ReviewEffective practices for school-based tobacco use prevention
Introduction
Tobacco use is the leading cause of preventable death (Department of Health and Human Services, 2004, Office on Smoking and Health, 2001) killing 50% of all lifetime users (Mackay and Eriksen, 2002) and has been clearly established as the cause of numerous cancers and chronic diseases (Kuper et al., 2002)(Department of Health and Human Services, 2004). Since roughly 90% of regular adult users start smoking prior to age 18 (American Lung Association, 2006), it is essential to target young people with prevention efforts. The decreasing age of tobacco initiation is concerning because those who start smoking before 18 years of age more likely to become established heavy users and are less likely to be able to quit (Kuper et al., 2002).
In the United States, the 2005 National Survey on Drug Use and Health found that 2.4% of 12 or 13 year olds, 9% of 14 or 15 year olds, and 21% of 16 or 17 year olds were current smokers (Substance Abuse and Mental Health Services Administration, 2006). Similar rates have been reported in Canada (Health Canada, 2005). Public health efforts need to be directed at promoting smoking prevention among children and youth (Kuper et al., 2002). The purpose of this research is to evaluate the effectiveness of school-based tobacco use prevention strategies for preventing tobacco use in children and youth.
Section snippets
Methods
A search for systematic reviews and meta-analyses was undertaken. The literature review was accompanied by in-depth interviews and a focus group conducted with a sample of Canadian decision makers in tobacco use prevention programming.
Description of included reviews
This review represents primary studies published between 1970 and 2007. The search strategy identified 10,163 titles. Of those, 92 were judged to be potentially relevant and assessed for relevance. Of these, 31 were judged as relevant. The most common reason reviews were judged not relevant was that the intervention was not focused on tobacco use prevention and/or was not school based.
Interventions were delivered in elementary and high schools, with some activities conducted in communities and
Discussion
Overall, findings from each of the three data sources consistently demonstrated that school-based tobacco use prevention interventions are effective in reducing smoking behavior, initiation, and intention to smoke, at least in the short term. However, these effects were not maintained until age 18 in the absence of ongoing intervention. There is sufficient evidence at this time to recommend ongoing implementation of school-based tobacco use prevention interventions as a means of preventing
Conclusions
Triangulation of the scientific published literature and the opinions of experts demonstrated the effectiveness of tobacco use prevention. Generally, there is reason for optimism regarding the effectiveness of prevention programs on smoking behavior and initiation, albeit in the short term. Although there are still a number of unanswered questions, convincing evidence indicates that multi-faceted and comprehensive programs are effective at reducing youth smoking initiation rates and overall
Acknowledgments
This research was funded by the Canadian Tobacco Control Research Initiative in partnership with the Social Sciences and Humanities Research Council. At the time of this work, the primary author held a postdoctoral fellowship from the Canadian Health Services Research Foundation and currently holds an Ontario Ministry of Health and Long-Term Care Career Scientist Award. Manske's involvement was supported by the Centre for Behavioural Research and Program Evaluation, a national program of the
References (48)
Preventing drug abuse in schools: Social and competence enhancement approaches targeting individual-level etiologic factors
Addict. Behav.
(2000)- et al.
Intervention and policy issues related to children's exposure to environmental tobacco smoke
Prev. Med.
(2001) Approaches to substance use prevention utilizing school curriculum plus environment change
Addict. Behav.
(2000)- et al.
Smoking cessation interventions for adolescents
Am. J. Prev. Med.
(2003) - et al.
Adolescent smoking: a review of prevalence and prevention
J. Adolesc. Health
(1989) - et al.
A review of 25 long-term adolescent tobacco and other drug use prevention program evaluations
Prev. Med.
(2003) - et al.
A critique of progress in adolescent smoking prevention
Child. Youth Serv. Rev.
(1985) - et al.
A systematic review of school-based smoking prevention trials with long-term follow-up
J. Adolesc. Health
(2005) - et al.
The effectiveness of policy and health education strategies for reducing adolescent smoking: A review of the evidence
J. Adolesc.
(1999) Trends in Tobacco Use
(2006)
Adolescent and young adult tobacco prevention and cessation: current status and future directions
Tob. Control
A meta-analysis of adolescent smoking prevention programs
Am. J. Public Health
Peer-led and adult-led school drug prevention: A meta-analytic comparison
J. Drug Educ.
The Research Act
The Health Consequences of Smoking: A Report of the Surgeon General
Adolescent smoking: onset and prevention
Ann. Behav. Med.
Psychosocial approaches to smoking prevention: a review of findings
Health Psychol.
Evaluation of antismoking advertising campaigns
JAMA
Prevention and treatment of smokeless tobacco use
Adv. Dent. Res.
Canadian Tobacco Use Monitoring Survey: results for first half of 2005
A meta-analysis of adolescent psychosocial smoking prevention programs published between 1978 and 1997 in the United States
Health Educ. Behav.
Effectiveness of adolescent smoking prevention strategies
MCN-Am. J. Matern-Chil.
Tobacco use, cancer causation and public health impact
J. Intern. Med.
Investing in youth tobacco control: a review of smoking prevention and control strategies
Tob. Control
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