SHEU Literature search from 1984-2006: Smoking

SHEU : nationally-recognised, since 1977, as the specialist provider of reliable local survey data for schools and colleges

SHEU Literature search from 1984-2006

Smoking

SHEU has provided a literature search resource about young people, smoking and school-based research from 1984 (308 items currently)

Thanks to Zotero and Jason Priem

Last updated July 03 2012  - - - - - SEE ALSO LINKS TO "DRUGS"

http://sheu.org.uk

 

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Adolescent Substance Use in Different Social and Peer Contexts: A Social Network Analysis

Abstract	This exploratory study investigates whether associations between social network measures and substance use differ according to type of substance and social context. The analyses use data obtained from 13 and 15 year olds (N=3146) in a school-based survey and focus on three social network measures: sociometric position (e.g. group, dyad, isolate); popularity (friendship nominations received); and expansiveness (nominations made). The study aims to investigate: (i) the patterning of these social network measures by age, gender and school socioeconomic status (SES); and (ii) their relationships with substance use (current smoking, experience of drugs, alcohol in the previous week). Females and those from higher SES schools were more likely to be in groups, more popular and more expansive. Analyses including all three network measures, together with age, gender and school SES found main effects of sociometric position on smoking (lower than average rates among group members, higher than average for pupils in dyads and among isolates), of popularity on drugs and alcohol (highest levels among the most popular pupils) and of expansiveness on alcohol (highest rates among the most expansive). Interactions between the network measures, age, gender, school SES and substance use were also examined. We discuss our results concerning the use of different substances in relation to the mechanisms of selection and influence (as suggested by sociometric position, popularity and expansiveness) in differing social contexts represented by gender and school SES. (Contains 1 figure and 4 tables.)
Publication	Drugs: Education, Prevention and Policy
Date	December 00, 2006
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ753952

 

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Smoking trends among adolescents from 1990 to 2002 in ten European countries and Canada

Abstract	Daily smoking adolescents are a public health problem as they are more likely to become adult smokers and to develop smoking-related health problems later on in their lives.
Publication	BMC Public Health
Date	2006-11-10
URL	http://www.biomedcentral.com/1471-2458/6/280/abstract

 

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Access Point Analysis: What Do Adolescents in South Africa Say about Tobacco Control Programmes?

Abstract	This paper explores adolescent preferences for the setting, timing, delivery format, provider and key elements of tobacco control programmes. The need for programme sensitivity towards urban/rural, gender and ethnic subgroups is also discussed. Schools were purposively selected from the Southern Cape-Karoo Region, South Africa. Twelve prevention and nine cessation focus group discussions were conducted with Grade 6-8 students and Grade 8-9 smokers and ex-smokers, respectively. Adolescents reported similar preferences for prevention and cessation programmes. Although they were unaware of smoking prevention or cessation programmes, they reported a willingness to participate in such programmes. Programmes should include school-based activities that are supported by out-of-school activities held over weekends and holidays. Non-judgemental and empathetic teachers and peers, as well as ex-smokers were preferred as programme providers. School-based participatory delivery formats should be supported by community-based mass media approaches. Programmes can be jointly presented to boys and girls of diverse ethnic backgrounds with some gender-sensitive sessions. Programme participation and sustainability would be enhanced if it were exciting, fun filled and integrated into their daily lives. School-based programmes must be embedded within comprehensive approaches that involve community- and policy-level interventions.
Publication	Health Education Research
Date	July 00, 2006
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ937457

 

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School-Based Smoking Prevention Programs for Adolescents in South Korea: A Systematic Review

Abstract	The number of research papers evaluating programs designed to prevent adolescent smoking have increased in the last 13 years in Korea. The purpose of this study was to evaluate these programs, to review the features of the studies and to systemically assess the results on the knowledge about, and attitude to, smoking and smoking behavior. Database searched were national digital library (NDL) and the Research Information Service System, which are major literature search systems for all academic fields in South Korea, and the Research Information Center for Health, which is a database for health field. A total of 11 papers were included. Program contents are described under five categories and the mode of delivery is described. Methodological features were investigated and effect of the size of the study on variables investigated was computed. Knowledge was the main content of the program in most of the studies. Most studies delivered classroom-based instructions that were mainly didactic presentations. School-based smoking programs have not influenced adolescent smoking behavior as much as anticipated. Methodological problems were discussed. Several recommendations are made to improve effectiveness of smoking prevention programs and reduce methodological flaws in future studies.
Publication	Health Education Research
Date	July 00, 2006
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ937475

 

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Developmental Differences in Risk Factors for Suicide Attempts between Ninth and Eleventh Graders

Abstract	In order to identify differences in risk factors for suicide attempts throughout adolescence, this study utilized a school-based survey of ninth (n = 1,192) and eleventh graders (N = 1,055). Suicide attempts were associated with cigarette and alcohol use, family violence, and depression for ninth graders and with illicit drug use, school violence, and sexual abuse for eleventh graders, while having friends was protective for both groups. Additionally, having more than one risk factor imparted an exponential risk for suicide attempts (ninth greater than eleventh graders). The differences detected are consistent with developmental changes of adolescence and represent important information for identification of at-risk youth.
Publication	Suicide and Life-Threatening Behavior
Date	April 00, 2006
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ744539

 

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A web-based smoking cessation and prevention curriculum for medical students: why, how, what, and what next

Abstract	This paper summarises some major developments in medical education relating to the health risks of tobacco and to training in tobacco cessation and prevention strategies, and discusses some of the barriers to training. We also describe a project whose purpose was to design, implement and evaluate a web-based self-study tobacco curriculum for medical students to teach medical students to assist smokers to quit and to counsel non-smoking adolescents not to start smoking. This curriculum addresses some of the barriers, namely lack of curriculum time, lack of access to materials and experts, and relevance of the materials. The project was designed and evaluated at two medical schools in Georgia: Morehouse School of Medicine and Mercer University School of Medicine. A curriculum on tobacco control strategies and techniques designed for use in clinical settings was made available to first-year medical students as interactive computer-based tutorials. The curriculum, based on the US Public Health Service Clinical Guideline for Treating Tobacco Use and Dependence, was divided into two parts: the tutorial and practicum sections. Pre- and post-exposure measures were collected for the evaluation. The mean differences for correctly answered knowledge items in the two schools were similar: mean for Morehouse was + 2.07 and for Mercer +1.67, indicating improvements in knowledge for both schools. There were statistically significant improvements in all categories of self-rated ability to perform six counselling skills, except for Mercer students for the ‘Ask’ skill category (p = 0.069). The amount of exposure (measured only at Morehouse) was not related to overall change in scores but was associated with self-reported improvement in skill in assisting patients to quit smoking, confidence in counselling patients not interested in quitting, and confidence in counselling teens. The web-based curriculum successfully improved the students' self-rated counselling skills. Given the need and desire on the part of practitioners for training, the curriculum may be found useful by practising physicians and other health-care professionals who wish to improve their skills in smoking prevention and cessation
Publication	Drug and Alcohol Review
Date	2006
URL	http://onlinelibrary.wiley.com/doi/10.1080/09595230500459503/abstract

 

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Reflections on 30 + years of smoking cessation research: from the individual to the world

Abstract	This is a personal retrospective in which I describe my career as a smoking cessation researcher and place cessation into an overall perspective of tobacco reduction. I spent approximately the first 15 years focusing primarily upon small group approaches to cessation emphasising relatively intensive behavioural interventions. It became apparent, however, that these types of approaches in isolation, even if broadly disseminated, would have relatively minimal impact on overall tobacco use. In part because I became discouraged with the potential of group programmes to reduce overall smoking prevalence, I began to focus more on population-based studies, especially in the context of ‘teachable moments’ including pregnancy, hospitalisation, forced abstinence in the military and existing smoking-related disease. I became concerned especially with the fact that there has been relatively little work with hard-core medically compromised smokers. It also became apparent that promoting cessation would be most likely to be effective with a comprehensive evidence-based tobacco reduction strategy including school and community-based prevention programmes, enforcement of ordinances restricting minors' access to tobacco, restrictions on tobacco advertising and promotion, counter advertising and strong smoke-free policies. In recent years I have become very concerned about the overall global tobacco epidemic and the projections of dramatically increasing tobacco morbidity and mortality in developing countries. I am now devoting my primary career emphasis to global tobacco reduction initiatives, including cessation research in India and Indonesia, cessation as part of broader tobacco reduction strategies and networking to increase resources and emphasis devoted to global tobacco reduction.
Publication	Drug and Alcohol Review
Date	2006
URL	http://onlinelibrary.wiley.com/doi/10.1080/09595230500459461/abstract

 

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Comparison of Smoking, Drinking, and Marijuana Use Between Students Present or Absent on the Day of a School-Based Survey

Abstract	Abstract: The aim of this population-based survey was to compare the prevalence of selected risk behaviors between students present or absent on the day of a school-based survey. The study population was a representative sample of all students of secondary schools in the Seychelles (Indian Ocean). Students absent on the day of the survey were traced and requested to complete the same self-administered questionnaire as did present students. Self-reported consumption of cigarettes, alcohol, and marijuana were measured. Of the sample of 1453 eligible students aged 11 to 17 years, 1321 “present students” completed the survey (90.9% participation), 11 refused to answer all questions, and 121 were not present at school. We could trace 105 of the 121 students not present at school on the survey day (“absent students”), and all of them completed the questionnaire over the next 4 weeks. The prevalence of risk behaviors was significantly higher in absent than present students for current smoking and drinking. Inclusion of data from the absent students resulted in a relative increase in the prevalence of the considered behaviors by 3% to 8% as compared to data based on present students only. In conclusion, the prevalence of risk behaviors was higher in absent than present students. Adjusting for data of absent students increased the prevalence estimates in the base population. (J Sch Health. 2006;76(4):133-137)
Publication	Journal of School Health
Date	2006
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2006.00081.x/abstract

 

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Health, schooling and lifestyle among young adults in Finland

Abstract	This was a longitudinal, general population study based on a Northern Finland 1966 Birth Cohort, using a structural equation approach to estimate the health production function and health input functions for four lifestyle variables (smoking, alcohol consumption, exercise and unhealthy diet) for males and females. In particular, we examined the productive and allocative effects of education on health. We used 15D, a generic measure of health-related quality of life, as a single index score measure but we also estimated models for some of its dimensions. Among the males, the important factors impacting on health were education and all the four lifestyle factors, as well as some exogenous variables at 31 years and variables describing parents' background, and health and behaviour at 14 years. An increase of five years in schooling increased the health score by 0.008, of which about 50% was due to direct effect and 50% due to indirect effects. Among the females, education does not impact on health, but health was affected by the use of alcohol, exercise and diet, but not by smoking.Our results indicate that policy options that increase education among men will increase their health indirectly via healthier lifestyles. However, since the total effect was rather modest and the direct effect insignificant, an increase of schooling is not a cost-effective way to increase health given the present high educational level of Finland. The young adults' and particularly women's internationally high educational status in Finland might be a reason why we find only a modest effect of schooling on health and the non-existence of such effects among women. Copyright © 2006 John Wiley & Sons, Ltd.
Publication	Health Economics
Date	2006
URL	http://onlinelibrary.wiley.com/doi/10.1002/hec.1123/abstract

 

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Analysis Versus Production: Adolescent Cognitive and Attitudinal Responses to Antismoking Interventions

Abstract	This study examined cognitive and attitudinal responses of adolescents to two inoculation-based media-literacy intervention approaches designed to reinforce adolescents’ attitudes against smoking. Participants were junior high students (sixth, seventh, and eighth grade) from schools in the northeast. Two kinds of experimental workshops and a control group were used in a repeated measure nonequivalent group experimental design. The two intervention workshops developed included analysis (where participants discussed and analyzed cigarette and antismoking ads) and production (where participants discussed, analyzed, and then created their own antismoking ads). Results showed an overall support for the production workshop in eliciting more attention and positive workshop perceptions than the analysis workshop. The production workshop was also successful in reducing positive attitudes toward smoking over time. Implications and directions for future research are discussed including implications for theories of message processing.
Publication	Journal of Communication
Date	2006
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1460-2466.2006.00319.x/abstract

 

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A population-based case–control study of risk factors for neural tube defects in four high-prevalence areas of Shanxi province, China

Abstract	Shanxi province in Northern China has one of the highest reported prevalence rates of neural tube defects (NTD) in the world. To explore the risk factors for NTDs in Shanxi province, we carried out a population-based case–control study in four selected counties with prevalence rates >10 per 1000 births during 2003. Using a multi-logistic regression model analysis (α = 0.10), 158 NTD cases were compared with 226 control mothers.Maternal factors significantly associated with increased risk for an NTD were a primary school education or lower (adjusted odds ratio [OR] 2.32, 95% confidence interval [CI] 1.09, 4.97); a history of a previous birth defect-affected pregnancy (adjusted OR 5.27, 95% CI 0.98, 28.37); history of a fever or ‘cold’ (adjusted OR 3.36, 95% CI 1.68, 6.72); use of analgesic and antipyretic drugs (adjusted OR 4.89, 95% CI 0.92, 25.97); daily passive exposure to cigarette smoke (adjusted OR 1.60, 95% CI 0.94, 2.73); poor ventilation during heating (adjusted OR 3.91, 95% CI 0.75, 20.81); and consumption of ≥ six meals per week containing pickled vegetables (adjusted OR 3.86, 95% CI 1.11, 13.47) during pregnancy.Factors which appeared to be protective were meat consumption one to three times per week (adjusted OR 0.62, 95% CI 0.37, 1.06), or ≥ four times per week (adjusted OR 0.28, 95% CI 0.11, 0.77); and legume consumption ≥ six times per week (adjusted OR 0.39, 95% CI 0.17, 0.89). Differences in risk were found between the two most common phenotypes, anencephaly and spina bifida. Most of the environmental factors had stronger positive and negative associations with risk for anencephaly rather than spina bifida, whereas history of a previous birth defect-associated pregnancy, as well as legume consumption, were more strongly associated with the risk for spina bifida than for anencephaly. The findings suggest that aetiological heterogeneity may exist between anencephaly and spina bifida.
Publication	Paediatric and Perinatal Epidemiology
Date	2006
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3016.2006.00694.x/abstract

