title: The relationship between school-based smoking policies and prevention programs on smoking behavior among grade 12 students in Prince Edward Island: a multilevel analysis.
abstract: OBJECTIVE
  To examine how school-based smoking policies and prevention programs are associated with occasional and regular smoking among a cohort of grade 12 students in Prince Edward Island, Canada, between 1999 and 2001.
  
  
  METHODS
  Data from the Tobacco Module of the School Health Action, Planning and Evaluation System (SHAPES) collected from 3,965 grade 12 students in 10 high schools were examined using multi-level regression analysis.
  
  
  RESULTS
  Attending a school with smoking prevention programming was associated with a decreased risk of being an occasional smoker (OR 0.42, 95% CI: 0.18, 0.97). School-based policies banning smoking on school property were associated with a small increased risk of occasional smoking (OR 1.06, 95% CI: 0.67, 1.68) among some students. The combination of both policies and programs was not associated with either occasional or regular smoking.
  
  
  CONCLUSIONS
  This preliminary evidence suggests that tailored school-based prevention programming may be effective at reducing smoking uptake; however, school smoking policies and the combination of programs and policies were relatively ineffective. These findings suggest that a new approach to school-based tobacco use prevention may be required.
authors.affiliation: School of Nursing, University Prince Edward Island, Charlottetown, Prince Edward Island, Canada. dmurnaghan@upei.ca
authors.forename: Donna A
authors.initials: DA
authors.lastname: Murnaghan
authors.forename: Marja
authors.initials: M
authors.lastname: Sihvonen
authors.forename: Scott T
authors.initials: ST
authors.lastname: Leatherdale
authors.forename: Pertti
authors.initials: P
authors.lastname: Kekki
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D016017:Odds Ratio; D016134:Organizational Policy; D011325:Prince Edward Island / Q000453:epidemiology; D015397:Program Evaluation; D012044:Regression Analysis; D018570:Risk Assessment; D012309:Risk-Taking; D012574:Schools / Q000458:organization & administration*; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention