A prescription for health: a primary care based intervention to maintain the non-smoking status of young people
Wendy Fidlera, Trevor W Lambertb
a Keith Durrant
Project for Cancer Prevention, Mental Health Centre, Oxford, UK, b Department of Public Health,
University of Oxford
Correspondence to: Wendy Fidler, Keith Durrant Project for Cancer Prevention, Mental Health Centre, Sandford Road, Littlemore, Oxford OX4 4XN, UK; wendyfidler{at}compuserve.com
Received 16 December
1999; Revision received 11 July 2000;
Accepted 12 July 2000
OBJECTIVES
To evaluate
the effectiveness of primary health care teams in maintaining a group
of young people aged 10-15 years as non-smokers.
DESIGNRandomised
controlled trial using postal questionnaires.
SETTINGOxfordshire, UK.
SUBJECTS2942 young
people who were initially self declared non-smokers.
INTERVENTIONInformation
about smoking, sent under signature of the subject's general
practitioner, certificates and posters intended to reinforce
non-smoking behaviour.
MAIN OUTCOME
MEASURESChanges in smoking behaviour, attitudes
measured after one year.
RESULTSAfter a year,
smoking uptake was 7.8% in the control group compared with 5.1% in
the intervention group (odds ratio (OR) 1.6, 95% confidence interval
(CI) 1.1 to 2.2). Among boys the corresponding results were 5.2% and
2.4% (OR 2.3, 95% CI 1.2 to 4.6), and among girls 10.0% and 7.5%
(OR 1.4, 95% CI 0.9 to 2.1). Among boys aged 14-15 the uptake rate
was 12.8% in the control group compared with 5.4% in the intervention
group. However, among girls of the same age the intervention was less
effective, with smoking uptake of 15.1% in the control group and
12.8% in the intervention group. The intervention was more effective
among young people whose initial attitudes identified them as definite
non-smokers than those who were potential smokers.
CONCLUSIONSThe
intervention substantially reduced smoking uptake among the young
people, particularly boys. Primary health care teams can play an
important role in maintaining the non-smoking status of their young
patients. Confidential postal contact from the doctor direct to the
young person at home is influential and cost-effective.
Keywords: smoking initiation; smoking prevention; young people; primary care
© 2001 by Tobacco Control
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