 

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School health nurses and substance use among adolescents – towards individual identification and early intervention

Abstract	Adolescents’ health is today threatened by the use of alcohol and other psychoactive substances. It is therefore important to develop interventions related to substance use in school health care. The aim of this study was to examine the empowering or risk background factors related to substance use among adolescents, and the ability of school nurses (PHN) to identify these factors and to provide needed individual early intervention. The data were collected by semistructured questionnaires completed by 14- to 18-year-old adolescents (n = 326, response rate 79) and PHNs (n = 10) in 2004. The adolescent questionnaire consisted of items related to the respondents’ background and Adolescents’ Substance Use Measurement (ADSUME). Following individual consent, adolescents’ ADSUME responses were sent to the PHNs for intervention. The PHNs assessed the adolescents’ empowering background factors and intervention using the questionnaire, and 70% (n = 228) of their answers matched the adolescents’ answers. The data were analysed with the SPSS software using the chi-squared test, Fisher's exact test, kappa coefficient and agreement percentages. Substance use among adolescents was associated with parental support, mother's education and smoking, the adolescents’ knowledge about substances, peer support and hobbies. The PHNs’ assessments regarding supportive background were not in agreement with the assessments of adolescents who were using hazardous substances. One-fifth of the adolescents received the brief intervention, although many of them might have needed extra support and follow-up on the basis of their ADSUME results. The research findings can be generalized only for alcohol use, because only 3% of the study informants used substances other than alcohol. Further research is warranted concerning PHNs’ ability to identify hazardous substance use and to ensure preventive early intervention and requisite support among substance-using adolescents in order to improve evidence-based health promotion.
Publication	Scandinavian Journal of Caring Sciences
Date	2006
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1471-6712.2006.00425.x/abstract

 

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Antitobacco Media Awareness of Rural Youth Compared to Suburban and Urban Youth in Indiana

Abstract	ABSTRACT: Purpose: This study examined the awareness and impact of antitobacco media messages among rural, suburban, and urban youth. Method: Self-administered questionnaires were received from 1,622, 1,059, and 1,177 middle school (sixth, seventh, and eighth grade) students in rural, suburban, and urban locations, respectively. Logistic regression compared media awareness and impact among the groups, controlling for grade, gender, race, and smoking behavior. Results: Compared to rural youth, suburban youth were more likely to recall media messages about the dangerous health effects of tobacco use (odds ratio [OR] = 1.94) and have their personal choice to use tobacco affected by the messages (OR = 1.85). Suburban and urban youth more often recalled antitobacco messages (OR = 2.00 and 2.15), reported that the messages made them think about the dangers of tobacco use (OR = 2.02 and 1.47), believed that these ads prevent youth from initiating tobacco use (OR = 3.21 and 1.46) and stop youth from using tobacco (OR = 2.25 and 1.47), and recalled seeing specific campaign television ads (OR = 3.72 and 3.57). Urban youth were more likely to recall specific campaign messages on the radio (OR = 1.58). Neither suburban nor urban youth differed from the rural youth on whether the campaign-specific radio and television ads made them think about not using tobacco. Conclusions: The results support the need for targeting antitobacco media announcements to youth, based on their residence.
Publication	The Journal of Rural Health
Date	2006
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1748-0361.2006.00019.x/abstract

 

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Family and School Influences on Adolescent Smoking Behaviour

Abstract	Purpose: This paper aims to examine how influences at home and school interact to predict smoking among adolescents. Design/methodology/approach: Data were collected from 15-year-old pupils from Norway (n=1,404 in 73 Grade 10 school classes). Multilevel logistic regression analysis was used to determine how family and school influences interact to predict adolescent smoking behaviour. Findings: A total of 14 schools strictly enforced the ban on smoking among pupils, and 60 schools strictly enforced existing restrictions on teachers' smoking. Pupils from all schools were exposed to smoking by both their families and teachers. Although the main effects of school enforcement and family smoking were not associated with adolescent smoking behaviour, a cross-level interaction term between these variables was significantly associated with school level variation in regular smoking (odds ratio [OR] 5.57, 95 percent confidence interval 1.47-21.12). Individual rather than school's perception of exposure to teacher's smoking, and parental norms were associated with adolescent smoking behaviour, irrespective of the school's level of enforcement. Practical implications: The effect of school smoking restrictions seems to be dependent on smoking norms at home. Thus, in addition to school-based anti-smoking policies, those directed at parents are needed as well. Originality/value: The present study used a multilevel statistical approach to study the association between the independent factors and adolescent smoking behaviour, an approach that takes into account the cluster effect in hierarchically structured data. The use of this approach is important in studies that involve data with hierarchies as a means to avoid false conclusions. (Contains 2 tables and 1 figure.)
Publication	Health Education
Date	2006
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ802238

 

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Participation in School Sports: Risk or Protective Factor for Drug Use among Black and White Students?

Abstract	This study examined the relationship between participation in school-based sports and drug use among Black and White high school students, using data from participants in the National Educational Longitudinal Survey of 1988 (NELS, NCES, 1988) and follow-up surveys in 1990 and 1992. While previous research produced inconsistent results, the present study revealed that participation in school-based sports was associated with a reduction in cigarette and marijuana use, thus, serving as a protective factor for Black and White students. However, the protective role of sports involvement for alcohol use was present only among Black females. Participation in sports was associated with an increase in alcohol use (serving as a risk factor) among White males and females and Black males (after controlling for conventional predictors of alcohol use in adolescence). Implications for expanding the role of sports as a potential school resource in drug use prevention planning are discussed. (Contains 2 tables.)
Publication	Journal of Negro Education
Date	2006
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ764602

 

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A Longitudinal Study Exploring Liverpool Primary Schoolchildren's Perspectives on Smoking

Abstract	A cohort study was designed to explore over 200 primary schoolchildren's (ages 4–7) perspectives on smoking in the context of their own lives and subsequently, to assess any changes in these perspectives over time. Results showed that, in general, the children had a negative disposition about the habit, which did not dissipate over the 3-year study period. They had a fairly substantive understanding of smoking, in particular of the consequences to health, which increased in breadth and depth over time and they acknowledged the central role that the family played within the 'culture' of smoking. Such results have implications for the development of effective school-based smoking prevention strategies.
Publication	Childhood
Date	November 01 , 2005
URL	http://chd.sagepub.com/cgi/content/abstract/12/4/425

 

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Indian Youth Speak About Tobacco: Results of Focus Group Discussions With School Students

Abstract	This article discusses the findings of Focus Group Discussions (FGDs) that were conducted as a formative assessment for Project MYTRI (Mobilizing Youth for Tobacco Related Initiatives in India), a randomized, multicomponent, school-based trial to prevent and control tobacco use among youth in India. Forty-eight FGDs were conducted with students (N = 435) in sixth and eighth grades in six schools in Delhi, India. Key findings include: (a) students in government schools reported as “consumers” of tobacco, whereas students in private schools reported as “commentators”; (b) parents and peers have a strong influence on youth tobacco use; (c) chewing gutkha is considered less harmful and more accessible than smoking cigarettes; (d) schools are not promoting tobacco control activities; and (e) students were enthusiastic about the role government should play in tobacco control. These findings are being used to develop a comprehensive intervention program to prevent and control tobacco use among Indian youth.
Publication	Health Education & Behavior
Date	June 01 , 2005
URL	http://heb.sagepub.com/cgi/content/abstract/32/3/363

 

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Evaluation of a School and Peer Based Anti-Smoking Program Targeting Southwest Louisiana Grade School Students

Abstract	Evidence suggests that anti-smoking programs that target school-aged children can be effective and that they can assist in reducing tobacco use among peers. This article presents an evaluation of a peer and school based mentoring program offered by Big Brothers/Big Sisters of Southwest Louisiana in conjunction with local elementary schools. The program matches high school mentors with elementary school children believed to be at a high risk for smoking, as well as for alcohol and drug abuse. The results of the evaluation were mixed. Teachers and mentors praised the program. Participation in the program was also associated with a reduction in peer use of alcohol and tobacco. However, there was no significant difference between experimental and control groups with respect to how the grade school subjects recognized the harm that alcohol can produce for children. Further, there was no significant difference in how experimental and control groups viewed the damage to children that could be done by a combination of alcohol, tobacco, and street drugs. The mixed results demonstrate the program's promise and its potential usefulness as a strategy to prevent teen smoking. At the same time, the results underscore the complex interplay of factors that may contribute to the success or failure of such innovative programs.
Publication	Journal of Applied Social Science
Date	2005
URL	http://jax.sagepub.com/cgi/content/abstract/os-22/2/91

 

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A school-based harm minimization smoking intervention trial: outcome results

Abstract	Aims To determine the impact of a school-based harm minimization smoking intervention compared to traditional abstinence-based approaches.Design, setting and participants A school-based cluster randomized trial was conducted in Perth, Western Australia in 30 government high schools from 1999 to 2000. Over 4000 students were recruited to participate and schools were assigned randomly to either the harm minimization intervention or a standard abstinence-based programme.Intervention The harm minimization intervention comprised eight 1-hour lessons over 2 years, quitting support from school nurses and enactment of policies to support programme components. Comparison schools implemented standard abstinence-based programmes and policies.Measures Cigarette smoking was categorized at two levels: regular smoking, defined as smoking on 4 or more days in the previous week; and 30-day smoking as any smoking within the previous month.Findings At immediate post-test (20 months post-baseline), after accounting for baseline differences, school-level clustering effects, socio-economic status, gender and family smoking, intervention students were less likely to smoke regularly [OR = 0.51, 95% confidence interval (CI) = 0.36, 0.71] or to have smoked within the previous 30 days (OR = 0.69, 95% CI = 0.53, 0.91).Conclusion The school-based adolescent harm minimization intervention appears to have been more effective than the abstinence-based social influences programme at reducing regular smoking.
Publication	Addiction
Date	2005
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2005.01052.x/abstract

 

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Evaluation of the school-based smoking-prevention program “BE smokeFREE”

Abstract	This article examines the impact of the school-based smoking-prevention program “BE smokeFREE” on adolescent smoking. A national representative sample of 99 schools (195 classes, 4,441 students) was used when the intervention started in November 1994. Schools were allocated to one of four groups: a comparison group (A) and three intervention groups (B, C, and D). Group B received the most comprehensive intervention. A baseline (autumn 1994) and three follow-up data collections (1995, 1996, and 1997) were conducted. There were no significant differences in smoking habits among the four groups at baseline. The smoking habits in the group that was involved in the most comprehensive intervention (group B) changed more favourably than those of students in the comparison schools over the three follow-up data collections. At the third follow-up, the proportion of students smoking weekly or more in the comparison group was 29.2%, compared with 19.6% in the model intervention group. The two less comprehensive interventions (no teacher in-service courses in group C, and no involvement of parents in group D) appeared to be less effective than the model intervention. Multilevel multiple logistic regression analyses, comparing changes in smoking habits between students in group B with those among students in the comparison schools, confirm the conclusion that the comprehensive intervention was the most effective. This school-based intervention, based on a social influence approach, proved to be effective at reducing smoking rates among participants.
Publication	Scandinavian Journal of Psychology
Date	2005
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1467-9450.2005.00448.x/abstract

 

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Evidence for Smoking Cessation: Implications for Gender-Specific Strategies

Abstract	Background: Facilitating smoking cessation requires an evidence-based approach. The Lienhard School of Nursing Institute for Healthy Aging in the United States, whose focus is providing health information to aging baby boomers, developed an interest in studying strategies for smoking cessation in women.Approach: Studies were reviewed and critiqued related to the question: What is the relative efficacy of first-line smoking cessation interventions for women versus men in the 40- to 65-year-old age group? This article first discusses the procedure used to construct an integrative framework for finding the evidence on smoking cessation, including a literature search and refinement of the problem to be studied, and then a summary of the evidence gathered on the selected variable (gender) and interventions (counseling, pharmacotherapy, nicotine replacement therapy).Findings: Evidence was found that supports the general efficacy of three first-line smoking cessation interventions: counseling, bupropion-sustained release (BSR), and nicotine replacement therapy (NRT). What the evidence does not show, however, is which of these interventions may be more effective for women versus men in general or specifically in the 40- to 65-year-old age group.Recommendations: Recommendations include the development of a clinical trial and the inclusion from the outset of gender as a major variable in all future intervention studies.Implications: Practice implications include the fact that since effective treatments already exist for assisting clients to stop smoking, all health-care providers should offer an intervention that has been found effective to any client who expresses a desire to quit smoking. Further studies of efficacy are needed to develop more focused implications.Worldviews on Evidence-Based Nursing 2005; 2(2):63-74
Publication	Worldviews on Evidence-Based Nursing
Date	2005
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1741-6787.2005.04055.x/abstract

 

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Ethno-specific patterns of adolescent tobacco use and the mediating role of acculturation, peer smoking, and sibling smoking

Abstract	Aims The objectives of this study are to identify the relationship between ethnic identity and tobacco use, and to examine the mediating effects of peer and sibling smoking and acculturation.Design and measurements Data were drawn from a cross-sectional survey of 3400 Toronto students, sampled from 30 schools between 1998 and 2000. Primary ethnic identity was based on adolescents’ self-identification of their ethnic heritage condensed to 12 groups for analysis. Tobacco use was measured as a dichotomy, predicting non-smoking in the past year. Multivariate logistic regression models were employed to test for baseline differences in non-smoking by ethnic identity. Subsequent models adjusted for controls (age, gender, social class, religious attendance, educational achievement) and introduced mediators.Findings Results indicated that smoking varied among adolescents of differing ethnic identities. Adolescents of western European, eastern European and southern European ethnicity were considerably less likely to be non-smokers, while Chinese, South Asian and East Indian and West Indian youth were more inclined to be non-smokers. The discrepancies in rates of non-smoking among western European and South Asian and East Indian adolescents were explained by a combination of peer and sibling smoking and acculturation; among southern European and eastern European youth via peer and sibling smoking; and by neither peer and sibling smoking nor acculturation for Chinese and West Indian youth.Conclusions This paper demonstrates that disparities in tobacco use among certain ethnic groups can be explained by peer and sibling smoking and acculturation; however, for other ethnic groups, knowledge of the processes that account for differences in tobacco use remains less clear.
Publication	Addiction
Date	2005
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2005.01165.x/abstract

