title: Comparing effects of tobacco use prevention modalities: need for complex system models.
abstract: Many modalities of tobacco use prevention programming have been implemented including various policy regulations (tax increases, warning labels, limits on access, smoke-free policies, and restrictions on marketing), mass media programming, school-based classroom education, family involvement, and involvement of community agents (i.e., medical, social, political). The present manuscript provides a glance at these modalities to compare relative and combined impact of them on youth tobacco use. In a majority of trials, community-wide programming, which includes multiple modalities, has not been found to achieve impacts greater than single modality programming. Possibly, the most effective means of prevention involves a careful selection of program type combinations. Also, it is likely that a mechanism for coordinating maximally across program types (e.g., staging of programming) is needed to encourage a synergistic impact. Studying tobacco use prevention as a complex system is considered as a means to maximize effects from combinations of prevention types. Future studies will need to more systematically consider the role of combined programming.
authors: Departments of Preventive Medicine and Psychology, University of Southern California, Soto Street Building 302A, 2001 N, Soto Street, Los Angeles, CA, 90033-9045, USA. ssussma@usc.edu.
authors: Steve
authors: S
authors: Sussman
authors: David
authors: D
authors: Levy
authors: Kristen Hassmiller
authors: KH
authors: Lich
authors: Crystal W
authors: CW
authors: Cené
authors: Mimi M
authors: MM
authors: Kim
authors: Louise A
authors: LA
authors: Rohrbach
authors: Frank J
authors: FJ
authors: Chaloupka