A systematic review of school-based smoking prevention trials with long-term follow-up.
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.
Wiehe
Sarah E
SE
Child Health Services Research, Indiana University School of Medicine, Indianapolis, IN, USA. swiehe@iupui.edu
Garrison
Michelle M
MM
Christakis
Dimitri A
DA
Ebel
Beth E
BE
Rivara
Frederick P
FP
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