 

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Young children's understandings of cigarette smoking

Abstract	Aims We explore young children's attitudes toward, beliefs about, and life-style associations with cigarette smoking using direct and indirect measures.Design, setting and participants Second (n = 100) and fifth grade (n = 141) elementary school students (i.e. 7–8 and 10–11-year-olds) were excused from class and individually interviewed.Methods Participants selected pictures in response to the questions: who would like to smoke cigarettes the most and who would like to smoke cigarettes the least? Their picture choices were probed using open-ended prompts designed to elicit the beliefs and life-style associations underlying their choices. Survey-based measures of attitudes and beliefs were also collected.Findings Second graders reported life-style associations with cigarette smoking that were consistent with those of fifth graders. While their associations with smoking are generally negative, children appear to perceive that others feel that smoking makes them look cool and feel cool and also helps them to fit in. By fifth grade, many children believe that smoking can help to reduce stress and alleviate negative mood states. The presence of a smoker in the household does not appear to affect these associations, suggesting that they may be being shaped by external socialization agents.Conclusion Young children appear to be developing understandings of cigarette smoking that go beyond knowing that cigarettes are products that are smoked. As some of their perceptions appear likely to predispose them for future experimentation, young children need to be included in prevention research so that age-appropriate interventions can be developed.
Publication	Addiction
Date	2005
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2005.01195.x/abstract

 

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School Tobacco Policies in a Tobacco-Growing State

Abstract	ABSTRACT: This study examined factors associated with tobacco-free policies and tobacco cessation in schools serving children in grades 6 to 12 in a tobacco-growing state using a cross-sectional telephone survey of school administrators from public and private middle and high schools (N = 691), representing 117 of the 120 Kentucky counties. Trained health department staff contacted 1028 schools; 691 (67%) participated in a phone survey, which lasted an average of 19 minutes. Variables of interest were indoor and outdoor smoking policies, fund-raising in Bingo halls, provision of cessation and prevention programs, owning or leasing a tobacco base, if the school received money from tobacco companies, type of school (public vs private), and school setting (urban vs rural). Only 20% of Kentucky schools reported comprehensive tobacco-free policies. Urban area schools were nearly twice as likely to have a tobacco-free campus than rural schools. Schools that did fund-raising in smoky Bingo halls were 30% less likely to have tobacco-free school policies. While few schools had a tobacco affiliation, those that received money from tobacco companies or grew tobacco were nearly 3 times as likely to provide cessation resources, compared to schools without tobacco affiliation. Rural schools were less likely to be tobacco free and provide cessation services. School-related, off-campus, extracurricular events might be considered as an element of tobacco-free school policy. Schools with tobacco affiliation may provide more cessation resources due to the increased prevalence of tobacco use in these areas.
Publication	Journal of School Health
Date	2005
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2005.tb06676.x/abstract

 

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Cannabis use in adolescents: the impact of risk and protective factors and social functioning

Abstract	The study uses a school-based sample to test the social and familial risk and protective factors relating to cannabis use. Based on a self-completion survey of 2078 14–16-year-olds (mean age of 15 years) attending seven standard state-run secondary schools in south London, an assessment was made of rates and risk factors for cannabis use. Twenty-four per cent of the total sample had ever used cannabis, with 15% having done so in the month prior to assessment. In addition to greater likelihood of illicit drug use, lifetime cannabis users were less likely to spend time regularly with both their mothers and fathers, but more likely to spend free time with friends who smoked, drank alcohol and used illicit drugs, and with friends involved in criminal activities. Among those who had ever used cannabis, frequency of cannabis use was predicted (using linear regression) by two onset factors (earlier initiation of drinking and cannabis use were both linked to more frequent use) and two social factors (more time spent with drug-using friends and less time spent with the mother). Overall, the study showed that early onset, itself predicted by social networks, is linked to more frequent use of cannabis and that this appears to be sustained by less time spent with parents and more with drug-using peers.
Publication	Drug and Alcohol Review
Date	2005
URL	http://onlinelibrary.wiley.com/doi/10.1080/09595230500292920/abstract

 

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A mixed-effects regression model for three-level ordinal response data

Abstract	Three-level data occur frequently in behaviour and medical sciences. For example, in a multi-centre trial, subjects within a given site are randomly assigned to treatments and then studied over time. In this example, the repeated observations (level-1) are nested within subjects (level-2) who are nested within sites (level-3). Similarly, in twin studies, repeated measurements (level-1) are taken on each twin (level-2) within each twin pair (level-3). A three-level mixed-effects regression model is described here. Random effects at the second and third level are included in the model. Additionally, both proportional odds and non-proportional odds models are developed. The latter allows the effects of explanatory variables to vary across the cumulative logits of the model. A maximum marginal likelihood (MML) solution is described and Gauss–Hermite numerical quadrature is used to integrate over the distribution of random effects. The random effects are normally distributed in this instance. Features of this model are illustrated using data from a school-based smoking prevention trial and an Alzheimer's disease clinical trial. Copyright © 2005 John Wiley & Sons, Ltd.
Publication	Statistics in Medicine
Date	2005
URL	http://onlinelibrary.wiley.com/doi/10.1002/sim.2186/abstract

 

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Size doesn't matter- Evidence does

Abstract	Guernsey recently voted to ban all smoking in enclosed public and working places. One of the biggest contributors, that demonstrated the impact the smoking campaign was having, was the strong evidence-base from monitoring smoking levels amongst young people
Publication	Education and Health
Date	2005
URL	/sheux/EH/eh332aw.pdf

 

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A Meta-Analysis of Adolescent Psychosocial Smoking Prevention Programs Published Between 1978 and 1997 in the United States

Abstract	Psychosocial smoking prevention studies have shown inconsistent results and theory-driven programs have been related to program success. This meta-analysis was used as a judgment tool for resolving these issues by estimating average program effects and investigating the relative efficacy of program types. The present study examined 65 adolescent psychosocial smoking prevention programs (1978 to 1997) among students in Grades 6 to 12 in the United States. Three program modalities (social influence, cognitive behavior, life skill) and two program settings (exclusively school based, school-community-incorporated) were identified as major a priori classifications. Knowledge had the highest effect sizes (.53) at short-term (≤ 1 year) but rapidly decreased (.19) at long-term(> 1 year). Behavioral effect was the most meaningful, being persistent over a 3-year period (.19 at ≤ 1 year; .18 at 1 to 3 years). Adolescent smoking reduction rates were increased by using either cognitive behavior or life skills program modalities, and/or a school-community-incorporated program setting.
Publication	Health Education & Behavior
Date	December 01 , 2004
URL	http://heb.sagepub.com/cgi/content/abstract/31/6/702

 

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How Does Active Parental Consent Influence the Findings of Drug-Use Surveys in Schools?

Abstract	This study examines the impact of passive and active parental consent procedures on the type of adolescents participating in a school-based survey examining substance use. Schools recruited from a random sample of metropolitan schools were assigned to passive or active parental consent condition. Results showed that participationrates in active consent schools were lower than in passive consent schools for junior students (60% vs. 80%) but not senior students. Although consent condition had limited impact on prevalence estimates among older students, among younger students estimates of cannabis use and ecstasy use were higher in the passive consent condition than the active consent condition. Active consent procedures introduce some degree of selection bias into studies of adolescents’ substance use and may compromise the external validity of prevalence estimates produced, especially among younger students.
Publication	Evaluation Review
Date	June 01 , 2004
URL	http://erx.sagepub.com/cgi/content/abstract/28/3/246

 

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Substance Abuse and Behavioral Correlates of Sexual Assault among South African Adolescents

Abstract	Objective: The aim of this article is twofold: first, to examine the prevalence of being the victim of actual and attempted rape among a large representative sample of Cape Town high school students; and second, to identify the correlates of sexual assault for both boys and girls, including alcohol, tobacco and other drug use, behavioral problems, and suicidality. Method: Data for this study were derived from the 1997 South African Community Epidemiology Network on Drug Use (SACENDU) school survey. A stratified sampling procedure was used to select students in Grades 8 and 11 at non-private high schools in Cape Town. A total of 2,946 students completed a survey consisting of socio-demographic questions and items about substance abuse, sexual activity, and other adolescent health risk behaviors. A subsample of 939 was randomly selected to complete items about sexual violence. Results: The results revealed that 8.4% of respondents were victims of attempted rape, while 5.8% were victims of actual rape. Ordinal logistic regression showed that girls were 3.9 times more likely than boys to have been victims of sexual abuse. Family structure was also significantly related to rape as persons who lived with a single parent (OR = 1.74, CI = 1.00-3.04) and those who resided with one biological parent and one step parent (OR = 2.59, CI = 1.34-5.01) were more likely to have been have been victims of sexual abuse than those living with both biological parents. Alcohol use (OR = 2.0, CI = 1.10-3.62), anti-social behavior (stolen property, caused physical damage to property, bullied others, or been in physical fights) (OR = 1.44, CI = 1.12-1.86), suicidal dialogue (OR = 2.48, CI = 1.19-5.19), and suicidal attempts (OR = 3.2, CI = 1.65-6.30) were also significant predictors of sexual abuse victimization. Racially classified social groups (RCSG), age, drug use, and cigarette smoking were not significant predictors of sexual abuse victimization, while socioeconomic status was found to be marginally significant. Conclusion: This study reinforces the importance of multiple factors including alcohol use, anti-social behavior, suicidal thoughts and actions, and family structure with respect to sexual assault of adolescents in South Africa. Establishing and strengthening intervention programs, school based child protective protocols, professional education of teachers and school personnel, community prevention programs, and initiatives could help prevent adolescent sexual violence and reduce the sequelae associated with this problem.
Publication	Child Abuse & Neglect: The International Journal
Date	June 00, 2004
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ731602

 

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Correlates of Bidi Use Among Youth

Abstract	Objectives: To identify characteristics associated with youth bidi use. Methods: The New Jersey Youth Tobacco Survey is a self-administered school-based survey that uses a 2-stage cluster sample design to obtain a representative statewide sample; 9589 students (grades 7?12) participated. Logistic regression was used to generate an adjusted odds ratio (OR) for current bidi use for each variable, controlling for gender, race, and school grade. Results: Higher odds for current bidi use were noted for black and Hispanic students, users of other tobacco products, and students that perceived bidis as safer than cigarettes. Conclusions: These results suggest specific groups that should be targeted for intervention.
Publication	American Journal of Health Behavior
Date	April 01, 2004
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ688364

 

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How All Stars Works: An Examination of Program Effects on Mediating Variables

Abstract	Prevention research continues to focus on school-based substance use programs aimed at adolescents. These programs are designed to reduce substance use and risk behavior by targeting key mediators, such as normative beliefs, which in turn reduce substance use. All Stars is a newly developed program that was recently evaluated in a randomized field trial in 14 middle schools in Lexington and Louisville, Kentucky. The authors examined targeted and nontargeted variables as possible mediators of program effectiveness. Findings indicate that All Stars achieved reductions in substance use and postponed sexual activity when teachers were successful at altering targeted mediators: normative beliefs, lifestyle incongruence, and manifest commitment to not use drugs. The program was not successful when it was delivered by specialists. At least in part, this failure is attributable to specialists' inability to change mediators as intended by the program. (Contains 3 tables and 1 figure.)
Publication	Health Education & Behavior
Date	April 00, 2004
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ828414

 

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Predictors of smoking behaviour among indigenous Sami adolescents and non-indigenous peers in North Norway

Abstract	Aims: A study was undertaken to examine predictors of smoking behaviour among indigenous Sami adolescents and non-indigenous peers in North Norway, and to examine for ethnic-specific predictors. Methods: This is a cross-sectional and longitudinal school-based and postal questionnaire study initially including 2,718 10th to 12th grade students (response rate (RR): 85%) in 1994—95 (T1). At the three-year follow-up (T2), in 1997 — 98, 1,405 were included (RR: 57%). Indigenous Sami contributed 23% (599/324) of the total samples. Logistic regression was used to examine the influence of sociodemographic and psychosocial predictors on smoking behaviour. Results: The proportions of regular smokers were 33% (729) and 35% (401) at T1 and T2, respectively, while 19% (153) had initiated current smoking during the study period. Substance use, externalizing problems, sexual activity and vocational training (p≤0.01) predicted regular smoking both cross-sectionally and prospectively. Among non-smokers at T1, age and frequent alcohol intoxication predicted current smoking prospectively (p≤0.01). Frequent intoxication predicted all stages of smoking (p≤0.001). Ethnicity did not predict smoking in this study. Laestadian Christian affiliation increased the prevalence of experimental smoking at T1 but only for Sami students. Conclusions: Youth smoking behaviour was strongly associated with risk-taking behaviours, indicating that a broader focus on health-compromising behaviours in anti-smoking campaigns is needed. The findings indicate little need for culturally sensitive anti-smoking campaigns specially designed for indigenous Sami youth, as the main predictors (risk-taking behaviours) were similar across ethnic groups.
Publication	Scandinavian Journal of Public Health
Date	March 01 , 2004
URL	http://sjp.sagepub.com/cgi/content/abstract/32/2/118

 

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No News is Bad News: 6th-grade smoking study

Abstract	Schools offer a convenient setting for research on adolescents.However, obtainingactive written parental consent is difficult. In a 6th-grade smoking study, students were recruited with two consent procedures: active consent (parents must provide written consent for their children to participate) and implied consent (children may participate unless their parents provide written refusal). Of 4,427 invited students, 3,358 (76%) provided active parental consent, 420 (9%) provided active parental refusal, and 649 (15%) provided implied consent (parental nonresponse). The implied consent procedure recruited more boys, African Americans, students with poor grades, and smokers. This dual-consentprocedure is useful for collecting some limited data from students who do not provide active consent or refusal.
Publication	Evaluation Review
Date	February 01 , 2004
URL	http://erx.sagepub.com/cgi/content/abstract/28/1/52

