A systematic review of school-based smoking prevention trials with long-term follow-up

J Adolesc Health. 2005 Mar;36(3):162-9. doi: 10.1016/j.jadohealth.2004.12.003.


Background: Several systematic reviews of school-based smoking prevention trials have shown short-term decreases in smoking prevalence but have not examined long-term follow-up evaluation. The purpose of this study was to conduct a systematic review of rigorously evaluated interventions for school-based smoking prevention with long-term follow-up data.

Methods: We searched online bibliographic databases and reference lists from review articles and selected studies. We included all school-based, randomized, controlled trials of smoking prevention with follow-up evaluation to age 18 or 12th grade and at least 1 year after intervention ended, and that had smoking prevalence as a primary outcome. The primary outcome was current smoking prevalence (defined as at least 1 cigarette in the past month).

Results: The abstracts or full-text articles of 177 relevant studies were examined, of which 8 met the selection criteria. The 8 articles included studies differing in intervention intensity, presence of booster sessions, follow-up periods, and attrition rates. Only one study showed decreased smoking prevalence in the intervention group.

Conclusions: Few studies have evaluated the long-term impact of school-based smoking prevention programs rigorously. Among the 8 programs that have follow-up data to age 18 or 12th grade, we found little to no evidence of long-term effectiveness.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Child
  • Child Behavior*
  • Endpoint Determination
  • Follow-Up Studies
  • Humans
  • Prevalence
  • Randomized Controlled Trials as Topic
  • School Health Services*
  • Smoking / epidemiology
  • Smoking Prevention*
  • Treatment Outcome