Short-term effects of a randomized computer-based out-of-school smoking prevention trial aimed at elementary schoolchildren

Background: Smoking prevention programs usually run during school hours. In our study, an out-of-school program was developed consisting of a computer-tailored intervention aimed at the age group before school transition (11- to 12-year-old elementary schoolchildren). The aim of this study is to evaluate the additional effect of out-of-school smoking prevention.

Methods: One hundred fifty-six participating schools were randomly allocated to one of four research conditions: (a) the in-school condition, an existing seven-lesson program; (b) the out-of-school condition, three computer-tailored letters sent to the students' homes; (c) the in-school and out-of-school condition, a combined approach; (d) the control condition. Pretest and 6 months follow-up data on smoking initiation and continuation, and data on psychosocial variables were collected from 3,349 students.

Results: Control and out-of-school conditions differed regarding posttest smoking initiation (18.1 and 10.4%) and regarding posttest smoking continuation (23.5 and 13.1%). Multilevel logistic regression analyses showed positive effects regarding the out-of-school program. Significant effects were not found regarding the in-school program, nor did the combined approach show stronger effects than the single-method approaches.

Conclusions: The findings of this study suggest that smoking prevention trials for elementary schoolchildren can be effective when using out-of-school computer-tailored interventions.