 

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Smoking Cessation for High School Students

Abstract	This pilot study was designed to evaluate the feasibility and the impact of a smoking-cessation program that would meet the specific needs of high school students. Feedback from focus groups conducted with adolescent smokers at a Connecticut high school was used to develop a tailored intervention. Intervention components included commonly used behavioral strategies, with additional options to assist students to quit smoking, including use of bupropion, concomitant support for parent smoking cessation, stress management, and physician counseling. On completion, 20 of the 22 enrolled students remained committed to quitting. Twenty-seven percent of students quit smoking and 69% of those who continued to smoke reduced the number of cigarettes smoked per day by an average of 13. Providing additional options to students and additional support for concomitant parental cessation may enhance the appeal of adolescent smoking-cessation programs. Further investigation into efficacy of bupropion use for adolescent cessation is warranted.
Publication	Behavior Modification
Date	January 01 , 2004
URL	http://bmo.sagepub.com/cgi/content/abstract/28/1/133

 

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Perceived peer smoking prevalence and its association with smoking behaviours and intentions in Hong Kong Chinese adolescents

Abstract	Background Among the many personal, social and environmental risk factors of adolescence smoking, normative beliefs stand out for their potential to be modified with factual information on smoking prevalence.Aims To study the perceived peer smoking prevalence and its association with smoking behaviours in Hong Kong Chinese adolescents.Design and setting Cross-sectional territorial-wide school-based survey conducted in 64 randomly selected secondary schools in Hong Kong.Participants A total of 13 280 forms 1–3 students (equivalent to grades 7–9 in the United States) aged 12–16 years.Measurements Perceived peer smoking prevalence, smoking status, intention to smoke in future, other smoking-related factors and demographic information.Findings Overestimation of peer smoking prevalence was observed regardless of gender and smoking status, and was more common in girls (69.4%) than boys (61.0%), and in experimental (74.3%) and current smokers (85.4%) than in never smokers (60.7%). Boys who overestimated and grossly overestimated (over two times) peer smoking were more likely to be current smokers, with adjusted odds ratios and 95% confidence intervals (95% CI) of 1.95 (1.24–3.07) and 3.52 (2.37–5.24) (P for trend <0.001). Similarly, boys who grossly overestimated peer smoking were 76% (95% CI: 41–120%) more likely to have ever smoked.Conclusion Overestimation of peer smoking prevalence was common in Hong Kong Chinese boys and girls, and was associated with current and ever smoking in boys. These findings have important implications on normative education in adolescence smoking prevention programmes.
Publication	Addiction
Date	2004
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2004.00797.x/abstract

 

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Theory-Based Determinants of Youth Smoking: A Multiple Influence Approach1

Abstract	This study tested a broad array of determinants of smoking grounded in general social psychological theories, as well as personality and social development theories. Using data from 2,004 middle school students, all proximal and distal determinants significantly predicted smoking in the hypothesized direction. Further, hierarchical logistic regressions showed that intention to smoke, positive and negative attitudes toward smoking, impediments to smoking, self-efficacy to resist smoking, parent norms, and academic success most strongly predicted current smoking. Hierarchical linear regressions suggested that parental relatedness, maladaptive coping strategies, depression, and low academic aspirations most strongly predicted susceptibility to smoking for those who had not yet smoked a cigarette. Global expectancies were the strongest predictor of susceptibility in low socioeconomic status students. These findings may guide the development of future theory-based interventions that produce the greatest reductions in youth smoking.
Publication	Journal of Applied Social Psychology
Date	2004
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1559-1816.2004.tb02537.x/abstract

 

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American youth consumption of licit and illicit substances

Abstract	Using a representative sample of the 2001 National School-based Youth Risk Behavior Survey, this study investigated the contemporaneous and intertemporal relationship between the use of licit and illicit substances by American youth between the ages 12 and 18. The results indicated a strong contemporaneous relationship between smoking cigarettes, drinking alcohol, smoking marijuana, and using cocaine. The results supported the gateway hypothesis indicating that prior smoking of cigarettes is significantly associated with the probability of current marijuana and cocaine use, as prior drinking of alcohol is significantly associated with the probability of current marijuana and cocaine use. The results also showed that males had a higher probability of using cocaine than females, whereas black students had a higher probability of smoking marijuana and using cocaine than white students. Age and race were associated with marijuana and cocaine use, but cocaine use was further linked with the factors of gender, region, and metropolitan area. These findings could have implications for public policies regarding prevention.
Publication	International Journal of Consumer Studies
Date	2004
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1470-6431.2004.00405.x/abstract

 

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Correlates of Body Mass Index, Weight Goals, and Weight-Management Practices Among Adolescents

Abstract	ABSTRACT: The study examined associations among physical activity, cigarette smoking, body mass index, perceptions of body weight, weight-management goals, and weight-management behaviors of public high school adolescents. The CDC Youth Risk Behavior Surwy provided a cross-sectional sample (n = 3,089) of public high school students in South Carolina. Logistic regression models were constructed separately for four race-gender groups. Adjusted odds ratios and 95% confidence intervals were calculated to determine the magnitude of associations. Based on self-reported height and weight, 13% of students were overweight, while 15% were at risk for becoming overweight. However, 42% of students were trying to lose weight, and 22% were trying to maintain current weight. Female students were less likely than male students to be overweight, but more likely to be attempting to lose weight. Extreme weight control practices were reported by 27% of the sample. Among Black females trying to lose weight, positive associations were observed for strengthening exercises (OR = 1.55), but that relationship was associated inversely in Black males (OR = .600). Among White females, attempted weight loss was associated with strengthening exercises (OR = 1.72) and cigarette smoking (OR = 1.54). For White males, attempted weight loss was associated positively with vigorous exercise (OR = 1.41) and inversely related to moderate exercise (OR = .617). Effective weight-management practices for adolescents should focus on appropriate eating behaviors, physical activity, and low-fat/calorie diets. Multicomponent weight management interventions should be conducted within a coordinated school health framework.
Publication	Journal of School Health
Date	2004
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2004.tb06617.x/abstract

 

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The effect of environmental tobacco smoke on eczema and allergic sensitization in children

Abstract	Background The negative impact of environmental tobacco smoke (ETS) on airway diseases in children is well known. Whether there is an effect on atopic eczema is not clear.Objectives To determine the impact of ETS on atopic eczema, allergic sensitization and allergic airway diseases in 1669 school beginners.Methods The prevalence of atopy-related health outcomes was assessed by questionnaire, dermatological examination, skin prick testing and specific immunoglobulin E measurement. Exposure assessments were based on measurement of cotinine [expressed as cotinine to creatine ratio (CCR)] in spot urine samples (n = 1220) together with questionnaire and interview data on smoking behaviour of the parents.Results In the total study group, prevalence of atopic eczema diagnosed on examination was significantly associated with urinary CCR values. The odds ratio (OR) and 95% confidence interval (CI), calculated for an increase of 100 ng mg−1 CCR was 1·97 (95% CI 1·23–3·16). The prevalence of skin manifestations according to questionnaire data as well as a history of asthma, wheezing, and hay fever were positively although not significantly associated with ETS exposure. When genetically predisposed children (defined by the presence of parental atopy) were compared with children whose parents had no atopy, the ORs of allergic outcome variables were generally higher in the first group. In the group of predisposed children, significant associations with urinary CCR were found for allergic sensitization against house dust mites as measured by skin prick test (OR 3·10, 95% CI 1·63–5·90).Conclusions Children are at a higher risk of developing an atopic eczema when exposed to ETS and genetically predisposed children are at higher risk of developing a sensitization against house dust mites.
Publication	British Journal of Dermatology
Date	2004
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.2004.05710.x/abstract

 

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Modifying Pro-Drug Risk Factors in Adolescents: Results from Project ALERT

Abstract	The objective of this study was to evaluate the impact of a revised state-of-the-art drug prevention program, Project ALERT, on risk factors for drug use in mostly rural midwestern schools and communities. Fifty-five middle schools from South Dakota were randomly assigned to treatment or control conditions. Treatment-group students received 11 lessons in Grade 7 and 3 more in Grade 8. Effects for 4,276 eighth graders were assessed 18 months after baseline. Results indicate that Project ALERT had statistically significant effects on all the targeted risk factors associated with cigarette and marijuana use and more modest gains with the pro-alcohol risk factors. The program helped adolescents at low, moderate, and high risk for future use, with the effect sizes typically stronger for the low- and moderate-risk groups. Thus, school-based drug prevention programs can lower risk factors that correlate with drug use, help low- to high-risk adolescents, and be effective in diverse school environments. (Contains 3 tables.)
Publication	Health Education & Behavior
Date	2004
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ828134

 

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Fifteen-Month Follow-Up Results of a School-Based Life-Skills Approach to Smoking Prevention

Abstract	The life-kills approach to smoking prevention was tested in this study. In total, 1024 pupils (mean age 11.4 years, SD = 0.90) from Austria, Denmark, Luxembourg and Germany were recruited as an experimental group, and a sample of 834 matched pupils served as a control group. While the pupils from the control group received no specific intervention, the pupils in the experimental group participated in an intervention programme which was based on the life-skills approach and consisted of 21 sessions. The aims of the programme were to promote fundamental social competencies and coping skills. In addition, specific information on cigarette smoking was given and skills for resisting social influences to smoke were rehearsed. The programme was conducted by trained school teachers during a course of 4 months. Anonymous questionnaires were administrated (1) before the programme was implemented and (2) 15 months after the programme had started. Teachers as well as pupils showed a high level of satisfaction with the programme idea and the materials. With regard to the outcome variables, the programme had no differential effect on current smoking (4-week prevalence). The programme showed a weak effect (P less than 0.1) on lifetime smoking prevalence and experimental smoking. There was also an effect of the programme on smoking knowledge, on the social competences of the pupils as well as on the classroom climate. No effects were found on susceptibility to smoking among never-smokers, attitudes towards smoking and the perceived positive consequences of smoking. The results indicate that prevention programmes that are run for only a few months can have a positive impact on variables considered to be protective with regard to smoking uptake. (Contains 3 tables.)
Publication	Health Education Research
Date	2004
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ961120

 

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Health warnings on cigarette packets: perceiving the risk.

Abstract	Health warnings on cigarette packets: perceiving the risk. Smokers do not lack the intelligence to understand the implications of warnings: they interpret the information and filter out the perception of risk and it is clear from research that many people see the personal benefits of smoking as outweighing the (long term) physical dangers associated with tobacco use.
Publication	Education and Health
Date	2004
URL	/sheux/EH/eh323md.pdf

 

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Adolescent Smoking Cessation Services of School-Based Health Centers

Abstract	A national sample of 390 junior and senior high school–based centers were mailed an 18-item survey to assess their institutional stages of change regarding smoking cessation education, referral, and prescription nicotine replacement therapy (NRT) services and their perceived barriers and benefits regarding the provision of these services. Nearly half were in the maintenance stage for cessation education programs, one-third were in maintenance stage for referral services, and 12% were in the maintenance stage for NRT. The most frequently cited perceived benefits included an increased awareness of short- and long-term effects of smoking (education programs and referral services) and increasing student access to cessation methods (NRT). The greatest barriers cited were a lack of financial resources (education programs), problems with student transportation (referral services), and staff not having the authority to provide prescription services (NRT). School-based centers can do more to help stop adolescents from using tobacco.
Publication	Health Education & Behavior
Date	April 01 , 2003
URL	http://heb.sagepub.com/cgi/content/abstract/30/2/196

 

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Institutionalization of a School Health Promotion Program: Background and Rationale of the Catch-on Study

Abstract	Research is lacking on how to make effective programs available on a large scale and how to maintain levels of implementation. CATCH: A Study of Institutionalization (CATCH-ON) was designed to help us understand the conditions under which such programs are institutionalized after the trial has ended. The Child and Adolescent Trial for Cardiovascular Health (CATCH) was the largest field trial of school-based health promotion in the United States conducted in 96 schools in four geographic areas of the United States: California, Louisiana, Minnesota, and Texas. The intervention was multicomponent, targeting school policy and practices in nutrition, physical activity, health education, and smoking. This report provides background on the CATCH study design, the conceptual framework for research on institutionalization of the CATCH program, and an overview of the seven original reports that present results from the CATCH-ON study in this theme issue.
Publication	Health Education & Behavior
Date	2003
URL	http://heb.sagepub.com/cgi/content/abstract/30/4/410

 

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Preventing Tobacco and Alcohol Use Among Elementary School Students Through Life Skills Training

Abstract	Study examined effectiveness of a substance abuse prevention program in preventing tobacco and alcohol use among elementary school students in grades 3 through 6. Program teaches social resistance skills and general personal and social competence skills. Findings indicate a school-based substance abuse prevention approach previously found to be effective among middle school students is also effective for elementary school students. (Contains 29 references and 4 tables.) (Author)
Publication	Journal of Child & Adolescent Substance Abuse
Date	2003
URL	http://dx.doi.org/10.1300/J029v12n04_01

 

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A hidden periodontitis epidemic during the 20th century?

