title: The European Smoking prevention Framework Approach (ESFA): effects after 24 and 30 months.
abstract: The European Smoking Prevention Framework Approach (ESFA) study in six countries tested the effects of a comprehensive smoking prevention approach after 24 (T3; N = 10,751) and 30 months (T4; N = 9,282). The programme targeted four levels, i.e. adolescents in schools, school policies, parents and the community. In Portugal, 12.4% of the T1 non-smokers in the control group had started smoking at T4 compared to 7.9% of the experimental group. Smoking onset in the experimental group was thus 36% lower. In Finland, 32.4% of the T1 non-smokers started smoking compared to 27.6% of the experimental group, implying a 15% lower onset in the experimental group. In Spain, 33.0% of the T1 non-smokers in the control group had started smoking, compared to 29.1% of the experimental group, implying a 12% lower onset. In The Netherlands, the ESFA programme was effective for non-native adolescents with 11.4% new weekly smokers compared to 19.9% in the control group. An opposite effect was found in native Dutch adolescents with 19.0% new weekly smokers in the comparison group compared to 24.0% new smokers in the experimental group. Future programmes should use more standardized ways to assess process evaluations and should assess which elements are responsible for behavioral effects.
authors.affiliation: Department of Health Promotion and Health Education, University of Maastricht, The Netherlands. hein.devries@gvo.unimaas.nl
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
authors.forename: Froukje
authors.initials: F
authors.lastname: Dijk
authors.forename: Joyce
authors.initials: J
authors.lastname: Wetzels
authors.forename: Aart
authors.initials: A
authors.lastname: Mudde
authors.forename: Stef
authors.initials: S
authors.lastname: Kremers
authors.forename: Carles
authors.initials: C
authors.lastname: Ariza
authors.forename: Paulo Duarte
authors.initials: PD
authors.lastname: Vitória
authors.forename: Anne
authors.initials: A
authors.lastname: Fielder
authors.forename: Klavs
authors.initials: K
authors.lastname: Holm
authors.forename: Karin
authors.initials: K
authors.lastname: Janssen
authors.forename: Riku
authors.initials: R
authors.lastname: Lehtovuori
authors.forename: Math
authors.initials: M
authors.lastname: Candel
mesh_terms: D000293:Adolescent; D005060:Europe / Q000453:epidemiology; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D012907:Smoking / Q000453:epidemiology*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires