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Carrión-Valero F, Ribera-Osca JA, Martin-Moreno JM, Martin-Gorgojo A. Prevention of tobacco use in an adolescent population through a multi-personal intervention model. Tob Prev Cessat 2023; 9:37. [PMID: 38111804 PMCID: PMC10726255 DOI: 10.18332/tpc/175065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION The study aimed to assess the impact of a new intervention proposal involving students, teachers, and parents on smoking prevalence in secondary school adolescents. METHODS A quasi-experimental study was conducted, in which the response to a preventive multi-personal intervention model (intervention) against tobacco consumption was compared with a standard anti-smoking activity carried out by the local government administration (control). The study was carried out during the 2017-2018 academic year. The study population included 306 students (intervention 151, control 155) with a mean age of 13.4 years. The model involved the parents, the students (aged 15-17 years), and the teachers. The primary outcome was the change in smoking status one year after the intervention. RESULTS The percentage of non-smokers increased from 84.1% to 88.7% in the intervention group and remained almost unchanged among controls (89.3% vs 89.9%). After one year, there was an increase in the prevalence of non-smokers of 4.6% and a decrease in the prevalence of smokers of 4.7% among students who received the multi-personal intervention, whereas changes among controls were almost negligible (there was in fact a slight increase in the prevalence of smokers of 0.9%). The students who received the intervention smoked less or quit smoking more than those in the control group (OR=0.135; 95% CI: 0.019-0.973, p=0.047). CONCLUSIONS The multi-personal model developed in the study with the participation of teachers and parents focused on students was feasible, and effectively reduced the prevalence of smoking among high school adolescents.
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Affiliation(s)
- Francisco Carrión-Valero
- Pneumology Department, Clinical University Hospital of Valencia, Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
| | | | - Jose M. Martin-Moreno
- Preventive Medicine and Public Health Department, Universitat de València, Valencia, Spain
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Song R, Park M. Meta-analysis of the effects of smoking prevention programs for young adolescents. CHILD HEALTH NURSING RESEARCH 2022; 27:95-110. [PMID: 35004501 PMCID: PMC8650902 DOI: 10.4094/chnr.2021.27.2.95] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose This meta-analysis aimed to analyze the effects of smoking prevention programs for young adolescents at early smoking stages to identify the appropriate characteristics of prevention programs for this population. Methods Searches of health-related databases and Google Scholar were conducted, and 23 randomized studies were included in the analysis. The main outcome variable was smoking behavior. The analysis was conducted using Comprehensive Meta-Analysis software (version 3.0). Results Smoking prevention programs significantly reduced smoking behaviors (OR=0.85, 95% CI=0.77-0.93). School-based programs (OR=0.79, 95% CI=0.75-0.83), programs by trained teachers or educators (OR=0.77, 95% CI=0.71-0.83), high-intensity programs (OR=0.82, 95% CI=0.75-0.91), and programs in an in-school setting (OR=0.82, 95% CI=0.74-0.90) had the most significant effect on reducing smoking behavior. Conclusion For young adolescents, smoking prevention programs are most effective when they are school-based or highintensity programs, and when conducted by teachers or educators with proper training. Further studies are required since there was insufficient research to explore the effect of web-based programs or family-centered programs on adolescent smokers.
