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At least 19 recordsLinked to original sources

Nursing students' perceptions of smoking prevention.

Smoking behaviors of student nurses may have a profound effect on the implementation of smoking-prevention activities in the future, as they are the future nurses. The aim of the study was to evaluate the prevalence of smoking among student nurses in Israel and to identify factors associated with the students' attitude to their role in smoking prevention and to nurses as role models regarding smoking. Student nurses from three large academic schools (782 respondents) answered a self-administered questionnaire. About 22% reported being current smokers. The latter more frequently reported positive attitudes to nurses' smoking and saw no ethical problems in their smoking. Smokers also reported less frequently that nurses should be active in smoking prevention. In a logistic regression model, attitudes to nurses' role in smoking prevention, smoking status, and having friends who smoked were associated with the attitude to nurses as role models. Attitude to nurses as role models was the main variable explaining variance in attitudes to nurses' role in prevention. Smoking status and students' social environment exerted a marked influence on students' attitudes to smoking role modeling. A more holistic approach to student nurses' education about smoking prevention is called for.

Adult↗

Education programs on smoking prevention and smoking cessation for students and housestaff in U.S. medical schools.

To determine the extent and characteristics of educational programs relating to smoking in U.S. medical schools, surveys of educational curricula were performed in 1983 and 1984. The first survey showed that 34% of medical schools had no course offerings on smoking for medical students, and very few addressed smoking prevention and smoking cessation. In the following year, the percentage of schools with curriculum courses on smoking prevention and smoking cessation had risen to 64% and 56%, respectively. Planned education programs for housestaff, however, were present in only 30% and 25% of medical school-affiliated programs. Only one housestaff program (5%) was present in the group of medical schools that had no educational programs on smoking prevention or cessation for its medical students. More emphasis on education regarding smoking prevention and smoking cessation in U.S. medical schools and in housestaff training programs is required.

Canada↗

The role of the pediatrician in smoking prevention.

Smoking prevention during childhood and adolescence is critical to the successful reduction of tobacco-related morbidity and mortality in the United States. The research literature is replete with surveys describing youth smoking acquisition and related factors. In addition to its direct harm, tobacco use may be a gateway to other substance abuse and a marker of other health-compromising behaviors. The pediatrician can play an important role in prevention by screening all patients and providing individual counseling. The pediatrician can also contribute as a consultant and advocate of school- and community-based smoking prevention efforts. Such a multicomponent approach provides the greatest likelihood of accelerating the decline in smoking and smokeless tobacco initiation.

Adolescent↗

[Smoking prevention. Courses on smoking prevention conducted at a regional hospital].

We present the results of four smoking cessation courses conducted during the period 1986 to 1988 and including 105 persons. 68 women and 37 men participated in weekly lessons, three prior to and two after a predetermined quit-smoking day. Physicians presented information and smoking cessation techniques, the latter based on cognitive behavioural modification. At one year follow-up 27% of the participants had stopped smoking and 49% had reduced smoking consumption. More intensive follow-up and pharmacological treatment might reduce the relapse rate further.

Hospitals, District↗

Development of a smoking prevention mass media program using diagnostic and formative research.

The process of developing a mass media campaign to prevent smoking among adolescents is described in detail. This campaign supplements a school smoking prevention program and shares educational objectives with the school program but is otherwise independent. It comprises various television and radio 30- and 60-sec "spot" messages. The campaign development process includes identifying educational objectives and strategies for appealing to young people; conducting diagnostic surveys and focus groups to determine target audience interests and perceptions about smoking and media content; suggesting approaches to producers to create preliminary television and radio messages for testing; conducting formative pretests with target groups to select optimal messages and suggest improvements to those messages; producing final messages for media presentation; and developing a media exposure plan to place messages in local media at optimal times for reception by target audiences. The media campaign is being evaluated in a 5-year project with 5,500 adolescents in four communities to determine the additional effect of mass media over a school program alone in preventing smoking.

Adolescent↗

School-based programmes for preventing smoking.