Abstract	Abstract – Objectives: Increasing evidence suggests a strong causal link between smoking and periodontitis. The goal of this study was to impute how the secular changes in smoking prevalence during the 20th century impacted the advanced periodontitis incidence in the US.Methods: Epidemiological analyses based on US prevalence data of advanced periodontitis and smoking, and predictions of future smoking prevalence.Results: Assuming other risk factors for periodontitis remained constant, we estimated that the incidence of advanced periodontitis decreased by 31% between 1955 and 2000. The changes in smoking habits, and consequently the changes in periodontitis incidence, depended strongly on education and gender. Between 1966 and 1998, we estimated a 43% decreased periodontitis incidence among college-educated individuals versus only an 8% decrease among individuals with less than a high school education. Between 1955 and 1999, we estimated a 41% decrease among males versus a 14% decrease among females. By the year 2020, the incidence of advanced periodontitis may decrease 43% from its level in 1955.Conclusions: A periodontitis epidemic fueled by smoking remained hidden for most of the 20th century. Because this epidemic was hidden, it distorted our understanding of the treatment and etiology of periodontitis. The socioeconomic polarization of this epidemic will dictate alterations in patterns of periodontal care.
Publication	Community Dentistry and Oral Epidemiology
Date	2003
URL	http://onlinelibrary.wiley.com/doi/10.1034/j.1600-0528.2003.00061.x/abstract

 

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Smoking, atopy and certain furry pets are major determinants of respiratory symptoms in children: the International Study of Asthma and Allergies in Childhood Study (Ireland)

Abstract	Background Environmental, cultural and health care differences may account for variation among countries in the prevalence of asthma and respiratory symptoms in teenagers.Objective To examine the prevalence of respiratory symptoms and the level of diagnosis, and to compare determinants of asthma and severe wheeze in two countries.Methods Self-completion questionnaires based on the International Study of Asthma and Allergies in Childhood (ISAAC) protocol were provided to school children in Ireland (Republic and Northern Ireland). In the Republic of Ireland, all children in classes largely aged 13–14 years from 30 post-primary schools were selected by random sampling stratified by school size, composition and Health Board in Spring 1995. In Northern Ireland, all children largely aged 13–14 years of age from 26 post-primary schools were selected by random sampling stratified by school type, composition and Education and Library Board in Spring 1996.Results Questionnaires were completed by 2364 children from Northern Ireland and 2671 from the Republic, about 90% of those eligible to participate. The prevalences of wheeze at various levels of severity, of diagnosed asthma and of treated wheeze were very similar in Northern Ireland and the Republic of Ireland. A significant proportion of those reporting more severe symptomatology (four or more attacks of wheeze in the past 12 months and/or one or more nights disturbed and/or moderate or greater disruption of daily activities and/or speech restriction due to wheeze) had been neither diagnosed nor treated for asthma (20–37%). To investigate the determinants of the more severe symptomatology of asthma or treated wheeze a series of stepwise multiple regression analyses was performed. A history of atopy, cigarette smoking, the possession of a furry pet other than a dog or cat and age were each independently associated with severe wheeze, whilst atopy, a furry pet (as above) and gender were each independently associated with asthma or treated wheeze.Conclusions Cigarette smoking is closely associated with the reporting of significant respiratory symptoms together with atopy and exposure to furry pets. Some 20–37% of severe symptoms were neither diagnosed nor treated as asthma.
Publication	Clinical & Experimental Allergy
Date	2003
URL	http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2222.2003.01572.x/abstract

 

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The effect of cigarette prices on youth smoking

Abstract	Prior economic research provides mixed evidence on the impact of cigarette prices on youth smoking. This paper empirically tests the effects of various price measures on youth demand for cigarettes using data collected in a recent nationally representative survey of 17 287 high school students. In addition to commonly used cigarette price measures, the study also examined the effect of price as perceived by the students. This unique information permits the study of the effect of teen-specific price on cigarette demand. The analysis employed a two-part model of cigarette demand based on a model developed by Cragg (1971) in which the propensity to smoke and the intensity of the smoking habit are modeled separately. The results confirm that higher cigarette prices, irrespective of the way they are measured, reduce probability of youth cigarette smoking. There is also some evidence of negative price effect on smoking intensity, but it is sensitive to the price measure used in the model. The largest impact on cigarette demand has the teen-specific, perceived price of cigarettes. Copyright © 2002 John Wiley & Sons, Ltd.
Publication	Health Economics
Date	2003
URL	http://onlinelibrary.wiley.com/doi/10.1002/hec.709/abstract

 

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Impact of the Life Skills Training Curriculum on Middle School Students Tobacco Use in Marion County, Indiana, 1997–2000

Abstract	Evaluation of school-based tobacco prevention and control programs have yielded mixed results. This study assessed the impact of the Life Skills Training curriculum on Marion County, Ind., middle school students' knowledge, attitudes, and ability to make good lifestyle decisions. From 1997 to 2000, students in grades six to eight in the study schools received the Life Skills Training curriculum. Survey data (n = 1,598) were used to compare tobacco use behavior, attitudes, and knowledge of those exposed with those not exposed to the program. Of the students surveyed, 12.5% were currently smoking. There were significantly fewer current smokers, and more students exposed to the program indicated they intended to stay smoke-free. Fewer of those participating in the program “hung out” with smokers and more said they could easily refuse a cigarette if offered one. Students completing the Life Skills Training curriculum were more knowledgeable about the health effects of smoking. Program effects were different for male and female students as well as for White and Black students.
Publication	Journal of School Health
Date	2003
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2003.tb04190.x/abstract

 

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The cigar as a drug delivery device: youth use of blunts

Abstract	Aims Blunts are hollowed-out cigars used to smoke marijuana (and perhaps other substances) in the United States. We investigated rates of blunt use; whether cigar use reported in surveys may actually be blunt use; the relationship of blunt to cigar use; characteristics of blunt users; brands of cigars used to make blunts; and drugs added to blunts.Design A school-based survey of youth, the Cigar Use Reasons Evaluation (CURE).Setting Eleven schools across Massachusetts.Participants A total of 5016 students in grades 7–12.Measurements CURE items assessing blunt, cigar and cigarette use, brands used to make blunts, drugs added to blunts and demographics were used.Findings Life-time blunt use was reported by 20.0% of the sample, with use greater among high school (25.6%) than middle school (11.4%) students, and among males (23.7%) than females (16.6%). Self-reported cigar use rates were not influenced strongly by blunt use being misreported as cigar use. In a multivariate model, blunt use was associated with male gender, higher grade in school, lower GPA, truancy, lower school attachment, not living in a two-parent family, being of ‘other’ race/ethnicity and current use of both cigarettes and cigars. ‘Phillies’ was the most popular brand of cigar for making blunts, used by 59.$% of users. ‘Garcia y Vega’ (18.0%) was the second most popular. Twenty-eight per cent of blunt users had added drugs other than marijuana to blunts.Conclusions The use of blunts as a drug delivery device is a serious problem. Efforts to address it will require the cooperation of the tobacco control and substance abuse prevention systems.
Publication	Addiction
Date	2003
URL	http://onlinelibrary.wiley.com/doi/10.1046/j.1360-0443.2003.00492.x/abstract

 

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Adolescent Problem Behavior in China and the United States: A Cross-National Study of Psychosocial Protective Factors

Abstract	An explanatory model of adolescent problem behavior (problem drinking, cigarette smoking, and general delinquency) based on protective and risk factors in the individual and in 4 social contexts (family, peer group, school, and neighborhood) is employed in school-based samples from the People's Republic of China (N=1,739) and the United States (N=1,596). Despite lower prevalence of the problem behaviors in the Chinese sample, especially for girls, a substantial account of problem behavior is provided by the same protective and risk factors in both countries and for both genders. Protection is generally higher in the Chinese sample than in the U.S. sample, but in both samples protection also moderates the impact of risk. Despite mean differences in psychosocial protective and risk factors, as well as in problem behavior, in the 2 samples—differences that may reflect societal variation—the explanatory model has, to a large extent, cross-national generality.
Publication	Journal of Research on Adolescence
Date	2003
URL	http://onlinelibrary.wiley.com/doi/10.1111/1532-7795.1303004/abstract

 

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A Meta-Evaluation of 11 School-Based Smoking Prevention Programs

Abstract	ABSTRACT: Eleven school-based smoking prevention programs were subjected to a meta- evaluation. Criteria for the meta-evalua-tion included: 1) adequacy of the research design, 2) evidence of reliability, 3) evidence of validity, 4) appropriate statistical analyses and interpretations, 5) reporting of effect sizes or practical significance, 6) accounting for attrition, and 7) tracking of fidelity to the program. A three-point rating scale was used ranging from 0 – 2. Criteria with the best ratings were research design and statistical analysis. The lowest ratings occurred for reliability and validity. The remainder of the criteria ranged between 1 and 2 with minor factors accounting for the difference in ratings. Recommendations include increasing the number of evaluations that included tests of reliability and validity and calculated effect size estimates.
Publication	Journal of School Health
Date	2003
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2003.tb03574.x/abstract

 

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Prevalence of irritable bowel syndrome in young adult Malaysians: A survey among medical students

Abstract	Background and Aims: Irritable bowel syndrome (IBS) is a common functional bowel disease in the West. Information on the prevalence of IBS in the Asian population is relatively scanty. The aims of the present study were to determine the prevalence of IBS and to assess the symptom subgroups based on the predominant bowel habit in a young adult population of Asian origin.Methods: Basic demographic data and symptoms of IBS using the Rome I criteria were sought using a questionnaire administered to all apparently healthy students in a medical school. Other questions asked related to alcohol intake, smoking, chili consumption, dietary fiber intake, and to psychological and psychosomatic symptoms of anxiety, depression, insomnia, headache, and backache. The health-care seeking behavior of the subjects was also analyzed.Results: Of the 610 questionnaires administered, 533 complete responses were received (response rate of 87.4%). The responders comprised 229 men (43.0%) and 304 (57.0%) women with a mean age of 22 ± 1.8 years. The ethnic distribution was Malays 278 (52.2%), Chinese 179 (33.6%), Indians 46 (8.6%), and others 30 (5.6%). Eighty-four (15.8%) reported symptoms consistent with the diagnosis of IBS, predominantly women. Sixty-five (77.4%) and six (7.1%) were of the constipation-predominant and diarrhea-predominant IBS subgroups, respectively. Thirteen (15.5%) subjects fell into the non-specific IBS subgroup. The self-reported psychological and psychosomatic symptoms of anxiety (P = 0.02), depression (P = 0.002), insomnia (P = 0.006), headache (P = 0.04), and backache (P = 0.006) were encountered more frequently in the subjects with IBS. Only 13.1% of the IBS group had consulted their health-care practitioner, and 20.2% reported self-medication.Conclusions: Symptoms supportive of the diagnosis of IBS were common among young Malaysians, with a prevalence rate of 15.8%. There were significantly more women with IBS than men. Within the IBS population, the majority (77.4%) was of the constipation-predominant IBS subgroup. A significantly higher prevalence of psychological and psychosomatic symptoms was found in individuals with IBS. Only a minority sought medical advice for their symptoms.
Publication	Journal of Gastroenterology and Hepatology
Date	2003
URL	http://onlinelibrary.wiley.com/doi/10.1046/j.1440-1746.2003.03212.x/abstract

 

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The epidemiology of atopic dermatitis in Italian schoolchildren

Abstract	Background: Atopic dermatitis (AD) is common in children in industrialized countries. Only one large population study on its prevalence has been conducted in Italy, based on self-report questionnaire. The present study was designed to estimate the prevalence of AD in schoolchildren in Italy by dermatologists’ assessment and by UK Working Party criteria, and to investigate associated symptoms and factors.Methods: Cross-sectional survey on a random sample of 9-year-old schoolchildren from seven Italian cities. Children were examined by experienced dermatologists. Parents and teachers answered standardized questionnaires.Results: Of the 1369 children examined, 88 had a diagnosis of AD, with an estimated point prevalence of 5.8% (95% CI 4.5–7.1) in the reference population. The reported lifetime prevalence was 15.2 (95% CI 12.2–18.2) for AD, 11.9% (95% CI 9.0–14.8) for asthma, and 17.6% (95% CI 14.6–20.7) for rhino-conjunctivitis. The strongest associated factor was the presence of AD in at least one parent. No association of AD with maternal smoking during pregnancy, birth weight, maternal age at the time of the child birth and breast-feeding was observed. The environmental characteristics of the house and the school did not correlate with the prevalence of AD. Episodes of lower respiratory tract infections were associated with asthma, and to a lower extent also with AD and rhinitis.Conclusions: The prevalence of doctor-diagnosed AD in Italian schoolchildren is comparable to those reported for other developed countries. Family history of atopy was the single most important associated factor, while the complex interplay of environmental factors remains to be elucidated.
Publication	Allergy
Date	2003
URL	http://onlinelibrary.wiley.com/doi/10.1034/j.1398-9995.2003.00112.x/abstract

 

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The Arizona CHAMPS Peer Project for Tobacco Use Prevention: Effects on Tobacco Use, Intentions to Use, and Knowledge

Abstract	This study reports on CHAMPS, a youth tobacco and prevention program intervention that focused on peer-led educational activities. Nineteen schools implemented a CHAMPS tobacco prevention program in grades 5, 6, and 7. Six schools served as nonintervention comparison sites. Baseline and follow-up questionnaires were completed by 1,412 students. The proportion of students reporting current cigarette use decreased significantly in the CHAMPS group but not in the comparison group. Intervention group students' knowledge about the harmful consequences of tobacco use increased significantly, whereas knowledge essentially stayed the same among comparison group students. Finally, the number of nonsmoking students who reported they would smoke a cigarette if one of their best friends offered it increased significantly in the comparison group but not in the intervention group. These results suggest that a well-planned and implemented peer-helping program represents an important potential resource that should be considered as a welcome adjunct to existing school-based tobacco education and prevention efforts. (Contains 1 table.)
Publication	American Journal of Health Education
Date	2003
URL	http://www.eric.ed.gov/ERICWebPortal/contentdelivery/servlet/ERICServlet? accno=EJ853612

 

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Reporting of Validity from School Health Promotion Studies Published in 12 Leading Journals.