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Affiliation(s)
- Rhayun Song
- Professor, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Moonkyoung Park
- Assistant Professor, College of Nursing, Chungnam National University, Daejeon, Korea
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Ünal E, Metintaş S. Effectiveness of anti-smoking interventions towards community: a meta-analysis study. Cent Eur J Public Health 2021; 29:134-142. [PMID: 34245554 DOI: 10.21101/cejph.a6350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 01/29/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Smoking is one of the biggest public health problems in the world. The World Health Organization (WHO) has declared the MPOWER package which provides a guide for tobacco control. The package includes six evidence based anti-smoking interventions. This meta-analysis study aims to assess the effectiveness of MPOWER - (M)onitor, (P)rotect, (O)ffer, (W)arn, (E)nforce, and (R)aise. In the study, "smoking prevalence rate, smoking cessation rate and number of cigarettes smoked daily" outputs were used in adult and adolescent age groups. METHODS Literature search has been made with "smok*, tobacco, cigarette*" keywords from the databases of Medline, Web of Science, Scopus, and Cochrane-Library. Abstracts were assessed in detail according to the inclusion criteria by the research team. Quality of articles was evaluated with modified Jadad criteria. The follow-up periods of articles were determined in two groups named as short and long term periods. We used random effects model (p ≤ 0.05) and fixed effects model (p > 0.05) according to the heterogeneity test results. RESULTS P and O interventions, which are evaluated with smoking cessation rate, increased the smoking cessation rate in adults by 39% in the longest follow-up period - RR: 1.39 (1.23-1.57). However, it was determined that the interventions were not effective on smoking cessation rate in adolescents - RR: 1.13 (0.90-1.42). Nicotine replacement therapy (NRT) was the most effective intervention for smoking cessation rate in adults. W interventions, which are evaluated with smoking prevalence rate, decreased the smoking prevalence rate in adults by 13% in the longest follow-up period - OR: 0.87 (0.82-0.92). P, W and E interventions, which are evaluated with smoking prevalence rate, decreased the smoking prevalence rate in adolescents by 26% in the longest follow-up period - OR: 0.74 (0.68-0.80). CONCLUSIONS MPOWER interventions affect smoking prevalence rate, smoking cessation rate and number of cigarettes smoked daily in different age groups. Well-controlled, well-planned and cost-effective anti-smoking interventions have great importance for public health protection.
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Affiliation(s)
- Egemen Ünal
- Department of Public Health, Medical Faculty, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Selma Metintaş
- Department of Public Health, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
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Future intentions and beliefs about roll-your-own cigarettes in adolescents. Aten Primaria 2021; 53:102043. [PMID: 33838538 PMCID: PMC8058530 DOI: 10.1016/j.aprim.2021.102043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/10/2020] [Accepted: 11/18/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the predisposition to use roll-your-own (RYO) cigarettes and the beliefs about RYO cigarettes of all the students of 3°-4° of ESO during the years 2016-17 and 2018-19. A cross-sectional study. SETTING Bisaura High School from Sant Quirze de Besora. Primary Health Care in the Catalan Health Institute, Catalunya, Spain. PARTICIPANTS 111 3rd and 4th of ESO (14-16 years). MAIN MEASUREMENTS Dependent variables used were future intentions of smoking and beliefs regarding RYO cigarettes. Independent variables were sex, course and ever smoked. The prevalence of the different dependent variables was described and compared according to the different independent variables with Pearson's Khi-square test. RESULTS 26.6% of the adolescents intended to smoke in the future of which 17.4% intended to smoke RYO cigarettes and 13.8% manufactured cigarettes (MC). Around 30% of adolescents express at least one wrong belief regarding RYO cigarettes. For example, the 26.7% believed that smoking RYO cigarettes generated less addiction than MC and the 32.1% that was less harmful. Those who had smoked at some time in their life had a greater intention to smoke in the future (54.5%), to smoke MC (27.3%) and RYO cigarettes (40.9%) than those who had never smoked (7.7%, 4.6% and 1.5% respectively) (p<0.005). Some misconceptions differed depending on whether adolescents had ever smoked in life, sex and course. The boys believed that smoking RYO cigarettes was more natural than smoking MC (p<0.005). CONCLUSIONS Educational activities to improve the information that young people have regarding RYO cigarettes are needed.
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Kempf C, Llorca PM, Pizon F, Brousse G, Flaudias V. What's New in Addiction Prevention in Young People: A Literature Review of the Last Years of Research. Front Psychol 2017; 8:1131. [PMID: 28729846 PMCID: PMC5498551 DOI: 10.3389/fpsyg.2017.01131] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 06/20/2017] [Indexed: 11/23/2022] Open
Abstract
Rationale: Addiction prevention is a major public health problem, particularly concerning young people. Despite the consensus that primary prevention is essential, the evaluation of its impact is questioned. Objective: The objective of this paper is to assess the latest knowledge of addiction prevention programs for young people. Method: Review a collection of research articles using a keyword-based search on three databases: Pubmed, Eric, and PsycInfo. The research was carried out using three groups of keywords and the eligibility study was completed using two criteria: articles published between 2010 and 2017, and articles in refereed journals. Results: Of a total of 13,720 articles in the three databases, 32 studies were included in the review and listed in a grid with five themes: authors, type of population, total population, addictive behavior, and results. Four categories were created based on the objective of the studies: the evaluation of prevention strategies, the study of risk factors for consumption, the prevalence study and other subjects studied. The analysis of the corpus was used to establish a list of risk factors to be taken into consideration in future interventions and research. A list of key elements for performing effective interventions and future research is also proposed. Conclusion: The understanding of the prevention strategies implementation process is discussed as a central element for future research, which will combine stakeholders and researchers. The complexity of the situations and the multifactorial aspects of addiction prevention in young people require a multidisciplinary approach involving the various stakeholders and researchers.
