title: Effects of in-school and tailored out-of-school smoking prevention among Dutch vocational school students.
abstract: This paper evaluates a smoking prevention intervention aimed at vocational school students, consisting of an existing Dutch in-school program (three lessons each lasting 50 min) and a computer-based tailored out-of-school program (three tailored letters with smoking prevention messages mailed to students' homes). Nineteen schools that already participated in the in-school program were randomly assigned to the in-school or to the combined in-school and out-of-school condition. The remaining 17 schools were randomly assigned to the out-of-school condition or to the control group. Effect outcomes were assessed at 6, 12 and 18 months after a pre-test, and were based on initiation among never-smokers and continuation among ever-smokers. Twelve months after the pre-test (post-test 2), the in-school intervention was successful in preventing vocational school students from continuing to smoke, compared with students in the control condition [odds ratio (OR) = 0.49; 95% confidence interval (CI) = 0.29-0.84]. Eighteen months after the pre-test (post-test 3), the tailored out-of-school intervention was successful in preventing smoking initiation, compared with students in the control condition (OR = 0.42; 95% CI = 0.18-0.96). The effect of the combined approach was not larger than the sum of the effects of the in-school and the out-of-school effects.
authors.affiliation: Maastricht Health Research Institute for Prevention and Care, Netherlands School of Primary Care Research, Department of Health Education and Promotion, Maastricht University, MD Maastricht, The Netherlands. m.ausems@gvo.unimaas.nl
authors.forename: Marlein
authors.initials: M
authors.lastname: Ausems
authors.forename: Ilse
authors.initials: I
authors.lastname: Mesters
authors.forename: Gerard
authors.initials: G
authors.lastname: van Breukelen
authors.forename: Hein
authors.initials: H
authors.lastname: De Vries
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care; D016730:Program Development; D015397:Program Evaluation; D012572:School Health Services / Q000458:organization & administration*; D000074606:Smoking Prevention; D014829:Vocational Education