Abstract	Used the RE-AIM (reach, efficacy, adoption, implementation, and maintenance) evaluation framework to assess how thoroughly recent school-based studies in 12 leading journals addressed RE-AIM issues, emphasizing external validity. Studies rarely addressed RE-AIM dimensions regarding external validity. School-based behavior change interventions frequently provided student-level participation rates and treatment efficacy information. (SM)
Publication	Journal of School Health
Date	2003
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ670611

 

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Estimates of Intragroup Dependence for Drug Use and Skill Measures in School-Based Drug Abuse Prevention Trials: An Empirical Study of Three Independent Samples

Abstract	Group-randomized drug abuse prevention trials customarily designate schools as the unit of assignment to experimental condition; however, students within schools remain the unit of observation. Students nestedwithin schools may show some resemblance based on common (peer) selection or school climate factors (i.e., disciplinary practices, group norms, or rules). Appropriate analyses of any treatment effects must be statisticallycorrect for the magnitude of clustering within these intact social units (i.e., intraclass correlation coefficient [ICC]). There is little reported evidence, however, of variation in ICCs that might occur with studies of raciallyor geographically diverse populations. The purpose of this study was to generate estimates of intragroupdependence for drug use and psychosocial measures (hypothesized mediators) from three separate drug abuseprevention trials. Clustering for the drug use measures averaged .02 across study and age-groups (range = .002to .053) and was equivalently small for the psychosocial measures (averaging .03 across studies and age-groups;range = .001 to .149). With few exceptions and across different samples, clustering decreased in magnitude overtime. Clustering was largest for peer smoking and drinking norms among white, suburban youth and smallestfor alcohol expectancies among urban black youth. Findings are discussed with respect to the influence of socialclimate factors and group norms in the design and analysis of school-based, drug abuse, prevention programs.
Publication	Health Education & Behavior
Date	February 01 , 2002
URL	http://heb.sagepub.com/cgi/content/abstract/29/1/85

 

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Risk factors for asthma and allergic diseases among 13–14-year-old schoolchildren in Japan

Abstract	Background: To identify risk factors for childhood wheezing and allergies, a questionnaire regarding family histories and environmental factors was added to the International Study of Asthma and Allergies in Childhood (ISAAC) Phase One questionnaire and the associations between current prevalence and risk factors were analyzed.Methods: Questionnaires were completed by 4466 schoolchildren, who were 13–14 years of age, in Tochigi Prefecture. Children were divided into groups on the basis of risk factors and the severity of each allergic disease according to answers to the ISAAC questionnaire.Results: In analyses of family histories, the odds ratios (OR) of children who have a family history with no symptoms were significantly lower by risk factor-based analyses compared with those children with a family history of symptoms of wheezing (OR = 2.34–4.39), rhinitis (1.76–2.68) and eczema (2.54–7.81), and significant correlations were observed between severity and family history in all diseases by the Mantel test (P < 0.001). Although the OR of household smoking was not significant, heavier smoking in a household had an effect on severity and showed a significant correlation with severity in rhinitis (P < 0.05) and eczema (P < 0.01). Regarding road traffic, the percentage of children living in an area with heavy traffic showed a significant correlation with the severity of wheezing (P < 0.05) and no children with severe wheezing lived in areas with light traffic. In addition, the mean percentage of children with current wheezing between school locations was significantly higher in the city area (10.2 ± 0.7%) compared with that in the suburbs (6.6 ± 0.9%; P = 0.01) and industrial areas (6.6 ± 0.7%; P = 0.01).Conclusions: These results suggest that the family histories may have potential effects on the severity of allergic diseases and that household smoking for rhinitis and eczema and heavy road traffic for asthma may be more important modifiable risk factors for severity in Japan.
Publication	Allergology International
Date	2002
URL	http://onlinelibrary.wiley.com/doi/10.1046/j.1440-1592.2002.00250.x/abstract

 

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Effectiveness of a School-Based Intervention at Changing Preadolescents' Tobacco Use and Attitudes.

Abstract	Evaluated the effectiveness of a tobacco intervention on preadolescents' tobacco use and attitudes. Surveys of students in intervention and non-intervention schools indicated that though not statistically significant, the number of smokers at the intervention school decreased from 43.2 to 31.1 percent after the intervention. Intervention students also predicted less smoking in 5 years and 20 years than did non-intervention students. (SM)
Publication	Journal of School Health
Date	2002
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ662045

 

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Building Capacity for System-Level Change in Schools: Lessons from the Gatehouse Project - reducing smoking rates

Abstract	The Gatehouse Project is an innovative, comprehensive approach to mental health promotion in secondary schools. It sets out to promote student engagement and school connectedness as the way to improve emotional well-being and learning outcomes. The key elements of the whole-school intervention are the establishment and support of a school-based adolescent health team; the identification of risk and protective factors in each school’s social and leaning environment from student surveys; and, through the use of these data, the identification and implementation of effective strategies to address these issues. The project evaluation used a cluster-randomized controlled trial design involving 26 schools with initial results demonstrating considerable success in reducing smoking rates among Year 8 children. This article describes and accounts for how system-level changes have been made in schools through a process of capacity building. This encourages teachers, parents, and students to view the core business of education differently.
Publication	Health Education & Behavior
Date	June 01 , 2001
URL	http://heb.sagepub.com/cgi/content/abstract/28/3/368

 

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Statewide Demonstration of Not On Tobacco: A Gender-Sensitive Teen Smoking Cessation Program

Abstract	This study represented the largest statewide demonstration (n = 346) of the teen smoking cessation program Not On Tobacco (N-O-T) to date and one of the few systematically controlled teen smoking cessation trials reported in the literature. Results showed that N-O-T female teens were 4 times more likely to quit smoking almost 6 months after the program ended than female teens who received a brief intervention (BI). The quit rate for the N-O-T female groups was significantly higher than that for female brief intervention comparison groups. The study demonstrated that 2 times more N-O-T than BI teens quit smoking overall. Differences in the biochemically validated quit rate between the N-O-T groups and the brief intervention groups overall and for male participants were not statistically different, however. Furthermore, findings showed that N-O-T was more effective than the brief intervention in assisting youth with cigarette reduction. There was a significant difference in the reduction rate between the N-O-T and the BI groups on weekdays and weekends 6 months after the program ended. Overall, approximately 84% of N-O-T teens either quit or reduced smoking, compared with approximately 55% of BI teens. This study is 1 phase of an ongoing multiphase evaluation of N-O-T This study resulted in several important findings that will help guide future teen cessation studies and tobacco cessation efforts of school health professionals.
Publication	The Journal of School Nursing
Date	April 01 , 2001
URL	http://jsn.sagepub.com/cgi/content/abstract/17/2/90

 

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Multilevel Risk Models for Retrospective Age-Of-Onset Data: age of onset of smoking

Abstract	Survival analysis provides a natural conceptual framework for considering risk.However, survey data on age of onset typically possess measurement error and sample design complexities that are absent from the usual settings in which survival analysis is applied.The authors describe a random effects discrete time survival model that addresses these problems.They illustrate its use by an analysis of retrospective report data on the age of onset of smoking from two cross-sectional school-based studies.
Publication	Journal of Adolescent Research
Date	March 01 , 2001
URL	http://jar.sagepub.com/cgi/content/abstract/16/2/188

 

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Attitudes Toward Smoking and Family-Based Health Promotion Among Rural Mothers and Other Primary Caregivers Who Smoke

Abstract	ABSTRACT: The family milieu provides a potential context for integrating smoking cessation and prevention activities to complement school-based efforts. In this study, surveys were mailed to caregivers of elementary school children to assess demographics, smoking characteristics and attitudes, and receptivity to and preferred format for health promotion programs. Fifty-three percent (n=276) of 501 caregivers responded. Among smokers, most did not want their children to smoke, and they wanted to quit themselves; 91% considered it important to involve their children in their smoking cessation attempts; and 70% expressed willingness to participate in health promotion for the entire family. Written materials either mailed home or brought home from school were the preferred program formats. These findings suggest the feasibility of a program in which adults and children work together at home on smoking cessation and prevention activities that might increase the effectiveness of school-based smoking prevention messages.
Publication	Journal of School Health
Date	2001
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2001.tb07286.x/abstract

 

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Social class and smoking at age 15: the effect of different definitions of smoking

Abstract	Aim. To explore whether the association between social class and smoking among teenagers varies according to the definition of smoking adopted. Design, setting and participants. A survey of 2196 15-year-olds in 43 secondary schools in the West of Scotland. Measures. Current smoking status and number of cigarettes smoked, and social class based on the occupation of the head of the household. Findings. 'Current smoker' was the only category not significantly differentiated by class; the ratio of smokers from unskilled compared with professional backgrounds rose with increasingly stringent definitions of smoking. Conclusion. The extent to which teenage smoking is patterned by social class depends on the definition of smoking adopted.
Publication	Addiction
Date	2001
URL	http://onlinelibrary.wiley.com/doi/10.1046/j.1360-0443.2001.969135715.x/abstract

 

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Prevention of Smoking Behaviors in Middle School Students: Student Nurse Interventions

Abstract	This article examines the use of the Tar Wars curriculum with the public health problem of preteen smoking and outlines interventions with a middle school population by community health student nurses from a state university. Smoking is the single most preventable cause of death and disability. Three million people die worldwide each year as a result of smoking. Cigarette smoking has now been labeled a pediatric disease. Estimates are that 3,000 children will begin a lifelong addiction to cigarettes every day. They will face a life of poor quality based on the medical consequences of smoking cigarettes. Mortality from tobacco use is annually greater than that from drug abuse, AIDS, suicide, homicide, and motor vehicle accidents combined. Preteen and teenage smoking is now a public health problem, therefore implications for service learning, nursing advocacy, and interventions with this health problem are discussed.
Publication	Public Health Nursing
Date	2001
URL	http://onlinelibrary.wiley.com/doi/10.1046/j.1525-1446.2001.00077.x/abstract

 

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Asthma, wheeze and cough in 7- to 9-year-old British schoolchildren

Abstract	Background Report on the characteristics of a cohort of children, aged 7–9 years, attending schools in the south of England and participating in a controlled intervention study to improve the care and knowledge of asthma in junior and primary schools and highlight problems for potential intervention.Methods A survey employing the International Study of Asthma and Allergies in Childhood (ISAAC) asthma questionnaire was undertaken to record the prevalence of asthma and the characteristics of children with asthma and wheeze in Year 3 and 4 pupils (age 7–9 years) in 25 schools, and to define disease severity and its management.Results Responses on 1732 children were received. Reports of asthma and wheeze in this study were similar to those in recent ISAAC studies. The frequency and severity of symptoms was associated with appropriate therapeutic intervention suggesting adherence to published British Thoracic Society (BTS) guidelines. However, 80% of children with asthma at any BTS level of treatment reported exercise-induced wheeze, indicating a need for education on pre-exercise inhaler use. One in 20 children who had wheezed in the past 12 months reported a symptom profile suggestive of unrecognised asthma. Significant associations were found between maternal smoking and both wheeze in the last 12 months [odds ratio (OR), 1.35; confidence interval (CI): 1.01–1.81, p < 0.05] and nocturnal cough [OR, 1.70; CI: 1.31–2.20, p < 0.001].Conclusions The characteristics of this sample are similar to those found for children of a similar age group in other studies. Therapeutic intervention is appropriate for the severity of disease but there are high levels of exercise-induced wheeze despite adequate control of other symptoms. Five percent of children who reported wheezing in the previous 12 months had a symptom profile of untreated asthma. Maternal cigarette smoking was associated with wheeze and cough.Implications for practic Recurrent untreated wheeze remains a problem for 5% of children reporting wheeze. A therapeutic hole has been identified – there is a need for further education on pre exercise inhaler use. Both these problems could be addressed by a school-based asthma management strategy. Maternal smoking and its effects on childhood asthma and wheeze need to be addressed.
Publication	Ambulatory Child Health
Date	2001
URL	http://onlinelibrary.wiley.com/doi/10.1046/j.1467-0658.2001.00140.x/abstract

 

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Relationship between Tobacco Advertising and Youth Smoking: Assessing the Effectiveness of a School-Based, Antismoking Intervention Program

Abstract	A significant consumer issue today concerns tobacco advertising and youth smoking behavior and what is being done in the interest of these young consumers to reduce smoking. Since the Master Settlement Agreement earmarked resources for consumer education, progress is being made researching the effectiveness of antismoking advertising and of school-based, antismoking interventions. This paper explores the effectiveness and potential of one such program to encourage additional interdisciplinary research attention and to provide direction in reducing smoking uptake behavior among youth.
Publication	Journal of Consumer Affairs
Date	2001
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1745-6606.2001.tb00113.x/abstract

 

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Adolescent smoking: Behavioural risk factors and health beliefs - cognitive factors of smoking behaviour in 885 teenagers

Abstract	Adolescent smoking: Behavioural risk factors and health beliefs - cognitive factors of smoking behaviour in 885 teenagers.
Publication	Education and Health
Date	2001
URL	/sheux/EH/eh194ku.pdf

 

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A School-Based Intervention Program to Prevent Adolescent Smoking

Abstract	Research has shown that tobacco use usually begins in early adolescence, results in an increase in future health problems, and ultimately affects national health care costs. Despite the messages about the dangers of smoking, young people continue to smoke. A school-based tobacco education program designed to produce a more favorable attitude about the positive effects of not smoking and increase knowledge of the hazards of smoking was implemented for 6th graders in a parochial middle school. After the intervention, there was a significant increase in knowledge about tobacco but no change in attitudes regarding the use of tobacco. The results have implications for school nurses who design and teach programs to prevent tobacco use.
Publication	The Journal of School Nursing
Date	October 01 , 2000
URL	http://jsn.sagepub.com/cgi/content/abstract/16/4/22

 

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Initiation and progression of cannabis use in a population-based Australian adolescent longitudinal study

Abstract	Aims. To examine predictors of cannabis use initiation, continuity and progression to daily use in adolescents. Design. Population-based cohort study over 3 years with 6 waves of data collection. Participants. 2032 students, initially aged 14-15 years, from 44 secondary schools in the state of Victoria, Australia. Measurements. Self-report cannabis use was categorized on four levels (none, any, weekly, daily) and summarized as mid-school (waves 2/3) and late-school (waves 4/5/6) use. Background, school environment, mid-school peer use and individual characteristics were assessed. Findings. Peer cannabis use, daily smoking, alcohol use, antisocial behaviour and high rates of school-level cannabis use were associated with mid-school cannabis use and independently predicted late-school uptake. Cannabis use persisted into late-school use in 80% of all mid-school users. Persisting cannabis use from mid- to late-school was more likely in regular users (odds ratio (OR) 3.4), cigarette smokers (OR any smoking: 2.0, daily smoking: 3.3) and those reporting peer use (OR 2.1). Mid-school peer use independently predicted incident late-school daily use in males (OR 6.5) while high-dose alcohol use (OR 6.1) and antisocial behaviour (OR 6.6) predicted incident late-school daily use in females. Conclusions. Most cannabis use remained occasional during adolescence but escalation to potentially harmful daily use in the late-school period occurred in 12% of early users. Transition was more likely in males, for whom availability and peer use were determinants. In contrast, females with multiple extreme behaviours were more likely to become daily users. Cigarette smoking was an important predictor of both initiation and persisting cannabis use.
Publication	Addiction
Date	2000
URL	http://onlinelibrary.wiley.com/doi/10.1046/j.1360-0443.2000.951116798.x/abstract

