title: Effectiveness of a school nurse-delivered smoking-cessation intervention for adolescents.
abstract: OBJECTIVE
  To evaluate the effectiveness of a school nurse-delivered smoking-cessation intervention in increasing abstinence among adolescent smokers.
  
  
  METHODS
  Thirty-five high schools were pair-matched and randomly assigned to 1 of 2 conditions, each of which consisted of 4 visits with the school nurse: (1) counseling intervention using the 5 A's model and cognitive-behavioral techniques; or (2) an information-attention control condition. Adolescents (n = 1068) who reported past 30-day smoking and interest in quitting completed surveys at baseline and at 3 and 12 months and provided saliva samples for biochemical validation of reported smoking abstinence.
  
  
  RESULTS
  Intervention condition participants were almost twice as likely to be abstinent per self-report at 3 months (odds ratio: 1.90 [95% confidence interval: 1.12-3.24]; P = .017) compared with control participants; at 12 months there were no differences. The difference at 3 months was driven by quit rates in male students (15.0% [intervention] vs 4.9% [control]; odds ratio: 3.23 [95% confidence interval: 1.63-6.43]; P = .001); there was no intervention effect in female students at either time point (6.6% vs 7.0% at 3 months and 16.6% vs 15.5% at 12 months) and no intervention effect in male students at 12 months (13.9% vs 13.2%). Smoking amount and frequency decreased significantly in intervention compared with control schools at 3 but not at 12 months.
  
  
  CONCLUSIONS
  A school nurse-delivered smoking-cessation intervention proved feasible and effective in improving short-term abstinence among adolescent boys and short-term reductions in smoking amount and frequency in both genders. Additional research is needed to enhance both cessation and maintained abstinence.
authors: Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA. lori.pbert@umassmed.edu
authors: Lori
authors: L
authors: Pbert
authors: Susan
authors: S
authors: Druker
authors: Joseph R
authors: JR
authors: DiFranza
authors: Diane
authors: D
authors: Gorak
authors: George
authors: G
authors: Reed
authors: Robert
authors: R
authors: Magner
authors: Anne H
authors: AH
authors: Sheetz
authors: Stavroula
authors: S
authors: Osganian
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy / Q000458:organization & administration*; D016001:Confidence Intervals; D003376:Counseling / Q000458:organization & administration; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D016014:Linear Models; D008297:Male; D024802:Nurse's Role; D016017:Odds Ratio; D010349:Patient Compliance; D015397:Program Evaluation; D012016:Reference Values; D018570:Risk Assessment; D012573:School Nursing / Q000379:methods*; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States