Table 3 Multisectorial interventions
Reference, year and locationParticipants, age and study qualityIntervention/controlFollow-up (rate), intervention durationGroup outcome(s) of smoking behaviour (as presented in original publication)
Spoth et al,44 2002, USAn = 1664, seventh grade, highLife skills training (LST): 15 sessions + 4 booster; Strengthening family program (SFP): above plus additional seven sessions, parent child skills and relationshipControl: no intervention12 months (LST: 88%, LST+SFP: 86%, C: 90%), NALifetime smoking (not smoking at baseline):LST+SFP: 12.1%LST: 13.9% (vs LST+SFP: NS)C: 16.7% (vs LST: NS, vs LST+SFP: NS)
Perry et al,43 2003, USAn = 6237, seventh to eighth grade, highDARE: 10 sessions, police officer led skill training; DARE-Plus: additional parental and community based activities, 4 sessions with peersControl: no intervention18 months (overall: 84%), NAGrowth curve analysis (current smokers), boys:C: 0.31 (SE: 0.05), vs DARE-Plus: p = 0.02DARE: 0.28 (SE: 0.05), Vs C: p = 0.28DARE-Plus: 0.18 (SE: 0.05), vs DARE, p = 0.08Growth curve analysis (current smokers), girls:C: 0.28 (SE: 0.07), vs DARE-Plus: p = 0.25DARE: 0.25 (SE: 0.07), Vs C: p = 0.38DARE-Plus: 0.22 (SE: 0.07), vs DARE, p = 0.35
Ellickson et al,39 2003, USAn = 4669, seventh grade, goodALERT: 11 sessions, interactive skills training, activities with parentsControl: standard prevention programs18 months (overall: 91.2%), 18 monthsLifetime smoking:I: 25.5%C: 31.6%IGD: p<0.01Ellickson II, 30-day smoking (not smoking at baseline):I: 8.6%C: 11.1%IGD: NSEllickson III, Regular smoking (not smoking at baseline):I: 4.0%C: 6.6%IGD: p<0.05
Furr-Holden et al,40 2004, USAn = 678, first grade, goodFamily school partnership (FSP): improve school–parent communication/relationship; classroom centred intervention (CC): improved teaching and support of disadvantaged pupilsControl: standard prevention program84 months (overall: 84%), 1 yearLifetime smoking (not smoking at baseline):RR (I vs C)FSP: 0.62 (0.39 to 0.98), p = 0.041CC: 0.55 (0.34 to 0.88), p = 0.013
Reddy et al,41 2002, Indian = 4776, 12 years, goodSchool-based intervention (I1): information and interactive sessions; school and family intervention (I2): additional brochures for parentsControl: no intervention12 months (I1: 90%, I2: 95%, C: 94%), NALifetime smoking:I1: 0.0571 (0.0422 to 0.0768)I2: 0.0366 (0.0264 to 0.0504)C: 0.0937 (0.0728 to 0.1198)intervention groups were significantly less likely to experiment with cigarettes
Simons-Morton et al,42 2005, USAn = 2231, sixth grade, goodGoing Places: 36 sessions, social skills, parental involvement and environmental changesControl: NAApprox. 36 months (overall: 67%), 3 yearsRegular smoking, average smoking stage:I: 0.88 (SD: 1.32)C: 1.11 (SD: 1.50)significantly favouring intervention group
Ausems et al,59 2004, The Netherlandsn = 1851, 13.1 years, fairSchool and out of school intervention (I1): three sessions, school-based skills training and information + individually tailored letters; out of school (I2): three individually tailored lettersControl: no intervention18 months (overall: 75.4%), NALifetime smoking (not smoking at baseline):I1: 40.0% (29.4 to 50.6)I2: 27.2% (8.8 to 53.5)C: 47.9% (29.1 to 66.6)OR: I1 vs I2: 1.85 (0.71 to 4.83)OR: I2 vs C: 0.42 (0.18 to 0.96)(other comparisons not reported)
de Vries et al,60 61 2003, Europen = 20 166, 13.3 years, fairEuropean Prevention Framework Approach: 5–6 sessions, different school-, community and family-based interventionsControl: partly standard and no intervention30 months (overall: 46%), NALifetime smoking:I: 51.7%C: 52.7%OR: 0.93 (0.84 to 1.03)Regular smoking:I: 21.9%C 23.4%OR: 0.89 (0.80 to 0.99)
Brown et al,62 2005, USAn = 959, 7.7 years, fairRaising Healthy Children: student and parental skill training, community activitiesControl: NAup to 120 months (no information), continuing12-month smoking:I: 16%C: 20%, no statistical analysis availableLatent growth model. No statistically significant differences
Schofield et al,63 2003, USAn = 4841, seventh to eighth grade, fairHealth Promoting Schools: student skill building, activities and parental educationControl: no intervention24 months (overall: 38%), NARegular smoking:I: 17.5%C: 20.5%IGD: NS
Winkleby et al,64 2004, USAn = 798, eleventh to twelfth grade, fairAdvocacy intervention: 18 sessions, information and development of community activitiesControl: modified “towards no drug abuse”12 months (I: 82%, C: 87%), 2 yearsCurrently smoking:I: 44.6% (SD 8.3)C: 39.1% (SD 7.8)IGD: p = 0.92 (post intervention to follow-up)Less than one pack/week:I: 35.1% (SD 7.4)C: 35.3% (SD 5.6)IGD: p = 0.95More than one pack/weekI: 20.3% (SD .7)C: 25.6% (SD 4.9)IGD: p = 0.97
  • Author names followed by II, III or abbreviation represent additional outcome measures in meta-analysis. If given, ranges in parentheses are 95% CIs. Interventions are given by program name, where applicable. Grade refers to school grade.

  • ALERT, Project ALERT; DARE, Drug Abuse Resistance Education; IGD, intergroup difference; C, control; I, intervention; OR, odds ratio; NS, not significant; NA, not available; SE, standard error.