title: Long-term effects of a home-based smoking prevention program on smoking initiation: a cluster randomized controlled trial.
abstract: OBJECTIVE
  The aims of the study were to evaluate the long-term effects of a home-based smoking prevention program 'Smoke-free Kids' during preadolescence on smoking initiation during adolescence and to test the potential moderating role of parental smoking, socioeconomic status, and asthma.
  
  
  METHODS
  In 2008, 1478 9-11year old children and their mothers were recruited from 418 elementary schools in the Netherlands. An independent statistician randomly allocated schools to one of the two conditions using a 1:1 ratio (single blind): 728 children in the intervention and 750 in the control condition. The intervention condition received five activity modules, including a communication sheet for mothers, by mail at four-week intervals and one booster module one year after baseline. The control condition received a fact-based intervention only. Intention-to-treat analysis was performed on 1398 non-smoking children at baseline.
  
  
  RESULTS
  In the intervention 10.8% of the children started smoking compared to 12% in the control condition. This difference was non-significant (odds ratio=0.90, 95% confidence interval=0.63-1.27). No moderating effects were found.
  
  
  CONCLUSIONS
  No effects on smoking initiation after 36months were found. Perhaps, the program was implemented with children that were too young. Programs closer to the age of smoking onset should be tested.
authors.affiliation: Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands. Electronic address: m.hiemstra@bsi.ru.nl.
authors.forename: Marieke
authors.initials: M
authors.lastname: Hiemstra
authors.affiliation: Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
authors.forename: Linda
authors.initials: L
authors.lastname: Ringlever
authors.affiliation: Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
authors.forename: Roy
authors.initials: R
authors.lastname: Otten
authors.affiliation: Department of General Practice, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Onno C P
authors.initials: OC
authors.lastname: van Schayck
authors.affiliation: Public Health and Environment Division, RTI International, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Jackson
authors.affiliation: Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
authors.forename: Rutger C M E
authors.initials: RC
authors.lastname: Engels
mesh_terms: D000328:Adult; D002648:Child; D002652:Child Behavior / Q000523:psychology; D016000:Cluster Analysis; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D009034:Mother-Child Relations; D009426:Netherlands / Q000453:epidemiology; D010290:Parents / Q000523:psychology; D015397:Program Evaluation; D012111:Residence Characteristics; D016037:Single-Blind Method; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D012927:Social Control, Informal; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Children; Cluster randomized controlled trial; Homed-based; Prevention; Smoking initiation