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Affiliation(s)
- Cédric Kempf
- Laboratoire HESPER EA7425, Université de Lyon-Université Claude Bernard Lyon 1Villeurbanne, France
| | - Pierre-Michel Llorca
- EA NPsy-Sydo, Université Clermont Auvergne-Université d'AuvergneClermont-Ferrand, France.,CHU Clermont-Ferrand, Pôle Psychiatrie BClermont-Ferrand, France
| | - Frank Pizon
- Université Clermont Auvergne - CNRS/SIGMA/Institut Pascal - UMR 6602 - TGI/PEPRADE - ESPE Clermont-AuvergneClermont-Ferrand, France
| | - Georges Brousse
- EA NPsy-Sydo, Université Clermont Auvergne-Université d'AuvergneClermont-Ferrand, France.,CHU Clermont-Ferrand, Pôle Psychiatrie BClermont-Ferrand, France
| | - Valentin Flaudias
- EA NPsy-Sydo, Université Clermont Auvergne-Université d'AuvergneClermont-Ferrand, France.,CHU Clermont-Ferrand, Pôle Psychiatrie BClermont-Ferrand, France
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Systematic review of universal school-based 'resilience' interventions targeting adolescent tobacco, alcohol or illicit substance use: A meta-analysis. Prev Med 2017; 100:248-268. [PMID: 28390835 DOI: 10.1016/j.ypmed.2017.04.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/02/2017] [Accepted: 04/02/2017] [Indexed: 01/03/2023]
Abstract
Universal school-based interventions that address adolescent 'resilience' may represent a means of reducing adolescent substance use, however previous systematic reviews have not examined the effectiveness of such an intervention approach. A systematic review was undertaken to 1) assess whether universal school-based 'resilience' interventions are effective in reducing the prevalence of tobacco, alcohol or illicit substance use by adolescents, and 2) describe such effectiveness per intervention characteristic subgroups. Eligible studies were peer-reviewed reports (1994-2015) of randomised controlled trials including participants aged 5-18years that reported adolescent tobacco, alcohol or illicit substance use, and implemented a universal school-based 'resilience' intervention (i.e. those addressing both individual (e.g. self-esteem) and environmental (e.g. school connectedness) protective factors of resilience). Trial effects for binary outcomes were synthesised via meta-analyses and effect sizes reported as odds ratios. Subgroup (by intervention type, prevention approach, setting, intervention duration, follow-up length) and sensitivity analyses (excluding studies at high risk of bias) were conducted. Nineteen eligible studies were identified from 16,619 records (tobacco: n=15, alcohol: n=17, illicit: n=11). An overall intervention effect was found for binary measures of illicit substance use (n=10; OR: 0.78, 95%CI: 0.6-0.93, p=0.007,Tau2=0.0, I2=0%), but not tobacco or alcohol use. A similar result was found when studies assessed as high risk of bias were excluded. Overall intervention effects were evident for illicit substance use within multiple intervention characteristic subgroups, but not tobacco and alcohol. Such results support the implementation of universal school-based interventions that address 'resilience' protective factors to reduce adolescent illicit substance use, however suggest alternate approaches are required for tobacco and alcohol use. PROSPERO registration: CRD42014004906.
