"Our study shows there is little evidence to suggest that existing school-based smoking prevention programs produce long-term reductions in smoking prevalence among youth," says the study's first author, Sarah Wiehe, M.D., M.P.H., assistant professor of pediatrics, Division of Children's Health Services Research at the Indiana University School of Medicine.
The researchers reviewed eight randomized, controlled smoking prevention trials with follow-up smoking data through at least 12th grade or age 18. Data from the popular Project DARE (Drug Abuse Resistance Education) program were included in the final analysis.
Seven of the studies, including Project DARE, showed no statistically significant difference in smoking prevalence between students enrolled in school based smoking prevention programs and students not enrolled in this type of program. Only one program, Life Skills Program, had fewer smokers at long-term follow-up than in control schools.
The Centers for Disease Control and Prevention currently recommends a comprehensive tobacco-control program, which includes a school-based component. In addition, Congress mandates that schools seeking Title IV funds use research-based prevention programs.
The March issue of the Journal of Adolescent Health includes an editorial by faculty of the Center for Tobacco Control Research and Education at the University of California, San Francisco. The commentary discusses the larger implications of the study's findings and offers some potentially more effective anti-smoking strategies such as use of the media, tax levies, and smoke-free environments.
The school-based programs studied by Dr. Wiehe and colleagues shared certain characteristics. Most targeted middle-school students, although some focused on high school students and one addressed both age groups. Most of the programs followed the social influences model of behavior change.
None of the smoking reduction programs reviewed included community or media programs, which have been shown to negatively influence adolescent smoking. There were wide variations in study populations, type and intensity of intervention, and outcome measures.
Along with Dr. Wiehe, the study was authored by, Michelle M. Garrison, M.P.H., Dimitri A. Christakis, M.D., M.P.H., Beth E. Ebel, M.D., M.Sc., M.P.H., and Frederick P. Rivara, M.D., M.P.H.. At the time of the study, all authors were at the University of Washington.
The study was funded by a grant from the Robert Wood Johnson Foundation.