A Meta-analysis of School-based Smoking and Alcohol Use Prevention Programs

Abstract

Tobacco and alcohol use among adolescents continue at historically high rates, and school-based interventions designed to deter students from smoking and drinking are increasingly being implemented. This study reports a meta-analysis of 47 smoking and 29 alcohol school-based intervention programs published after 1970. Results indicate that, in general, smoking and alcohol interventions have equally modest effects on immediate behavioral outcomes. Smoking interventions, however, have been more successful than alcohol interventions at altering students' long term behavior. All of the alcohol programs and all but one of the smoking programs reviewed successfully increased knowledge regarding the risks of these behaviors. Attitude change appears to be more difficult to achieve. Twenty-nine of 33 smoking studies and only 19 of 31 alcohol studies successfully changed students' attitudes. Finally, the data indicate that for immediate smoking outcomes and long-term alcohol outcomes innovative interventions relying upon social reinforcement, social norms, and developmental behavioral models are more effective than traditional "awareness" programs designed to inform adolescents about the health risks associated with tobacco and alcohol use. The implications of these findings for future of school-based health promotion programs are discussed.

A randomised controlled trial of a school-based intervention to prevent tobacco use among children and adolescents in Italy

“…Recent review of the scientific literature underlines the need to reinforce smoking prevention programmes even at very young ages Many systematic reviews demonstrate that school-based smoking prevention programmes are effective in reducing smoking habits, if conducted in a methodologically rigorous way (Rundall and Bruvold 1988;Bruvold 1993;Rooney and Murray 1996;Thomas 2002;Sowden et al 2003;Hwang et al 2004;Thomas and Perera 2009;Richardson 2009) . 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 11 They show evidence of a decreased prevalence of smoking among students exposed to the social influence programmes compared to students in control groups, with the mean difference between treated and nontreated groups (schools or classrooms) ranging from 5% to 60%, with a duration of 1-4 years.…”

Effective prevention programs school of drugs with interactive methodology / Eficacia de los programas de prevención escolar de drogas con metodología interactiva

“…Otros meta-análisis posteriores estudiaron la prevención del tabaquismo y abuso de alcohol (Rooney y Murray, 1996;Rundall y Bruvold, 1988), de marihuana (Tobler, Lessard, Marshall, Ochshorn y Roona, 1999), el papel de los compañeros líderes como monitores (BangertDrowns, 1988), o evaluaron programas específicos como el DARE (Drug Abuse Resistance Education) (Enneth, Tobler, Ringwalt y Flewelling, 1994).…”

“…En líneas generales, se confirma la idea de que es mejor intervenir que no hacerlo, aunque es preciso añadir que el efecto es pequeño y se sitúa en el límite inferior de la categoría "baja eficacia" establecida por Cohen (1988). La eficacia de los programas de prevención escolar en nuestro país es similar a la observada en otros países (Bangert-Drowns;1988;Enneth et al, 1994;Rooney y Murray, 1996;Rundall y Bruvold, 1988;Tobler, 1986Tobler, , 1992Tobler et al, 1999;Womer, 1998). Una transformación habitual en los estudios meta-analíticos es convertir el tamaño del efecto en porcentaje de prevención.…”

How Connectedness Contributes to Experimental Smoking Among Rural Youth: Developmental and Ecological Analyses

“…Yet, in previous studies of genetic and role model influences on smoking initiation, rarely have researchers examined how connectedness to others contributes to the likelihood that a youth will begin smoking. Doing so could provide a better understanding of how relationship factors facilitate or impede genetic and social learning processes, and could assist in the development of smoking prevention programs for youth (Bruvold, 1993;Rundell & Bruvold, 1988).…”