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Krist L, Lotz F, Bürger C, Ströbele-Benschop N, Roll S, Rieckmann N, Müller-Nordhorn J, Willich SN, Müller-Riemenschneider F. Long-term effectiveness of a combined student-parent and a student-only smoking prevention intervention among 7th grade school children in Berlin, Germany. Addiction 2016; 111:2219-2229. [PMID: 27447693 DOI: 10.1111/add.13537] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 02/01/2016] [Accepted: 07/15/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS In Germany, the smoking prevalence among adolescents is among the highest in Europe. Our aim was to evaluate the long-term effectiveness of a combined student-parent and a student-only smoking prevention programme to reduce the smoking prevalence among 7th grade students in Berlin. DESIGN Three-armed cluster-randomized controlled trial (RCT). Schools as cluster units were randomized into (i) student intervention, (ii) combined student-parent intervention or (iii) control group, with follow-up after 12 and 24 months. SETTING High schools and integrated secondary schools in Berlin, Germany. PARTICIPANTS Seventh grade students aged 11-16 years. We included 47 schools, 161 classes and 2801 students [50.1% girls, mean age ± standard deviation (SD) = 13.0 ± 0.6 years]. MEASUREMENTS The primary outcome was self-reported regular smoking (at least one cigarette per day) after 24 months (point prevalence). Further self-reported outcomes were other smoking behaviours as well as parental rules and attitudes towards smoking. Comparisons were calculated as odds ratios (OR) with 95% confidence intervals (CI). FINDINGS At baseline, 2.3% of the students reported that they smoked regularly. After 24 months, 7.8% and 7.0% were regular smokers in the student-only intervention and the student-parent intervention, respectively, compared with 10.1% in the control group. The OR for being a regular smoker was 0.81 (0.34-1.92) for the student-parent intervention versus control, 0.95 (CI = 0.41-2.22) for the student-only intervention versus control and 0.85 (0.38-1.89) for student-parent intervention versus student-only intervention. CONCLUSION A combined student-parent smoking prevention intervention delivered via secondary schools in Berlin, Germany did not result in a statistically significant reduction in regular smoking compared with a control group or a student-only intervention. The student-only intervention did not result in a significant reduction in regular smoking compared with the control group.
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Affiliation(s)
- Lilian Krist
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Fabian Lotz
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christin Bürger
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Stephanie Roll
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Nina Rieckmann
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Stefan N Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Falk Müller-Riemenschneider
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Saw Swee Hock School of Public Health, National University, 21 Lower Kent Ridge Road, Singapore.,Yong Loo Lin School of Medicine, National University, 21 Lower Kent Ridge Road, Singapore
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Assessment of School-Based Quasi-Experimental Nutrition and Food Safety Health Education for Primary School Students in Two Poverty-Stricken Counties of West China. PLoS One 2015; 10:e0145090. [PMID: 26658459 PMCID: PMC4677813 DOI: 10.1371/journal.pone.0145090] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/26/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Few studies on nutrition and food safety education intervention for students in remote areas of China were reported. The study aimed to assess the questionnaire used to measure the knowledge, attitude and behavior with respect to nutrition and food safety, and to evaluate the effectiveness of a quasi-experimental nutrition and food safety education intervention among primary school students in poverty-stricken counties of west China. METHODS Twelve primary schools in west China were randomly selected from Zhen'an of Shaanxi province and Huize of Yunnan province. Six geographically dispersed schools were assigned to the intervention group in a nonrandom way. Knowledge, attitude and behavior questionnaire was developed, assessed, and used for outcome measurement. Students were investigated at baseline and the end of the study respectively without follow-up. Students in intervention group received targeted nutrition and food safety lectures 0.5 hour per week for two semesters. Item response theory was applied for assessment of questionnaire, and a two-level difference-in-differences model was applied to assess the effectiveness of the intervention. RESULTS The Cronbach's alpha of the original questionnaire was 0.84. According to item response model, 22 knowledge items, 6 attitude items and 8 behavior items showed adequate discrimination parameter and were retained. 378 and 478 valid questionnaires were collected at baseline and the end point. Differences of demographic characteristics were statistically insignificant between the two groups. Two-level difference-in-differences models showed that health education improved 2.92 (95% CI: 2.06-3.78) and 2.92 (95% CI: 1.37-4.47) in knowledge and behavior scores respectively, but had no effect on attitude. CONCLUSION The questionnaire met the psychometric standards and showed good internal consistence and discrimination power. The nutrition and food safety education was effective in improving the knowledge and behavior of primary school students in the two poverty-stricken counties of China.
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Smith B, Carson K. Commentary on Valdivieso Lopez et al. (2015): Lessons to be learnt from a randomized controlled trial of smoking prevention in secondary schools. Addiction 2015; 110:861. [PMID: 25868545 DOI: 10.1111/add.12868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 01/23/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Brian Smith
- The Basil Hetzel Institute for Translational Health Research, Clinical Practice Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, 5011, Australia
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