Article Text

Download PDFPDF

Long-term effectiveness of behavioural interventions to prevent smoking among children and youth
  1. F Müller-Riemenschneider1,
  2. A Bockelbrink1,
  3. T Reinhold1,
  4. A Rasch2,
  5. W Greiner2,
  6. S N Willich1
  1. 1
    Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
  2. 2
    Health Economics and Health Care Management, University of Bielefeld, Bielefeld, Germany
  1. Dr Falk Müller-Riemenscheider, Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, 10098 Berlin, Germany; falk.mueller-riemenschneider{at}


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, community-based 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 high-quality studies.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: None.

  • Funding: This systematic review was commissioned and funded by the German Institute of Medical Documentation and Information (DIMDI).