Does a smoking prevention program in elementary schools prepare children for secondary school?

Prev Med. 2011 Jan;52(1):53-9. doi: 10.1016/j.ypmed.2010.11.003. Epub 2010 Nov 13.


Introduction: A smoking prevention program was developed to prepare children in elementary school for secondary school. This study assessed the effects on smoking in secondary school.

Methods: In 2002, 121 schools in The Netherlands were randomly assigned to the intervention or control group. The intervention group received 3 lessons in 5th grade of elementary school and a second 3 lessons in 6th grade. The control group received "usual care". Students completed 5 questionnaires: before and after the lessons in 5th and 6th grade and in the first class of secondary school. At baseline, 3173 students completed the questionnaire; 57% completed all questionnaires.

Results: The program had limited effect at the end of elementary school. One year later in secondary school significant effects on behavioral determinants and smoking were found. The intervention group had a higher intention not to smoke (β=0.13, 95% confidence interval=0.01-0.24) and started to smoke less often than the control group (odds ratio=0.59, 95% confidence interval=0.35-0.99): smoking increased from 2.5% to 3.6% in the intervention group and from 3.2% to 6.5% in the control group. Girls showed the largest differences in smoking between intervention and control condition.

Conclusions: A prevention program in elementary school seems to be effective in preventing smoking.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Cluster Analysis
  • Female
  • Health Promotion
  • Humans
  • Male
  • Program Evaluation
  • Schools
  • Smoking Prevention*
  • Students / psychology*
  • Surveys and Questionnaires