Prevention of adolescent smoking: A prospective test of three models of intervention

Abstract

Objective: The onset of smoking in adolescence leads to significant health problems in later life and so adolescent smoking prevention is a crucial concern of health psychology. Yet the evidence on smoking prevention in adolescence is not encouraging. The objective of this study was to examine the relative long-term efficacy of three specifically focussed prevention strategies (health-oriented, fitness-oriented and social skills/stress management-oriented) directed at the onset of adolescent smoking. Design: A longitudinal intervention study.Method: A large sample of adolescents aged 11-17 years was assessed for smoking behaviour and then assigned through group randomization to one of the three intervention programmes listed above. Following intervention, based on four standard classroom sessions, smoking behaviour was then reassessed immediately after intervention. Final follow-up of smoking behaviour at 12 months after intake yielded completed data for n51,694 (62.3%) of the intake cohort. Data on smoking behaviour were then compared both across intervention strategies and with another large ''control'' cohort of adolescents who had been identically assessed in a previous study by DGB. Results: Application of a health-oriented strategy was significantly better than the other two strategies in controlling smoking behaviour immediately following intervention. The intervention strategy emphasizing social skills and stress management in the face of peer pressure to smoke was, however, superior to either the health-or fitness-oriented strategies, or to the ''control'' group in controlling smoking behaviour at 12-month follow-up. Conclusions: While the health message cannot be dismissed as a focus for adolescent smoking prevention, a strategy that assists young people to resist the effects of peer pressure through social skills and stress management seems to provide the most enduring means of controlling smoking behaviour in adolescence.

Smoking and Cardiovascular Risk: Role of Personality in Adolescent Smoking

“…The efficacy literature is more consistent with evidence that global self-efficacy influences onset (Otten et al 2011a). Specifically, the protective effect of refusal selfefficacy interventions has been shown in studies of association (Islam and Johnson 2005;Nebot et al 2005) and in retarding onset (Bruvold 1993;Byrne and Mazanov 2005). Self-efficacy also seems to influence the readiness to change smoking status (Stephens et al 2004) perhaps as a function of cessation (increased self-efficacy and quitting; Etter et al 2000a).…”

The role of stress and area‐specific self‐esteem in adolescent smoking

“…Lastly, many smoking prevention and intervention initiatives have focused on stress management (Byrne & Mazanov, ; Daubenmier et al., ; Sussman, Dent, & Lichtman, ). However, this study indicates that low stress is only likely to decrease smoking risk to the extent that it increases school self‐esteem.…”

“Do you intend to smoke?”: A test of the assumed psychological equivalence in adolescent smoker and nonsmoker intention to change smoking behaviour

“…This indicates that asking nonsmokers about their intentions in relation to smoking behaviour is a good indicator of abstinence and a poor indicator of change. Prevention efforts on the majority of adolescent nonsmokers may be wasted because they are unlikely to take up smoking anyway, and a different way needs to be found to identify the 5% who do (e.g., Byrne & Mazanov, 2003, 2005.…”

“…These two levels of evidence are tested using data from a 12-month longitudinal study on adolescent smoking in Australia. The variables included in the study reflect those found to be effective descriptors of differences between adolescent nonsmokers and smokers and predictors of change in adolescent smoking behaviour, largely following Byrne and Mazanov (1999, 2005 and Mazanov and Byrne (2002). These include demographic (e.g., age, gender, year at school and parental education), smoking of significant others (e.g., parents, best friends and peer group) and psychosocial variables (e.g., self-esteem, neuroticism, coping, stress and risk taking).…”