BACKGROUND: Smoking rates in adolescents are rising. Helping young people to avoid starting smoking is a widely endorsed goal of public health, but there is uncertainty about how to do this. Schools provide a route for communicating with a large proportion of young people, and school-based programmes for smoking prevention have been widely developed and evaluated. OBJECTIVES: To review all randomised controlled trials of behavioural interventions in schools to prevent children (aged 5 to12) and adolescents (aged 13 to18) starting smoking. SEARCH STRATEGY: We searched The Cochrane Controlled Trials and Tobacco Review group registers, MEDLINE, EMBASE, Psyclnfo, ERIC, CINAHL, Health Star, Dissertation Abstracts and studies identified in the bibliographies of articles. Individual MEDLINE searches were made for 133 authors who had undertaken randomised controlled trials in this area. SELECTION CRITERIA: Types of studies: those in which individual students, classes, schools, or school districts were randomised to the intervention or control groups and followed for at least six months. TYPES OF PARTICIPANTS: Children (aged 5 to12) or adolescents (aged 13 to18) in school settings. Types of interventions: Classroom programmes or curricula, including those with associated family and community interventions, intended to deter use of tobacco. We included programmes or curricula that provided information, those that used social influences approaches, those that taught generic social competence, and those that included interventions beyond the school into the community. We included programmes with a drug or alcohol focus if outcomes for tobacco use were reported. Types of outcome measures: Prevalence of non-smoking at follow-up among those not smoking at baseline. We did not require biochemical validation of self-reported tobacco use for study inclusion. DATA COLLECTION AND ANALYSIS: We assessed whether identified citations were randomised controlled trials. We assessed the quality of design and execution, and abstracted outcome data. Because of the marked heterogeneity of design and outcomes, we did not perform a meta-analysis. We synthesised the data using narrative systematic review. We grouped studies by intervention method (information; social competence; social influences; combined social influences/social competence and multi-modal programmes). Within each category, we placed them into three groups according to validity using quality criteria for reported study design. MAIN RESULTS: Of the 76 randomised controlled trials identified, we classified 16 as category one (most valid). There were no category one studies of information giving alone. There were fifteen category one studies of social influences interventions. Of these, eight showed some positive effect of intervention on smoking prevalence, and seven failed to detect an effect on smoking prevalence. The largest and most rigorous study, the Hutchinson Smoking Prevention Project, found no long-term effect of an intensive 8-year programme on smoking behaviour. There was a lack of high quality evidence about the effectiveness of combinations of social influences and social competence approaches. There was limited evidence about the effectiveness of multi-modal approaches including community initiatives. REVIEWER'S CONCLUSIONS: There is no rigorous test of the effects of information giving about smoking. There are well-conducted randomised controlled trials to test the effects of social influences interventions: in half of the group of best quality studies those in the intervention group smoke less than those in the control, but many studies showed no effect of the intervention. There is a lack of high-quality evidence about the effectiveness of combinations of social influences and social competence interventions, and of multi-modal programmes that include community interventions.

Adolescent↗

School-based programmes for preventing smoking.

BACKGROUND: Smoking rates in adolescents are rising in some countries. Helping young people to avoid starting smoking is a widely endorsed goal of public health, but there is uncertainty about how to do this. Schools provide a route for communicating with a large proportion of young people, and school-based programmes for smoking prevention have been widely developed and evaluated. OBJECTIVES: To review all randomized controlled trials of behavioural interventions in schools to prevent children (aged 5 to12) and adolescents (aged 13 to18) starting smoking. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Tobacco Addiction Group's Specialized Register, MEDLINE, EMBASE, PsyclNFO, ERIC, CINAHL, Health Star, Dissertation Abstracts and studies identified in the bibliographies of articles. Individual MEDLINE searches were made for 133 authors who had undertaken randomized controlled trials in this area. SELECTION CRITERIA: Types of studies: those in which individual students, classes, schools, or school districts were randomized to the intervention or control groups and followed for at least six months. TYPES OF PARTICIPANTS: Children (aged 5 to12) or adolescents (aged 13 to18) in school settings. Types of interventions: Classroom programmes or curricula, including those with associated family and community interventions, intended to deter use of tobacco. We included programmes or curricula that provided information, those that used social influences approaches, those that taught generic social competence, and those that included interventions beyond the school into the community. We included programmes with a drug or alcohol focus if outcomes for tobacco use were reported. Types of outcome measures: Prevalence of non-smoking at follow up among those not smoking at baseline. We did not require biochemical validation of self-reported tobacco use for study inclusion. DATA COLLECTION AND ANALYSIS: We assessed whether identified citations were randomized controlled trials. We assessed the quality of design and execution, and abstracted outcome data. Because of the marked heterogeneity of design and outcomes, we computed pooled estimates only for those trials that could be analyzed together and for which statistical data were available. We predominantly synthesized the data using narrative systematic review. We grouped studies by intervention method (information; social competence; social influences; combined social influences/social competence; multi-modal programmes). Within each group, we placed them into three categories (low, medium and high risk of bias) according to validity using quality criteria for reported study design. MAIN RESULTS: Of the 94 randomized controlled trials identified, we classified 23 as category one (most valid). There was one category one study of information-giving and two of teaching social comeptence. There were thirteen category one studies of social influences interventions. Of these, nine found some positive effect of intervention on smoking prevalence, and four failed to detect an effect on smoking prevalence. The largest and most rigorous study, the Hutchinson Smoking Prevention Project, found no long-term effect of an intensive eight-year programme on smoking behaviour. There were three category one RCTs of combined social influences and social competence interventions: one provided significant results and one only for instruction by health educators compared to self-instruction. There was a lack of high quality evidence about the effectiveness of combinations of social influences and social competence approaches. There was one category one study providing data on social influences compared with information giving. There were four category one studies of multi-modal approaches but they provided limited evidence about the effectiveness of multi-modal approaches including community initiatives. AUTHORS' CONCLUSIONS: There is one rigorous test of the effects of information-giving about smoking. There are well-conducted randomized controlled trials to test the effects of social influences interventions: in half of the group of best quality studies those in the intervention group smoke less than those in the control, but many studies failed to detect an effect of the intervention. There are only three high quality RCTs which test the effectiveness of combinations of social influences and social competence interventions, and four which test multi-modal interventions; half showed significant positive results.