 

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Development of schoolchildren's smoking habits: questionnaire studies in intervention and control groups

Abstract	The objective of the present study was to describe the development of smoking from the sixth grade (age 12) to the eighth (age 14), for girls and for boys, and to study the effect of a simple anti-smoking intervention carried out in the sixth grade. All the roughly 2000 schoolchildren in Kronoberg County, born in 1982, completed an annual anonymous classroom questionnaire on smoking habits in the years 1994–96. In 1994, there were two visits, each lasting 80 min, by a campaigner from A Non-Smoking Generation to the 59 schools which opted for intervention, and no visits to the 21 schools which declined intervention. Before the intervention there were no differences in the frequency of smokers between the intervention group and the control group. In 2y the proportion of smokers then rose among the girls from 1% to 12% and among the boys from 2% to 7%. Two years after the intervention, the proportion of smokers in the intervention group was approximately two-thirds of that in the control group. When the statistical analysis was based on the individual pupils, the difference between the two groups was statistically significant, but if the schools were used as the unit of analysis, the result was non-significant.Even a small-scale intervention may have an effect on the development of smoking among schoolchildren, but other preventive measures in the schools probably also contributed to the positive development of smoking in the intervention group.
Publication	Acta Pædiatrica
Date	2000
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1651-2227.2000.tb00745.x/abstract

 

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Substance use by Indigenous and non-Indigenous primary school students

Abstract	Objective:Recent Australian research with adolescents aged 13 to 17 years has found that Indigenous youth are more likely than non-Indigenous adolescents to smoke tobacco and cannabis, although they may be less likely to use alcohol. The objective of this study was to examine whether this pattern exists among younger children.Method:A school-based, self-report survey was conducted in primary schools that had high proportions of Aboriginal and Torres Strait Islander children. Four schools were located in metropolitan Brisbane and three in Far North Queensland (sample n=507 students: 270 girls, 237 boys, aged 9–13 years).Results:Significant numbers of these children had started to experiment with recreational drugs. Twenty-two per cent had attempted to smoke at least one cigarette, 14% smoked in the preceding year, while 3% had smoked more than 10 cigarettes in their lives. Thirty-eight per cent had had at least one drink of alcohol, while 6% had smoked marijuana at least once. There was no significant association between Indigenous/non-lndigenous background and risk of smoking tobacco or marijuana, while Indigenous children were less likely than non-Indigenous children to report experience with alcohol.Conclusions:Contrary to data from secondary school students, Indigenous youth in primary schools were not more likely than non-Indigenous children to have experimented with tobacco or marijuana, or to be frequent tobacco smokers. It appears therefore that the excessive uptake of drug use among Indigenous youth occurs in the early stages of secondary school. This finding underlines the importance of preventive education in primary schools, especially for Indigenous children who have a high risk of making the transition to drug use in adolescence.
Publication	Australian and New Zealand Journal of Public Health
Date	2000
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1467-842X.2000.tb00509.x/abstract

 

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Conjoint Smoking and Drinking: A Case for Dual-substance Intervention among Young Emergency Department Patients

Abstract	Abstract. Objectives: To better understand conjoint smoking and drinking among young adult emergency department (ED) patients, the purposes of this investigation were: 1) to assess the prevalence of conjoint use; 2) to determine the factors associated with conjoint alcohol use and smoking; and 3) to address the implications for future ED-based investigation of dual-substance intervention. Methods: Data for this investigation were obtained from a battery of questionnaires administered to the routine-care patients during an alcohol screening in the ED, which was part of a larger alcohol intervention study. Results: Study findings revealed that a majority of patients with self-reported alcohol-related problems were smokers. In fact, drinkers who smoked were likely to be pack-a-day smokers. Among the study sample, being female, having low education levels (e.g., high school education or less), having some emotional problems, and currently using marijuana were risk factors for conjoint smoking and drinking. Conclusions: Conjoint users were identifiable through brief screening. Given the prevalence of conjoint smoking and alcohol use among the ED sample and a specific set of risk factors, tailored intervention for alcohol and nicotine dependence may be an important and opportunistic clinical ED service.
Publication	Academic Emergency Medicine
Date	2000
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2000.tb01262.x/abstract

 

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Wheezing in early life and asthma at school age: Predictors of symptom persistence

Abstract	Early childhood wheezing is associated with asthma later in life. However, the high spontaneous recovery rate and the lack of firm predictors for persistence of wheezing complicates the development of evidence-based guidelines for long-term management of wheezy infants and toddlers. Our aim was to define variables that could be used to identify wheezy individuals younger than 3 years of age who would continue to be symptomatic at school age. The method used was a questionnaire-based cross-sectional survey of 2027 randomly chosen, 6–13-year-old school children. Altogether 1829 (90%) questionnaires were returned. Emergency medical care had been sought for 186 (10.2%) children for wheezing during the first 3 years of life, and only 17.2% of these children had received similar emergency treatment during the 12 months preceding the survey. The total proportion of children with current asthma at school age was 11.4%. A logistic regression analysis indicated that for the early wheezers, a family history of asthma, an itchy rash or food allergy, and exposure to tobacco smoke at home before the age of 3 years, were all independently associated with symptom persistence until school age. Among all wheezy children younger than 3 years, those who have a history of food allergy, itchy rash, asthma occurrence in a sibling or parent, or are exposed to tobacco smoke during the first years of life are at highest risk for symptom persistence until school age.
Publication	Pediatric Allergy and Immunology
Date	2000
URL	http://onlinelibrary.wiley.com/doi/10.1034/j.1399-3038.2000.00088.x/abstract

 

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Youth Risk Behavior Surveillance — United States, 1999

Abstract	ABSTRACT: Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults – behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 33 state surveys, and 16 local surveys conducted among high school students during February through May 1999.In the United States, approximately three fourths of all deaths among persons aged 10–24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1999 national Youth Risk Behavior Survey demonstrate that numerous high school students engage in behaviors that increase their likelihood of death from these four causes – 16.4% had rarely or never worn a seat belt; during the 30 days preceding the survey, 33.1% had ridden with a driver who had been drinking alcohol; 17.3% had carried a weapon during the 30 days preceding the survey; 50.0% had drunk alcohol during the 30 days preceding the survey; 26.7% had used marijuana during the 30 days preceding the survey; and 7.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 1999, nationwide, 49.9%of high school students had ever had sexual intercourse; 42.0% of sexually active students had not used a condom at last sexual intercourse; and 1.8% had ever injected an illegal drug. Two thirds of all deaths among persons aged ≥25 years result from only two causes – cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 1999, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey; 76.1% had not eaten ≥5 servings/day of fruits and vegetables during the 7 days preceding the survey; 16.0% were at risk for becoming overweight; and 70.9% did not attend physical education class daily.These YRBSS data are already being used by health and education officials at national, state, and local levels to analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators.
Publication	Journal of School Health
Date	2000
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2000.tb07252.x/abstract

 

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Possible risk factors and precipitants for migraine with aura in discordant twin-pairs: a population-based study

Abstract	The aim of the present study was to detect possible risk factors in migraine with aura (MA) by analysis of discordant twin-pairs. In a recent population-based twin study we established that environmental factors account for approximately 50% of the variation in liability to MA. A cohort of 5360 same-gender twin-pairs from the general population was screened for migraine. All twin-pairs with possible migraine were interviewed by a physician. A questionnaire provided information about living conditions and lifestyle. Of the 169 discordant twin-pairs 51 were monozygotic and 118 were dizygotic twin-pairs. Several putative risk factors—schooling, education, marital status, smoking status and alcohol consumption—showed no association with MA. The presence of migraine without aura or tension-type headache did not increase the risk of MA. Stress and mental tension, and bright light precipitated attacks of MA in, respectively, 44% and 28% of the twins.
Publication	Cephalalgia
Date	2000
URL	http://onlinelibrary.wiley.com/doi/10.1046/j.1468-2982.2000.00135.x/abstract

 

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The Common Risk Factor Approach: a rational basis for promoting oral health

Abstract	Abstract – Conventional oral health education is not effective nor efficient. Many oral health programmes are developed and implemented in isolation from other health programmes. This often leads, at best to a duplication of effort, or worse, conflicting messages being delivered to the public. In addition, oral health programmes tend to concentrate on individual behaviour change and largely ignore the influence of socio-political factors as the key determinants of health. Based upon the general principles of health promotion this paper presents a rationale for an alternative approach for oral health policy. The common risk factor approach addresses risk factors common to many chronic conditions within the context of the wider socio-environmental milieu. Oral health is determined by diet, hygiene, smoking, alcohol use, stress and trauma. As these causes are common to a number of other chronic diseases, adopting a collaborative approach is more rational than one that is disease specific. The common risk factor approach can be implemented in a variety of ways. Food policy development and the Health Promoting Schools initiative are used as examples of effective ways of promoting oral health.
Publication	Community Dentistry and Oral Epidemiology
Date	2000
URL	http://onlinelibrary.wiley.com/doi/10.1034/j.1600-0528.2000.028006399.x/abstract

 

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Longitudinal Tracking and Retention in a School-based Study on Adolescent Smoking: Costs, Variables, and Smoking Status.

Abstract	Describes the design of a cohort of 6th-grade students, methods for tracking and retaining students as they advanced through 8th and 11th grade, and costs involved for survey completion in school and by mail for students who had ever and never used tobacco. Problems unique to the school setting are addressed, with suggestions for efficient tracking and questionnaire completion. (SM)
Publication	Journal of School Health
Date	2000
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ605882

 

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Special Report. Youth Risk Behavior Surveillance. United States, 1999.

Abstract	Summarizes results from 1999 national school-based surveys and trends during 1991-99 in selected youth risk behaviors as well as 33 state and 16 local school-based surveys. Prevalence of several injury-related behaviors and sexual behaviors have improved. Current smoking rates may be declining. Certain risk behaviors are more common among particular subpopulations of students. (SM)
Publication	Journal of School Health
Date	2000
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ612261

 

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Sources of adolescent stress, smoking and the use of other drugs

Abstract	Stress is an established correlate of smoking behaviour in regular adult smokers and has been related to the use of alcohol and other drugs as well. Empirical data supporting these assertions are entirely consistent with theoretical conceptions of both smoking and other substance use behaviours. Despite both supportive theory and empirical evidence with adults, however, little work has been done to extend such views to adolescent smoking and the use of other substances, where the evolution of these health risk behaviours is still plastic and potentially amenable to intervention. The present study reports associations between sources of adolescent stress assessed by an instrument purposely constructed for that exercise and both smoking behaviour and the use of alcohol and other substances. Some sources of stress in the self-reported experience of adolescents statistically related both to current smoking and to the use of alcohol and other drugs. Associations were generally stronger for smoking than for other substances and both stronger and broader for girls than for boys. Stress arising from compulsory school attendance was broadly associated with substance use for both boys and girls and this was in line with past evidence; for girls, however, associations extended to stressors arising from other sources and particularly those to do with the family. The theoretical bases for these findings are discussed in the context of the stress reduction properties of smoking and other substance use, and the implications for intervention through targeted stress management are raised. Copyright © 1999 John Wiley & Sons, Ltd.
Publication	Stress Medicine
Date	1999
URL	http://onlinelibrary.wiley.com/doi/10.1002/(SICI)1099-1700(199910)15:4<215::AID-SMI817>3.0.CO;2-1/abstract

 

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Different pattern of risk factors for atopic and nonatopic asthma among children – report from the Obstructive Lung Disease in Northern Sweden Study

Abstract	Background: A cross-sectional study was performed among 7–8-year-old schoolchildren during the winter of 1996 in three municipalities in the most northern province of Sweden, Norrbotten. The study was the starting point of a longitudinal study of asthma, rhinitis, eczema, and type-1 allergy, and provided data on prevalence and risk factors for these conditions. The aim of the present study was to validate the classification of asthma based on a parental questionnaire, and to examine risk factors for atopic and nonatopic asthma.Methods: The ISAAC questionnaire with additional questions was distributed by the schools to the parents. The response rate was 97%, and 3431 completed questionnaires were returned. The children in Kiruna and Luleå were also invited to be skin tested, and 2149 (88%) were tested with 10 common airborne allergens. A structured interview was administered by pediatricians in stratified samples of the children to test the validity of the diagnosis of asthma based on the questionnaire.Results: After the validation study, the prevalence of “ever asthma” was estimated to be 8.0%. The specificity of the question, “Has your child been diagnosed as having asthma by a physician?”, was high, >99%, while the sensitivity was around 70%. The strongest risk factor for “ever asthma” was a positive skin test (OR 3.9). Risk factors for asthma in the asthmatics who were not sensitized were family history of asthma, OR 3.6; breast-feeding less than 3 months, OR 1.8; past or present dampness at home, OR 1.8; smoking mother, OR 1.7; and male sex, OR 1.6. Among the sensitized asthmatics, only a family history of asthma was a significant risk factor (OR 3.0), while breast-feeding less than 3 months was not associated with an increased risk (OR 1.0). A synergistic effect between genetic and environmental factors was found especially in the nonatopic asthmatics; the children with a family history of asthma who had a smoking mother and past or present dampness at home had an OR for “ever asthma” of 13.Conclusions: Different risk-factor patterns were found for asthma and type-1 allergy. In addition, the risk factors for atopic or allergic asthma diverged from those for nonatopic asthma.
Publication	Allergy
Date	1999
URL	http://onlinelibrary.wiley.com/doi/10.1034/j.1398-9995.1999.00044.x/abstract

