A critique of evaluated adolescent smoking cessation programmes

Time trends of Finnish adolescents' mental health and use of alcohol and cigarettes from 1998 to 2014

This study reports time-trend changes in self-reported mental health problems, smoking, and alcohol habits among Finnish adolescents over a 16-year period using three cross-sectional studies with similar designs, methodologies, and geographical recruitment areas. There were 4508 participants with a mean age of 14.4 years (range 13-18) in 1998 (n = 1449), 2008 (n = 1560), and 2014 (n = 1499). The information they provided on their mental health was measured with the Strengths and Difficulties Questionnaire and they were also asked questions about their alcohol and smoking habits. The findings showed that from 1998 to 2014 females reported less hyperactivity and conduct problems and males reported fewer peer problems and better prosocial skills. The only mental health problem that showed a significant increase was emotional symptoms among females. Smoking and alcohol use consistently decreased in males and females during the 16-year period. Our findings suggest that overall adolescent's self-reported mental health problems were either stable or falling, indicating increased well-being. The decreased smoking indicates that anti-smoking campaigns have been successfully changing teenagers' attitudes towards smoking. The important finding is that self-reported emotional symptoms had increased in females. This may indicate an increase or earlier onset of affective disorders.

Adolescent Smoking Cessation: Development of a School Nurse Intervention

The purpose of this study was to examine the feasibility of a range of strategies to engage and to enhance secondary school nurse involvement in teenage smoking prevention and cessation. School nurses were willing to assist students to quit smoking, but they felt unprepared. Information provided by nurses involved in a three-stage review, pilot-testing, and trial design resulted in the development of a resource for nurses. This resource comprised individual student approaches (brief intervention based on motivational interviewing and written activities designed to help students examine their smoking behavior), approaches to assist parents (letter of support for parents of students who smoke), and school newsletter items. Each component of the resource was found by school nurses to be appropriate, useful, and complementary to their other school-wide approaches to assist adolescents to quit smoking. Nurses also reported an interest to expand or to enhance their smoking cessation role in the school.

Communication about smoking between depressed adolescents and their parents

INTRODUCTION

Better understanding of effective parent-adolescent communication regarding tobacco use could inform smoking cessation intervention.

METHODS

Semistructured interviews related to communication about smoking were conducted with 15 depressed adolescent smokers and their parents, primarily from urban areas. This study, conducted in 2006-2008, was funded by the Pennsylvania Department of Health. Interview transcripts (N = 30) were coded in QSR N6.

RESULTS

Quality of communication, rather than content, seemed to determine whether parental communication was effective. Parents reactivity to, or avoidance of, adolescent smoking presented a barrier to effective communication. In this sample, parents and adolescents were more concerned about problems, such as depression, than smoking.

DISCUSSION

Involving parents in adolescent smoking cessation programs may be promising. Parental involvement may include teaching parent-child communication skills, building stronger relational bonds, or helping parents quit simultaneously. Further research is needed to explore whether coupling smoking cessation with depression treatment increases parent and adolescent treatment engagement and effectiveness.

Modèles socio-écologiques : renforcement de la recherche interventionnelle dans le contrôle du tabac

Quelques aspects dans le domaine du contrôle du tabac ont été marqués par une conceptualisation plus large des facteurs complexes qui déterminent la santé de la population. Les programmes de santé publique de contrôle du tabac accordent une part de plus en plus grande à des interventions à plusieurs niveaux et à des changements de politiques pour influencer le contexte. De plus, des concepts socio-écologiques (par exemple, stratégies visant des interactions intrapersonnelles, interpersonnelles et socio-environnementales) sont implicites à de nombreuses politiques exhaustives de réduction du tabac. Par contraste, la recherche interventionnelle sur le tabac est à la traîne par rapport à cette progression, avec des stratégies au niveau individuel qui continuent à dominer le programme de recherche. De nouvelles méthodes de recherche sont suggérées pour renforcer la recherche interventionnelle dans la prévention et l’arrêt du tabagisme. En utilisant l’exemple des adolescents et des transitions développementales, nous illustrerons comment la réflexion entourant les modèles socio-écologiques offre de nouvelles possibilités pour la recherche interventionnelle sur le contrôle du tabac.

Predictors of smoking cessation processes among secondary school students

Many adolescents want to quit and have specific ideas on how they want to go about it. This study extended the search for factors related to different aspects of quitting. Four cross-sectional surveys of Queensland (Australia) secondary schools every three years over the past decade (1993, 1996, 1999, and 2002). A total of 9993 school students in grades 8 to 12 completed the survey. The data for 2451 students who had smoked in the last week (51% female) were used for the analysis of smoking cessation outcomes. The outcome measures for the study represented various smoking cessation outcomes, such as a desire to quit, attempts to quit, quitting for a week or more, and an intention not to be smoking in the following year. More than 60% of adolescent smokers are involved in the process of smoking cessation. The strongest predictor of cessation was whether or not students had actively influenced other students not to smoke. This finding supports the concept of involving adolescents more actively in prompting their peers to try quitting and supporting their efforts to quit smoking.

A school-based harm minimization smoking intervention trial: outcome results

AIMS

To determine the impact of a school-based harm minimization smoking intervention compared to traditional abstinence-based approaches.

DESIGN, SETTING AND PARTICIPANTS

A school-based cluster randomized trial was conducted in Perth, Western Australia in 30 government high schools from 1999 to 2000. Over 4000 students were recruited to participate and schools were assigned randomly to either the harm minimization intervention or a standard abstinence-based programme.

INTERVENTION

The harm minimization intervention comprised eight 1-hour lessons over 2 years, quitting support from school nurses and enactment of policies to support programme components. Comparison schools implemented standard abstinence-based programmes and policies.

MEASURES

Cigarette smoking was categorized at two levels: regular smoking, defined as smoking on 4 or more days in the previous week; and 30-day smoking as any smoking within the previous month.

FINDINGS

At immediate post-test (20 months post-baseline), after accounting for baseline differences, school-level clustering effects, socio-economic status, gender and family smoking, intervention students were less likely to smoke regularly [OR = 0.51, 95% confidence interval (CI) = 0.36, 0.71] or to have smoked within the previous 30 days (OR = 0.69, 95% CI = 0.53, 0.91).

CONCLUSION

The school-based adolescent harm minimization intervention appears to have been more effective than the abstinence-based social influences programme at reducing regular smoking.

Smoking and adolescence: narratives of identity

The purpose of this study was to understand the identities that youth hold in relation to smoking, as revealed in narrative accounts of their smoking experiences. The analysis was a narrative inquiry, a qualitative approach based on the propensity of people to narrate or tell stories about the experiences in their daily lives. A purposeful sample of 35 youths ages 14-18 years with a variety of smoking histories (all had tried smoking) participated in in-depth interviews. A detailed analysis of the transcripts revealed the key identities communicated by the youths including the confident nonsmoker, the vulnerable nonsmoker, the ardent nonsmoker, the accepting nonsmoker, the in-control smoker, the confirmed smoker, and the contrite smoker. Tobacco control interventions for youth must be designed to respond to and incorporate multiple smoking identities.