title: A systematic review of school-based smoking prevention trials with long-term follow-up.
abstract: BACKGROUND
  Several systematic reviews of school-based smoking prevention trials have shown short-term decreases in smoking prevalence but have not examined long-term follow-up evaluation. The purpose of this study was to conduct a systematic review of rigorously evaluated interventions for school-based smoking prevention with long-term follow-up data.
  
  
  METHODS
  We searched online bibliographic databases and reference lists from review articles and selected studies. We included all school-based, randomized, controlled trials of smoking prevention with follow-up evaluation to age 18 or 12th grade and at least 1 year after intervention ended, and that had smoking prevalence as a primary outcome. The primary outcome was current smoking prevalence (defined as at least 1 cigarette in the past month).
  
  
  RESULTS
  The abstracts or full-text articles of 177 relevant studies were examined, of which 8 met the selection criteria. The 8 articles included studies differing in intervention intensity, presence of booster sessions, follow-up periods, and attrition rates. Only one study showed decreased smoking prevalence in the intervention group.
  
  
  CONCLUSIONS
  Few studies have evaluated the long-term impact of school-based smoking prevention programs rigorously. Among the 8 programs that have follow-up data to age 18 or 12th grade, we found little to no evidence of long-term effectiveness.
authors.affiliation: Child Health Services Research, Indiana University School of Medicine, Indianapolis, IN, USA. swiehe@iupui.edu
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Wiehe
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Garrison
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Christakis
authors.forename: Beth E
authors.initials: BE
authors.lastname: Ebel
authors.forename: Frederick P
authors.initials: FP
authors.lastname: Rivara
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D002652:Child Behavior; D023381:Endpoint Determination; D005500:Follow-Up Studies; D006801:Humans; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012572:School Health Services; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention; D016896:Treatment Outcome