Regardless of the type of intervention, the reductions observed in smoking rates were only modest. Conclusions: The present work identified moderate evidence for the effectiveness of behavioural interventions to prevent smoking. Although evidence for the effectiveness of school-based interventions was inconclusive, evidence for the effectiveness of community-based and multisectorial interventions was somewhat stronger. Future research should investigate the effectiveness of specific intervention components and the cost-effectiveness of interventions analysed in methodologically highquality studies.The hazardous health effects of smoking and second-hand smoke are well known and have been confirmed in numerous studies. In industrialised countries, tobacco smoke is the single most common preventable risk factor for many chronic and potentially life-threatening conditions, such as respiratory, cardiovascular and malignant disease.

Long-Term Effects of the Life Skills Program IPSY on Substance Use: Results of a 4.5-Year Longitudinal Study

“…For example, reviewing 56 RCTs, Foxcroft et al (2003) found only limited evidence for long-term effects (>3 years) of adolescent alcohol prevention programs, among them Life Skills programs. Similarly, based on 35 evaluation studies on youth tobacco prevention programs with follow-ups conducted 12 to 120 months after baseline assessment, Müller-Riemenschneider et al (2008) identified only moderate evidence that behavioral interventions affected smoking. For interventions within the school context, evidence was inconclusive.…”

Estimates of effectiveness and reach for ‘return on investment’ modelling of smoking cessation interventions using data from England

“…26) or smokers with substance use disorders (because of lack of evidence for differential effectiveness); (2) outcomes other than overall effect sizes (e.g. health inequalities 27, 28); (3) particular behavioural techniques, such as motivational interviewing 29; and (4) smoking initiation 30.…”

Assess the Impact of an Online Tobacco Prevention Training Program on Teachers and Their Students

“…Critical reviews on youth smoking prevention programs indicated that school-based tobacco prevention interventions are effective in improving knowledge level, reducing smoking initiation and continuation in the short term (Baska, Straka, Baskova, & Madar, 2004;Dobbins, Decorby, Manske, & Goldblatt, 2008;Fray, 2009;Muller-Riemenschneider, Bockelbrink, Reinhold, Rasch, Greiner, & Willich, 2008;Peterson, Kealey, Mann, Marek, & Sarason, 2000;Skara & Sussman, 2003;Wiehe, Garrison, Christakis, Ebel, & Rivara, 2005). The researchers also found the intervention effectiveness has not been maintained for more than 3 years post-intervention and suggested continuous implementation of school-based tobacco prevention interventions (Dobbins et al, 2008).…”