title: Meta-analysis on the effects of the smoke-free class competition on smoking prevention in adolescents.
abstract: BACKGROUND
  The 'Smoke-Free Class competition' (SFC) is a school-based smoking prevention programme including commitment not to smoke, contract management and prizes as rewards broadly implemented in Europe.
  
  
  OBJECTIVE
  To meta-analyse (randomised) controlled trials on the effects of SFC on current smoking at latest follow-up in adolescents.
  
  
  METHODS
  A systematic review of articles using MEDLINE and the Cochrane Library was conducted. The study selection included randomised controlled trials and controlled trials with follow-up assessment that investigated the efficacy of SFC on current smoking in students participating in SFC compared to non-participating students. Independent extraction of articles was performed by both authors.
  
  
  RESULTS
  Of 24 records identified, five fulfilled the inclusion criteria. These studies were conducted in three European countries (Finland, The Netherlands and Germany) and recruited 16,302 students altogether. A random effects meta-analysis of these five studies revealed a pooled risk ratio of 0.86 (95% CI 0.79-0.94; z = 3.44, p = 0.001) on current smoking at follow-up by participation in the competition.
  
  
  CONCLUSIONS
  SFC appears to be an effective tool in school-based smoking prevention.
authors.affiliation: Institute for Therapy and Health Research, Kiel, Germany. isensee @ ift-nord.de
authors.forename: Barbara
authors.initials: B
authors.lastname: Isensee
authors.forename: Reiner
authors.initials: R
authors.lastname: Hanewinkel
mesh_terms: D000293:Adolescent; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012572:School Health Services; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D013334:Students