(RxWiki News) The health community has been striving to lower smoking rates for decades. The good news is that prevention programs have worked, some better than others.
A recent large-scale review looked at anti-smoking programs in elementary, middle and high schools from all over the world.
The results showed that prevention programs in which adults taught students about the dangers of alcohol, drugs and tobacco and how to handle peer pressure worked the best in the long run.
"Smoking prevention programs can help."
Roger E. Thomas, MD, PhD, from the Department of Family Medicine at the University of Calgary in Canada, led an investigation into whether smoking prevention programs delivered in primary and secondary school settings have helped reduce smoking rates.
The study authors searched through multiple medical study databases for studies and trials that tested anti-smoking campaigns in students from kindergarten through the 12th grade.
A total of 64 studies that involved 188,002 students from the past four decades were included in this review. Most of the studies (56 percent) were from North America, while the other 44 percent were from Europe, Asia, Australia and Africa.
The studies were classified into two groups: 49 were “Pure Prevention” and 15 were “Change in Smoking Behaviour.”
Pure Prevention programs were designed to prevent kids who had never smoked before from starting to smoke. Change in Smoking Behaviour programs were designed to get students to either never start smoking or quit if they had started.
The Pure Prevention programs did not appear to reduce smoking rates within the first year. The prevention programs that simply handed out anti-smoking information or dealt with peer-pressure did not appear to reduce smoking rates.
The prevention programs that combined ways to deal with peer-pressure and delivered information about the negative consequences of smoking and other substances did reduce smoking rates. Multi-substance prevention approaches addressed tobacco, alcohol and drug abuse.
The researchers found that programs using booster sessions that combined information and peer-pressure guidance after the initial session also helped reduce smoking rates. However, booster sessions delivered within one year of the initial program did not appear to affect smoking rates compared to booster sessions after one year.
The results showed that Pure Prevention approaches provided an average 12 percent reduction in starting smoking compared to no smoking program. This 12 percent reduction was not found in the short-term, but rather at least one year or more after the Pure Prevention program was delivered.
With the Changes in Smoking Behaviour programs, little to no improvements were made. And in some cases, more kids picked up smoking.
The researchers found that prevention programs had better results when they were led by adults rather than peer-led.
The study authors recommended further studies look into gender and ethnic differences in prevention programs that incorporate smoking, alcohol and drug education as well as techniques for coping with peer pressure.
This study was published in April in The Cochrane Review.
The National Institutes for Health Research in the UK supported funding for this project. The authors declare no conflicts of interest.