Meta-Analysis on the Effects of the Smoke-Free Class Competition on Smoking Prevention in Adolescents

Abstract

Background: The ‘Smoke-Free Class competition’ (SFC) is a school-based smoking prevention programme including commitment not to smoke, contract management and prizes as rewards broadly implemented in Europe. Objectives: To meta-analyse (randomised) controlled trials on the effects of SFC on current smoking at latest follow-up in adolescents. Methods: A systematic review of articles using MEDLINE and the Cochrane Library was conducted. The study selection included randomised controlled trials and controlled trials with follow-up assessment that investigated the efficacy of SFC on current smoking in students participating in SFC compared to non-participating students. Independent extraction of articles was performed by both authors. Results: Of 24 records identified, five fulfilled the inclusion criteria. These studies were conducted in three European countries (Finland, The Netherlands and Germany) and recruited 16,302 students altogether. A random effects meta-analysis of these five studies revealed a pooled risk ratio of 0.86 (95% CI 0.79–0.94; z = 3.44, p = 0.001) on current smoking at follow-up by participation in the competition. Conclusion: SFC appears to be an effective tool in school-based smoking prevention.

Does It Matter What Friends Think, Say, or Do? The Role of Friends’ Smoking Attitudes and Behavior for Dutch Adolescents’ Smoking Behavior

“…What friends they think or say seems to be more important than compared to what they do as pointed out in various other studies. This finding has implications for smoking prevention programs which only have meager and temporal effect (Isensee & Hanewinkel, 2012). The findings of this study suggest that it is of relevance what friends think, believe, and talk about in addition what they do.…”

Consumo de cigarrillo tradicional en adolescentes: un grave problema de Salud Pública. Medidas efectivas para su prevención

“…in Adolescents se evaluó un programa escolar de prevención del tabaquismo que incluye el compromiso de no fumar, la gestión de acuerdos y los premios como recompensas ampliamente implementadas en Europa 4 . Este programa parece ser una herramienta eficaz en la prevención del tabaquismo en las escuelas 4 .…”

“…Este programa parece ser una herramienta eficaz en la prevención del tabaquismo en las escuelas 4 . Se conceptualiza para la implementación en las escuelas orientado en los alumnos de 11-14 años.…”

“…Los estudiantes en estas clases informan regularmente sobre si han fumado o no. Al final del período de competencia, las clases exitosas pueden ganar premios atractivos en una lotería 4 .…”

Short-Term Effects of a Home-Based Smoking Prevention Program on Antismoking Socialization and Smoking-Related Cognitions: A Cluster Randomized Controlled Trial

“…However, the effectiveness of a nonsmoking agreement is less clear. Some studies find a lower risk for smoking onset and lower regular smoking rates [20,29,30]; others find no effect of a nonsmoking agreement [14,25,31]. The availability of cigarettes is also associated with smoking onset [32,33].…”