Incentives for preventing smoking in children and adolescents

Abstract

BackgroundAdult smoking usually has its roots in adolescence. If individuals do not take up smoking during this period it is unlikely that they ever will. Further, once smoking becomes established, cessation is challenging; the probability of subsequently quitting is inversely proportional to the age of initiation. One novel approach to reducing the prevalence of youth smoking is the use of incentives. ObjectivesTo determine whether incentives prevent children and adolescents from starting to smoke. We also attempted to assess the dose-response of incentives, the costs of incentive programmes, whether incentives are more or less effective in combination with other interventions to prevent smoking initiation and any unintended consequences arising from the use of incentives. Search methodsWe searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE, EMBASE, CINAHL, CSA databases and PsycINFO for terms relating to incentives, in combination with terms for smoking and tobacco use, and children and adolescents. The most recent searches were in May 2012. Selection criteriaWe considered randomized controlled trials allocating children and adolescents (aged 5 to 18 years) as individuals, groups or communities to intervention or control conditions, where the intervention included an incentive aimed at preventing smoking uptake. We also considered controlled trials with baseline measures and post-intervention outcomes. Data collection and analysisData were extracted by two authors and assessed independently. The primary outcome was the smoking status of children or adolescents at follow-up who reported no smoking at baseline. We required a minimum follow-up of six months from baseline and assessed each included study for risk of bias. We used the most rigorous definition of abstinence in each trial; we did not require biochemical validation of self-reported tobacco use for study inclusion. Where possible we combined eligible studies to calculate pooled estimates at the longest follow-up using the Mantel-Haenszel fixed-effect method, grouping studies by study design. 1 Incentives for preventing smoking in children and adolescents (Review)

A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Germany: Randomized Controlled Trial

“…However, this result was mostly due to a too low sample size: only 47 schools were randomized due to an underestimated intracluster correlation coefficient [21,22]. The largest tobacco prevention program for secondary schools in Germany, the Smoke-Free Class Competition, has demonstrated limited effectiveness in increasing knowledge and making students initiate a quit attempt, but was not able to prevent smoking onset [23-25]. …”

Comparing effects of tobacco use prevention modalities: need for complex system models

“…We do not consider unique populations (e.g., indigenous youth; [15]) or unique types of prevention programming (e.g., use of incentives; [16]), for which only a couple of research studies exist. Rather, we consider five general types of regulatory approaches/policies (tax increases, warning labels, access laws, smoke-free policies, and marketing/advertisement bans), and mass media, school, family, and community agent modalities of programming (see Table 1).…”

Wie wirksam sind schulbasierte Interventionen zur Prävention und/oder Reduktion von Substanzkonsum bei Schülern/-innen in Grund- und Sekundarschulen? Eine systematische Übersicht vorhandener Reviews

“…Die Hinzunahme einer familiären Komponente wird in diesem Zusammenhang diskutiert [9]. Doch bislang konnte auch hierzu noch kein überzeugender Wirksamkeitsnachweis geliefert werden [14,21] Studien aus bestimmten Ländern) sein [8,12,13,16,22]. Zudem beziehen einige Publikationen neben schulbasierten Interventionen auch Studien aus anderen Settings wie dem Wohnumfeld/Quartier ein [9,15].…”