Effects of sixty six adolescent tobacco use cessation trials and seventeen prospective studies of self-initiated quitting

Abstract

<p>Abstract</p> <p>This paper provides a review of the last two and a half decades of research in adolescent and young-adult tobacco use cessation. A total of 66 tobacco cessation intervention studies – targeted or population – are reviewed. In addition, an exhaustive review is completed of adolescent self-initiated tobacco use cessation, involving 17 prospective survey studies.</p> <p>Average reach and retention across the intervention studies was 61% and 78%, respectively, and was higher when whole natural units were treated (e.g., classrooms), than when units created specifically for the program were treated (e.g., school-based clinics). The mean quit-rate at a three to 12-month average follow-up among the program conditions was 12%, compared to approximately 7% across control groups. A comparison of intervention theories revealed that motivation enhancement (19%) and contingency-based reinforcement (16%) programs showed higher quit-rates than the overall intervention cessation mean. Regarding modalities (channels) of change, classroom-based programs showed the highest quit rates (17%). Computer-based (expert system) programs also showed promise (13% quit-rate), as did school-based clinics (12%).</p> <p>There was a fair amount of missing data and wide variation on how data points were measured in the programs' evaluations. Also, there were relatively few direct comparisons of program and control groups. Thus, it would be difficult to conduct a formal meta-analysis on the cessation programs. Still, these data suggest that use of adolescent tobacco use cessation interventions double quit rates on the average.</p> <p>In the 17 self-initiated quitting survey studies, key predictors of quitting were living in a social milieu that is composed of fewer smokers, less pharmacological or psychological dependence on smoking, anti-tobacco beliefs (e.g., that society should step in to place controls on smoking) and feeling relatively hopeful about life. Key variables relevant to the quitting process may include structuring the context of programming for youth, motivating quit attempts and reducing ambivalence about quitting, and making programming enjoyable as possible. There also is a need to help youth to sustain a quit-attempt. In this regard, one could provide ongoing support during the acute withdrawal period and teach youth social/life skills. Since there is little information currently available on use of nicotine replacement in young people, continued research in this arena might also be a useful focus for future work.</p

Tobacco use in youth with mental illnesses

“…Motivation enhancement strategies grounded in the transtheoretical (TTM) ''Stages of Change'' model, as well as behavioral therapy interventions have been the most thoroughly studied and have been shown to be the most effective intervention strategies thus far (Aveyard et al, 2001;J Behav Med (2012) 35:139-148 143 Brown et al, 2003Colby et al, 1998;Hollis et al, 2005;McDonald et al, 2003;Sussman, 2002;Sussman et al, 2006;CDC, 2009). A meta-analysis conducted by Sussman et al (2006) examined 48 smoking cessation studies and found significant treatment effects for those studies with motivation enhancement and cognitive-behavioral treatment foci, as well as for those with social-influence oriented treatment, which has been relatively less emphasized in the literature.…”

“…The N-O-T program has been implemented in schools across 48 states and has resulted in statistically significant reductions in smoking across studies and smoking cessation for approximately one in six participants (CDC, 2009). Overall, structured settings such as schools or clinics have been found to be most effective in implementing cessation programs for youth with and without mental illnesses (Sussman, 2002;Sussman & Sun, 2009). …”

Cost-Effectiveness Analysis of the Not On Tobacco Program for Adolescent Smoking Cessation

“…N-O-T is a ten-session theory-based program delivered by trained facilitators, typically in school settings (Dino et al 2001). N-O-T studies showed end-of-program intent-totreat quit rates between 15% and 19% for the period 1998-2003 (Horn et al 2005), among the highest rates reported in the literature (Sussman 2002). It has been rigorously evaluated as an effective, adoptable program (Horn et al 2005).…”

“…Although there have been important successes in smoking prevention (Mermelstein 2003), these efforts do not address the needs of youth who smoke and want to quit. Consistently, there remains a critical need for effective and adoptable teen smoking cessation interventions (Houston et al 1998;Lamkin et al 1998;Sussman 2002).…”

Sind Wettbewerbe zur Tabakentwöhnung von Jugendlichen geeignet?

“…Dort wurden Abstinenzraten von durchschnittlich ebenfalls 12% ermittelt [1]. Dies korrespondiert mit einem jüngeren Review, welches bei Entwöhnungsprogrammen für Jugendliche eine durchschnittliche Abstinenzrate von ebenfalls 12% berichtet [24].…”