Adolescent↗

Skills-building methods to prevent smoking by adolescents.

This study evaluated cigarette smoking prevention methods with a sample of adolescent females and males. Arranged by school, 331 informed and consenting sixth graders were randomly divided into four groups: 1) pretest, skills-building methods, posttest; 2) pretest, discussion methods, posttest; 3) pretest and posttest; and 4) posttest only. All subjects were followed for 6 and 15 months after the posttest. Outcome results on measures of non-smoking intentions, attitudes, predictions, problem-solving abilities, and peer interactions favored subjects in the skills-building group when compared with subjects in the discussion and pretest-posttest control groups. Smoking rates at posttest and at both follow-ups were lower in the skills-building group than in the other three groups. Results from posttest-only subjects did not support pretest reactivity. The study's strengths and limits are discussed along with directions for future smoking prevention research.

Adolescent↗

Smoking prevention for ethnically diverse adolescents: 2-year outcomes of a multicultural, school-based smoking prevention curriculum in Southern California.

BACKGROUND: Effective school-based curricula are needed to prevent smoking among ethnically diverse adolescents. This study evaluated a multicultural smoking prevention curriculum in ethnically diverse Southern California middle schools. METHODS: Students in 24 middle schools (N = 3157 sixth graders) received the multicultural curriculum, a similar curriculum without references to cultural issues, or a control condition. Odds ratios for experimentation with smoking over a 2-year period were calculated. RESULTS: The multicultural program was associated with a lower risk of smoking between sixth and eighth grade, relative to the control group. Program effects varied according to the ethnic composition of the schools. In schools with predominantly Hispanic populations, the multicultural curriculum was more effective than the control, but the standard curriculum was not. In schools with predominantly Asian or multicultural populations, the standard curriculum was more effective than the control, but the multicultural curriculum was not. Analyses stratified by ethnicity within the schools revealed that the multicultural curriculum was effective among Hispanic students within predominantly Hispanic schools, but not among Hispanic students within predominantly Asian/multicultural schools. CONCLUSIONS: Smoking prevention for adolescents in culturally diverse school contexts is a challenge. In this study, a multicultural curriculum was most effective among Hispanic students in predominantly Hispanic schools. Further research is needed to determine the best ways to prevent smoking in predominantly Asian and multicultural schools.

Adolescent↗

Preventing smoking and other drug use: let the buyers beware and the interventions be apt.

Those concerned with smoking prevention programs in the schools may be misled by a recent report that "we know what works; now let's make it happen." The advocated "social influences" programs appear to have no reliable effects on regular (greater than or equal to weekly) smoking and only short-term and small effects (5-8 percentage points) on "experimental" (less than weekly) smoking. To prevent smoking and other drug abuse among the children most at risk, it may be crucial to use broad-based, multidisciplinary interventions that go well beyond the health education classroom.

