Effect of a sport-for-health intervention (SmokeFree Sports) on smoking-related intentions and cognitions among 9-10 year old primary school children: a controlled trial

Abstract

BackgroundPreventing children from smoking is a public health priority. This study evaluated the effects of a sport-for-health smoking prevention programme (SmokeFree Sports) on smoking-related intentions and cognitions among primary school children from deprived communities.MethodsA non-randomised-controlled trial targeted 9-10 year old children from Merseyside, North-West England. 32 primary schools received a programme of sport-for-health activities over 7 months; 11 comparison schools followed usual routines. Data were collected pre-intervention (T0), and at 8 months (T1) and one year post-intervention (T2). Smoking-related intentions and cognitions were assessed using an online questionnaire. Intervention effects were analysed using multi-level modelling (school, student), adjusted for baseline values and potential confounders. Mixed-sex focus groups (n = 18) were conducted at T1.Results961 children completed all assessments and were included in the final analyses. There were no significant differences between the two study groups for non-smoking intentions (T1: β = 0.02, 95 % CI = -0.08–0.12; T2: β = 0.08, 95 % CI = -0.02–0.17) or for cigarette refusal self-efficacy (T1: β = 0.28, 95 % CI = -0.11–0.67; T2: β = 0.23, 95 % CI = -0.07–0.52). At T1 there was a positive intervention effect for cigarette refusal self-efficacy in girls (β = 0.72, 95 % CI = 0.21–1.23). Intervention participants were more likely to ‘definitely’ believe that: ‘it is not safe to smoke for a year or two as long as you quit after that’ (RR = 1.19, 95 % CI = 1.07–1.33), ‘it is difficult to quit smoking once started’ (RR = 1.56, 95 % CI = 1.38–1.76), ‘smoke from other peoples’ cigarettes is harmful’ (RR = 1.19, 95 % CI = 1.20–2.08), ‘smoking affects sports performance’ (RR = 1.73, 95 % CI = 1.59–1.88) and ‘smoking makes ‘no difference’ to weight’ (RR = 2.13, 95 % CI = 1.86–2.44). At T2, significant between-group differences remained just for ‘smoking affects sports performance’ (RR = 1.57, 95 % CI = 1.43–1.72). Focus groups showed that SFS made children determined to remain smoke free and that the interactive activities aided children’s understanding of smoking harms.ConclusionSFS demonstrated short-term positive effects on smoking attitudes among children, and cigarette refusal self-efficacy among girls. Although no effects were observed for non-smoking intentions, children said that SFS made them more determined not to smoke. Most children had strong intentions not to smoke; therefore, smoking prevention programmes should perhaps target early adolescents, who are closer to the age of smoking onset.

Children’s learning from a Smokefree Sports programme: Implications for health education

“…The Love Life, Smokefree Sports programme is a UK-based preventative tobacco intervention, informed by work conducted with more than 30 primary schools in the North West of England between 2010(McGee et al, 2016Trigwell et al, 2015). Delivered in primary schools over six physical education learning periods, the programme utilised sports, games and physical activities to convey a range of anti-smoking messages ( Table 1) (Brady et al, 2015).…”

“…At one school, sessions were 30 minutes long with 26-28 pupils in each session (each session was delivered three times). At the other school, sessions were one hour long with 41 pupils in each session.Like the original programme in the North West of England, the intervention design was guided by the Socioecological Model of Health, the Health Belief Model, the Theory of Planned Behaviour and Social Cognitive Learning(McGee et al, 2016;Trigwell et al, 2015) and the key themes addressed were broadly the same. Similarly, both interventions were delivered in areas of high deprivation, replaced regular PE sessions (six in the Love Life and five in the original programme) and included a final celebration assembly and a Smokefree pledge.…”

Sport and scholastic factors in relation to smoking and smoking initiation in older adolescents: a prospective cohort study in Bosnia and Herzegovina

“…5 7 18 Participation in sport is often considered as a potentially effective way of reducing the tendency of adolescents to smoke cigarettes. [19][20][21][22] Indeed, when comparing groups of adolescent athletes versus non-athletes, there is a lower prevalence of smoking in those involved in sports. [23][24][25] However, when sport participation was analysed more specifically, there were some conflicting findings with the association between sports and cigarette smoking.…”

Institutional strategies as a mechanism to rationalize the negative effects of the judicialization of access to medicine in Brazil

“…To analyze the effects of the interventions and the determinants of the total cost of the medications, bivariate and multiple linear regressions with robust variance were performed [39,40]. The following were considered determinants in the cost of the process: the prescription's origin, the quantity of medicines, and the disease.…”