title: It takes two: reducing adolescent smoking uptake through sustainable adolescent-adult partnership.
abstract: OBJECTIVE
  To assess the effects of a long-term intervention for tobacco use prevention that targets adolescents (Tobacco Free Duo).
  
  
  METHODS
  School-based community intervention combined with repeated cross-sectional surveys over 7 years. The intervention was performed in the County of Västerbotten, Sweden, where survey data were collected in grade seven to nine schools on an annual basis for 7 years. Data for comparison were collected in grade nine on the national level in Sweden. In the intervention area, the annual number of seventh to ninth grade students participating in the study varied between 1300 and 1650. In the reference data, the number of participating ninth grade students approximated 4500 annually.
  
  
  RESULTS
  A significant decrease of nearly 50% was seen in smoking prevalence in the intervention area. The decrease was evident in grades eight and nine (ages 14-15 years) in both boys and girls. At the start of the intervention, smoking prevalence in grade nine was 16.1% in the intervention area and 23% in the national reference group. Although the prevalence in the national sample remained stable, there was a decrease to 9.0% in the intervention area at the end of the study period.
  
  
  CONCLUSIONS
  These results suggest that the Tobacco Free Duo program contributed to a reduction in adolescent smoking among both boys and girls. Using a multi-faceted intervention that includes adolescent-adult partnership can reduce adolescent smoking uptake, and the intervention has been proven to be sustainable within communities.
authors.affiliation: Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences, Umeå University, Umeå, Sweden. maria.nilsson@epiph.umu.se
authors.forename: Maria
authors.initials: M
authors.lastname: Nilsson
authors.forename: Hans
authors.initials: H
authors.lastname: Stenlund
authors.forename: Erik
authors.initials: E
authors.lastname: Bergström
authors.forename: Lars
authors.initials: L
authors.lastname: Weinehall
authors.forename: Urban
authors.initials: U
authors.lastname: Janlert
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D008297:Male; D008611:Mentors; D015995:Prevalence; D015397:Program Evaluation; D012380:Role; D012574:Schools / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention; D013548:Sweden / Q000453:epidemiology