Adolescent↗

Hutchinson Smoking Prevention Project: long-term randomized trial in school-based tobacco use prevention--results on smoking.

BACKGROUND: No long-term impact has yet been observed with the use of the social-influences approach to school-based smoking prevention for youth. However, whether this lack of impact is due to methodologic problems with the studies or to the failure of the interventions is unclear. The Hutchinson Smoking Prevention Project (HSPP), conducted from September 1984 through August 1999, aimed to attain the most rigorous randomized trial possible to determine the long-term impact of a theory-based, social-influences, grade 3-12 intervention on smoking prevalence among youth. METHODS: Forty Washington school districts were randomly assigned to the intervention or to the control condition. Study participants were children enrolled in two consecutive 3rd grades in the 40 districts (n = 8388); they were followed to 2 years after high school. The trial achieved high implementation fidelity and 94% follow-up. Data were analyzed with the use of group-permutation methods, and all statistical tests were two-sided. RESULTS: No significant difference in prevalence of daily smoking was found between students in the control and experimental districts, either at grade 12 (difference [Delta] = 0.2%, 95% confidence interval [CI] = -4.6% to 4.4%, and P =.91 for girls; Delta = 0.3%, 95% CI = -5.0% to 5.5%, and P =.89 for boys) or at 2 years after high school (Delta = -1.4%, 95% CI = -5.0% to 1.6%, and P =.38 for girls; Delta = 2.6%, 95% CI = -2.5% to 7.7%, and P =.30 for boys). Moreover, no intervention impact was observed for other smoking outcomes, such as extent of current smoking or cumulative amount smoked, or in subgroups that differ in a priori specified variables, such as family risk for smoking. CONCLUSION: The rigor of the HSPP trial suggests high credence for the intervention impact results. Consistent with previous trials, there is no evidence from this trial that a school-based social-influences approach is effective in the long-term deterrence of smoking among youth.

Adolescent↗

The European Smoking Prevention Framework Approach (EFSA): an example of integral prevention.

A smoking prevention project in six European countries (European Smoking prevention Framework Approach) was developed, featuring activities for adolescents, schools and parents, including out-of-school activities. Consensus meetings resulted in agreement between the countries on goals, objectives and theoretical methods. Countries' specific objectives were also included. National diversities required country-specific methods to realize the goals and objectives. The community intervention trial was used as the research design. Since interventions took place at the community level, communities or regions were allocated at random to the experimental or control conditions. Complete randomization was achieved in four countries. At baseline, smoking prevalence among 23 125 adolescents at the start of the project was 5.6% for regular smoking and 4.0% for daily smoking. Smoking prevalence rates were higher among girls than boys in all countries as far as weekly smoking was concerned. Process evaluations revealed that the project's ambitions were high, but were limited by various constraints including time and delays in receiving funds. Future smoking prevention projects should aim to identify the effective components within the social influence approach as well as within broader approaches and on reaching sustained effects.

Adolescent↗

Research in using mass media to prevent smoking.

Mass media are particularly appropriate for reaching young people in smoking-prevention campaigns; however, past research has placed little emphasis on designing effective interventions. Only a few studies have been conducted to develop and evaluate methods to use media for smoking reduction among youth, and only one quasi-experimental study has demonstrated actual reductions in youth smoking. This research requires the use of large controlled field studies that cross disciplines. These lack an established funding base. Furthermore, campaign approaches seeking to reduce youth demand for tobacco products are currently receiving less attention from anti-tobacco policy makers than approaches restricting the supply of tobacco to youth. Scientists from various health behavior and education disciplines should join with creative media production professionals to develop more effective messages and message delivery systems to reach youth at high risk of smoking. Further efforts should be made to share information among these professionals and producers of entertainment programs for youth, as well as among anti-tobacco policy makers, so that the most effective approaches can be employed to reduce youth smoking on a broad scale.

Adolescent↗

Effects of a school-based smoking prevention program among subgroups of adolescents.

