"Smoke-free Class Competition": far-reaching conclusions based on weak data.
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Biomedical subjects
Publications and source records attributed to Gudrun Wiborg.
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There is a lack of effective smoking cessation programmes for young people, despite the urgent need for them. The present study reports the initial results of a real-world self-help cessation programme which also contained a "quit and win"-contest component designed for adolescents and young adults. Consecutive registrants (N=1265) were surveyed 11 to 23 months after they registered to the programme to assess continuous abstinence. Results must be interpreted cautiously because this is an uncontrolled study with a 20.7% response rate (N=262). The programme was assessed positively by the participants. Results showed an 8.5% intention-to-treat quit rate with an average duration of 51.30 weeks continuous abstinence. Predictors for successful smoking were occasional smoking (not daily smoking) and older age.
BACKGROUND: This paper examines the effectiveness of the "Smoke-Free Class Competition" in delaying the onset of smoking in adolescence. Each participating class must decide if they want to be a "smoke-free class" for the 6-month period from fall to spring. Classes monitor their (non-)smoking behavior and report it to the teacher regularly. Classes in which pupils refrain from smoking for this period of time participate in a prize draw, in which they can win a number of attractive prizes. METHODS: To evaluate the effectiveness of the competition, a sample of 131 participating and nonparticipating classes (number of pupils 2,142; mean age 12.9 years, SD = 0.98) was compared with regard to their smoking behavior. Smoking status was determined by self-assessment on three occasions: (a) prior to the beginning of the competition, (b) 1 month after the competition, and (c) 1 year after the start of the competition. RESULTS: From pretest to posttest smoking increased by 7.5% in the comparison group, while it decreased by 0.2% in the intervention group (OR = 2.19; P < 0.001). In the follow-up measurement, a clear increase in smoking prevalence occurs in all groups; however, the pupils in the intervention condition still have a significant lower increase of smoking (OR = 1.45; P < 0.01). Moreover, with regard to the nonsmokers at baseline, pupils in the comparison group showed significantly higher prevalences in smoking than the intervention group in the postmeasurement, 7.8 versus 13.9% (OR = 1.98; P < 0.001), as well as in the in the follow-up-measurement, 17 versus 21.3% (OR = 1.36; P < 0.05). CONCLUSIONS: The results suggest that the participation in the competition could delay the onset of smoking in adolescence.