title: Cluster randomised controlled trial of expert system based on the transtheoretical ("stages of change") model for smoking prevention and cessation in schools.
abstract: OBJECTIVE
  To examine whether a year long programme based on the transtheoretical model of behaviour change, incorporating three sessions using an expert system computer program and three class lessons, could reduce the prevalence of teenage smoking.
  
  
  METHODS
  Cluster randomised trial comparing the intervention to a control group exposed only to health education as part of the English national curriculum.
  
  
  METHODS
  52 schools in the West Midlands region.
  
  
  METHODS
  8352 students in year 9 (age 13-14 years) at those schools.
  
  
  METHODS
  Prevalence of teenage smoking 12 months after the start of the intervention.
  
  
  RESULTS
  Of the 8352 students recruited, 7444 (89.1%) were followed up at 12 months. The intention to treat odds ratio for smoking in the intervention group relative to control was 1.08 (95% confidence interval 0.89 to 1.33). Sensitivity analysis for loss to follow up and adjustment for potential confounders did not alter these findings.
  
  
  CONCLUSIONS
  The smoking prevention and cessation intervention based on the transtheoretical model, as delivered in this trial, is ineffective in schoolchildren aged 13-14.
authors.affiliation: Department of Public Health, University of Birmingham, Birmingham B15 2TT. p.n.aveyard@bham.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Aveyard
authors.forename: K K
authors.initials: KK
authors.lastname: Cheng
authors.forename: J
authors.initials: J
authors.lastname: Almond
authors.forename: E
authors.initials: E
authors.lastname: Sherratt
authors.forename: R
authors.initials: R
authors.lastname: Lancashire
authors.forename: T
authors.initials: T
authors.lastname: Lawrence
authors.forename: C
authors.initials: C
authors.lastname: Griffin
authors.forename: O
authors.initials: O
authors.lastname: Evans
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D012572:School Health Services / Q000458:organization & administration; D016540:Smoking Cessation; D000074606:Smoking Prevention