In autumn 1995 The Norwegian Cancer Society in cooperation with The Research Center for Health Promotion, University of Bergen started a study of school-based interventions aiming at preventing smoking among pupils in Norwegian secondary schools. The study comprised a nationwide sample of 4441 students at 99 schools (195 classes). This panel of students is followed through annual data collections till they graduate in spring 1997. Written consensus from students and parents was obtained from 95%. Schools were systematically allocated to one of four groups: Group A, control; Group B, intervention, containing classroom program, involvement of parents and teacher courses; Group C, like B, but without teacher courses; Group D, like B, but without parental involvement. Baseline data were collected by questionnaires administered in class in November 1994 and the first follow-up survey was carried out in May 1995. At follow-up the proportion of smokers had increased by 8.3 percentage points in Group A (control) and by 1.9 percentage points in Group B (most extensive intervention). As expected, the recruitment of smokers was higher in Groups C and D than in the ideal intervention, but lower than in the control group. Effects of the most extensive program among subgroups of students were examined by comparing Groups A and B. Students are categorized as high risk or low risk based on scores on scales measuring sensation seeking, physical maturity, antisocial behavior and parental smoking. The effect of the program on recruitment of smokers seems to have been at least as strong or even stronger among 'high-risk' students than among other students.

Adolescent↗

The effect of endorsement by local opinion leaders and testimonials from teachers on the dissemination of a web-based smoking prevention program.

The effect of endorsement by local opinion leaders and teacher testimonials on dissemination of a web-based program to prevent smoking was tested in a group-randomized 2 x 2 factorial post-test-only design with 394 junior and senior high schools. Schools were assigned to condition by region served by local tobacco control coalitions. Visits to the 'Consider This' (CT) website were recorded. Teachers at 226 schools completed a post-test. More schools receiving the opinion leader letter had visits to the website by teachers (12%) than schools not receiving it (4%, P = 0.015). More teachers at schools receiving the testimonials reported reading the materials (29%) than those not receiving them (22%, P = 0.059). Testimonials created more intentions to use CT (49% testimonials, 35% no testimonials, P = 0.047). Testimonials may be effective at increasing teachers' exposure to the promotional materials but recommendations from opinion leaders appear to convince some teachers to visit and assign students to use it.

Adolescent↗

Community interventions for preventing smoking in young people.

BACKGROUND: Decisions to smoke are made within a broad social context. Community interventions use co-ordinated, widespread, multi-component programmes to try and influence behaviour. OBJECTIVES: To determine the effectiveness of community interventions in preventing the uptake of smoking in young people. SEARCH STRATEGY: The Tobacco Addiction group specialised register, Medline and 21 other health, psychology and public policy electronic databases were searched, the bibliographies of identified studies were checked and contact was made with content area specialists. SELECTION CRITERIA: Randomised and non randomised controlled trials that assessed the effectiveness of multi-component community interventions compared to no intervention or to single component or school-based programmes only. Reported outcomes had to include smoking behaviour in young people under the age of 25 years. DATA COLLECTION AND ANALYSIS: Information relating to the characteristics and the content of community interventions, participants, outcomes and methods of the study was extracted by one reviewer and checked by a second. Studies were combined using qualitative narrative synthesis. MAIN RESULTS: Thirteen studies were included in the review, 44 studies did not meet all of the inclusion criteria. All studies used a controlled trial design, with four using random allocation of schools or communities. Of nine studies which compared community interventions to no intervention controls, two, which were part of cardiovascular disease prevention programmes, reported lower smoking prevalence. Of three studies comparing community interventions to school-based programmes only, one found differences in reported smoking prevalence. One study reported a lower rate of increase in prevalence in a community receiving a multi-component intervention compared to a community exposed to a mass media campaign alone. One study reported a significant difference in smoking prevalence between a group receiving a media, school and homework intervention compared to a group receiving the media component only REVIEWER'S CONCLUSIONS: There is some limited support for the effectiveness of community interventions in helping prevent the uptake of smoking in young people.

Adolescent↗

A comprehensive multi-media program to prevent smoking among black students.

Much research has been done in developing and implementing smoking prevention programs; however, few studies have focused on urban Black populations. In November of 1989, a comprehensive prevention program was implemented to decrease the incidence of new smokers within the adolescent population in a Black community. The program combined a school-based curriculum with a comprehensive media intervention. All components of the program were financed by business leaders from the targeted community. There were two experimental conditions: one group participated in a school-based intervention and were prompted to participate in a multi-media intervention and the other group had access to the multi-media intervention; however, they were not prompted to participate. A key finding was that the rate of smoking decreased for all children involved in the intervention. The authors present a model that can be employed to prevent other high-risk behaviors within the Black population.

Adolescent↗