 

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Evaluation of Developmentally Appropriate Programs for Adolescent Tobacco Cessation

Abstract	ABSTRACT: Despite introduction of numerous smoking prevention programs in schools, tobacco use has not declined among adolescents. Schools face the dilemma of what to do with students who smoke and are not ready to quit. This study evaluated two programs based on the stages of change model. The educational program, the Tobacco Education Group (TEG), was designed for adolescents not yet thinking about quitting. The cessation program, the Tobacco Awareness Program (TAP), was intended for adolescents who want to quit. Evaluation was completed on 351 students at six public high schools. Compared to a control group of adolescent smokers not assigned to programs, both intervention groups significantly decreased tobacco use. Self-reported use was validated biochemically. Self-efficacy for quitting increased in both programs. Posttest use was predicted by posttest self-efficacy, peer support, and parental support, after controlling for initial use and initial self-efficacy.
Publication	Journal of School Health
Date	1999
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1999.tb06420.x/abstract

 

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Substance use and socio-demographic factors among Aboriginal and Torres Strait Islander school students in New South Wales

Abstract	Objective: To estimate prevalence rates of substance use and associated socio-demographic factors among Aboriginal and Torres Strait Islander (ATSI) secondary students.Method: This paper presents ATSI data from population-based school surveys conducted in 1996, 1992 and 1989 in New South Wales and replicates identical analysis using the three datasets.Results: The proportion of ATSI students in each survey ranged from 2.5% to 3.8%. After adjusting for age, gender and socio-demographic factors, ATSI students were more likely to smoke cigarettes, and to have tried cannabis and other illicit substances.Conclusions: This study suggests that Aboriginal and Torres Strait Islander students were more susceptible to, and maintained a higher rate of, substance use than non-Aboriginal and Torres Strait Islander youth. Socio-demographic differences between Aboriginal and non-Aboriginal students in age, rural/urban status, living with both parents, reporting poor school performance, low parental supervision and high school absenteeism remained significantly associated with Aboriginal status and substance use.Implications: This is one of the first studies examining substance use in a large and representative sample of in-school ATSI youth. These results provide information useful for public health advocates, and require policy changes more likely to reduce substance use among ATSI youth.
Publication	Australian and New Zealand Journal of Public Health
Date	1999
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1467-842X.1999.tb01259.x/abstract

 

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Trends from 1987 to 1991 in Alcohol, Tobacco, and Other Drug (ATOD) Use among Adolescents Exposed to a School District-Wide Prevention Intervention.

Abstract	Discusses a school-based prevention program initiated to reduce alcohol, tobacco, and other drug (ATOD) use among adolescents. Investigates changes in reported ATOD use from 1987 to 1991. Significant decreases were found for use of most drugs with the exception of alcohol. Involvement in problem behaviors was the most salient risk factor whereas having a member of a non-using peer group was most salient protective factor. (Author/MKA)
Publication	Journal of Drug Education
Date	1999
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ589136

 

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Youth Risk Behavior Surveillance — United States, 1997

Abstract	ABSTRACT: Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, and are interrelated. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults — behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by the Centers for Disease Control and Prevention as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 33 state surveys, 3 territorial surveys, and 17 local surveys conducted among high school students from February through May 1997.In the United States, 73% of all deaths among youth and young adults 10–24 years of age result from only four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the national 1997 YRBSS demonstrate that many high school students engage in behaviors that increase their likelihood of death from these four causes — 19.3% had rarely or never worn a seat belt; during the 30 days preceding the survey, 36.6% had ridden with a driver who had been drinking alcohol; 18.3% had carried a weapon during the 30 days preceding the survey; 50.8% had drunk alcohol during the 30 days preceding the survey; 26.2% had used marijuana during the 30 days preceding the survey; and 7.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity among school-age youth, young adults, and their children also result from unintended pregnancies and STDs, including HIV infection. YRBSS results indicate that in 1997, 48.4% of high school students had ever had sexual intercourse; 43.2% of sexually active students had not used a condom at last sexual intercourse; and 2.1% had ever injected an illegal drug. Of all deaths and substantial morbidity among adults greater than or equal to 25 years of age, 67% result from two causes — cardiovascular disease and cancer. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1997, 36.4% of high school students had smoked cigarettes during the 30 days preceding the survey; 70.7% had not eaten five or more servings of fruits and vegetables during the day preceding the survey; and 72.6% had not attended physical education class daily.These YRBSS data are already being used by health and education officials to improve national, state, and local policies and programs to reduce risks associated with the leading causes of morbidity and mortality. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and one of the eight National Education Goals. (J Sch Health. 1998;68(9):355–369)
Publication	Journal of School Health
Date	1998
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1998.tb07202.x/abstract

 

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Peer Helping/Involvement: An Efficacious Way to Meet the Challenge of Reducing Alcohol, Tobacco, and Other Drug Use among Youth.

Abstract	Examines the use of peer-helping programs in minimizing alcohol, tobacco, and other drug use. Discusses results of a meta-analysis of school-based drug-prevention programs, false conclusions about peer programs' ineffectiveness, features of two model programs that compared peer leadership to teacher/researcher-led programs, and suggestions for designing and implementing high-quality, peer-led programs. (SM)
Publication	Peer Facilitator Quarterly
Date	1998
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ578612

 

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Twelfth Grade Follow-Up of the Effectiveness of a Middle School-Based Substance Abuse Prevention Program.

Abstract	Assesses the effects of a sixth- and seventh-grade substance-abuse-prevention program in the twelfth-grade year. Questionnaires administered to students who had completed the two-year intervention and students with no intervention (N=262) showed that the effects evident in seventh grade had not been maintained through twelfth grade. (Author/MKA)
Publication	Journal of Drug Education
Date	1998
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ579115

 

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Peer Education: An Important Component of an Effective School-Based Tobacco Prevention Program.

Abstract	Reviews the detrimental effects of adolescent tobacco use and stresses the importance of prevention efforts targeting youth at school, discussing characteristics of effective school-based approaches and the unique aspects of peer teaching and peer leadership programs. Research suggests that peer-led tobacco prevention programs can foster desirable behaviors. However, many prevention professionals are unaware of the peer education literature. (SM)
Publication	Peer Facilitator Quarterly
Date	1998
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ586893

 

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'Smoke-free Soccer' scores in the Humber region: The contradiction between trying to achieve their sporting potential and damaging their fitness by smoking is fully exposed

Publication	Education and Health
Date	1998
URL	/sheux/EH/eh162bc.pdf

 

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Who worries? Young smokers certainly do!: The Unit's latest survey shows that half the Year 10 girl smokers worry 'quite a lot' or 'a lot' about at least five things

Publication	Education and Health
Date	1998
URL	/sheux/EH/eh163jb.pdf

 

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Familial Constraints on the Initiation of Cigarette Smoking Among Adolescents: An Elaboration of Social Bonding Theory and Differential Association Theory

Abstract	Researchers have identified specific familial risk factors associated with the onset of smoking among adolescents. Two theoretical perspectives have been employed to integrate the research. Social bonding theory suggests that weak family relations have a direct influence on adolescent smoking behavior, whereas the differential association perspective proposes that the quality of family relations has an indirect impact in the initiation of smoking through facilitating association with smoking peers. Parental smoking behavior and the nature of the family structure are acknowledged as important factors that may interact with or directly influence family relations. This article explores how familial risk factors play a direct and an indirect role in influencing the initiation of smoking. Implications for school-based smoking preventive programs and recommendations for future research are presented and discussed.
Publication	Canadian Journal of School Psychology
Date	June 01 , 1997
URL	http://cjs.sagepub.com/cgi/content/abstract/12/2/177

 

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Stopping them starting: evaluation of a community-based project to discourage teenage smoking in Cardiff

Abstract	A project in Cardiff in 1994/95 aimed to delay the onset of smoking among Year 7 pupils (11-12-year-olds) through a combination of school-based education and community interventions. Pupils' intention to smoke and attitudes towards smoking were compared before and after a six-month intervention period. There was evidence that fewer young people thought that they would become smokers in those schools where there was local agency involvement, althouth the numbers of pupils smoking increased over the intervention period. The study period was insufficient to allow conclusive statements about the effects of the community initiatives to be made. This modest experiment used limited resources to encourage community-wide participation in tackling the smoking issue and requires sustaining to counter positive images of smoking. Practical examples of such community interventions to support school-based education are given.
Publication	Health Education Journal
Date	March 01 , 1997
URL	http://hej.sagepub.com/cgi/content/abstract/56/1/42

 

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Diet, smoking and exercise: interrelationships between adolescent health behaviours

Abstract	A questionnaire measuring smoking status, exercise and dietary behaviour was administered to 932 high school pupils during regular classroom periods. Pupils were taken from three year groups which included 327 year 8 (12–13 years), 313 year 9 (13–14 years) and 292 year 10 (14–15 years). Pupils also indicated whether they could recall classroom teaching on 15 food- and health-related issues. Scores were derived representing self-reported frequency of eating foods that were high in fat, and fresh fruits and vegetables. Smoking was found to be associated with lower levels of exercise, consumption of less fresh foods and greater consumption of fatty foods. In addition, consumption of fresh foods was found to be positively correlated with exercise. These findings have implications for the organization of school-based health education efforts and suggest that health education programmes need to adopt an integrated approach rather than treat health behaviours in isolation from each other.
Publication	Child: Care, Health and Development
Date	1997
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2214.1997.tb00964.x/abstract

 

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National Assessment of Early Elementary Teachers' Perceived Self-Efficacy for Teaching Tobacco Prevention Based on the CDC Guidelines

Abstract	ABSTRACT: A national random sample of 505 early elementary school teachers completed a 47-item survey to determine their perceived self-efficacy for teaching tobacco prevention education based on the Centers for Disease Control and Prevention guidelines for grades K-3, their training status on tobacco prevention, and their level of teaching about tobacco prevention. Results indicated most of the teachers were female, White, held a bachelor's or master's degree, never smoked, and had not received formal tobacco prevention training. The teachers' scores were high for efficacy expectations, and for outcome expectations. Conversely, for outcome value, teachers ranked tobacco prevention fifth out of six health topics, as the most important health topic to teach elementary students. Also, teachers trained in four tobacco areas or more had statistically significantly higher scores for efficacy expectations than those trained in three or fewer areas. Statistically significant positive associations were also found between years of teaching tobacco prevention and efficacy and outcome expectation scores, and between the amount of time that tobacco prevention was taught during the past school year and outcome value. (J Sch Health. 1997;67(8):348–354)
Publication	Journal of School Health
Date	1997
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1997.tb03471.x/abstract

 

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Adjusting for Attrition in School-Based Samples: Bias, Precision, and Cost Trade-Offs of Three Methods.

Abstract	Tracking and two statistical methods (probability weighting and sample selection modeling) were studied as ways to minimize bias attributable to sample attrition in school-based studies. Data on student smoking from 30 middle schools illustrate that sample weighting yields the best results, with estimates superior to sample selection and much less expensive than tracking. (SLD)
Publication	Evaluation Review
Date	1997
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ554759

 

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Under-age sales: Making retailers count the cost

Publication	Education and Health
Date	1997
URL	/sheux/EH/eh154tf.pdf

 

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A Meta-Analysis of Smoking Prevention Programs After Adjustment for Errors in the Unit of Analysis

Abstract	This article presents the results of a meta-analysis designed to test the prevailing view that we largely understand why adolescents start to smoke and how to delay it. This view has developed even though none of the major reviews of the last 12 years has adjusted for the important methodological problems that all of those reviews identified as common in the published literature. School-based smoking prevention programs based on peer or social-type programs, published between 1974 and 1991, were included in this meta-analysis. Treatment characteristics were used to predict an effect size after adjustment for study design and population characteristics, and in particular, after a post hoc correction for errors in the original unit of analysis. The results suggest that the average effect for peer or social-type programs is likely to be quite limited in magnitude, and that the reduction in smoking may be only 0.10 standard deviation units, or perhaps 5%. Even under optimal conditions, the reduction in smoking may be only 0.50 to 0.75 standard deviation units, or perhaps 20%-30%.
Publication	Health Education & Behavior
Date	February 01 , 1996
URL	http://heb.sagepub.com/cgi/content/abstract/23/1/48

 

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Smoking Prevention and Young People: using research to identify out‐of‐school intervention sites in three countries

Publication	Educational Review
Date	1996
URL	http://dx.doi.org/10.1080/0013191960480204

 

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School-based programmes for preventing smoking

Abstract	Background: Smoking rates in adolescents are rising in some countries. Helping young people to avoid starting smoking is a widely endorsed goal of public health, but there is uncertainty about how to do this. Schools provide a route for communicating with a large proportion of young people, and school-based programmes for smoking prevention have been widely developed and evaluated.ObjectivesObjectivesTo review all randomized controlled trials of behavioural interventions in schools to prevent children (aged 5 to12) and adolescents (aged 13 to18) starting smoking.Search methodsSearch methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Tobacco Addiction Group's Specialized Register, MEDLINE, EMBASE, PsyclNFO, ERIC, CINAHL, Health Star, Dissertation Abstracts and studies identified in the bibliographies of articles. Individual MEDLINE searches were made for 133 authors who had undertaken randomized controlled trials in this area.Selection criteriaSelection criteriaTypes of studies: those in which individual students, classes, schools, or school districts were randomized to the intervention or control groups and followed for at least six months. Types of participants: Children (aged 5 to12) or adolescents (aged 13 to18) in school settings. Types of interventions: Classroom programmes or curricula, including those with associated family and community interventions, intended to deter use of tobacco. We included programmes or curricula that provided information, those that used social influences approaches, those that taught generic social competence, and those that included interventions beyond the school into the community. We included programmes with a drug or alcohol focus if outcomes for tobacco use were reported. Types of outcome measures: Prevalence of non-smoking at follow up among those not smoking at baseline. We did not require biochemical validation of self-reported tobacco use for study inclusion.Data collection and analysisData collection and analysisWe assessed whether identified citations were randomized controlled trials. We assessed the quality of design and execution, and abstracted outcome data. Because of the marked heterogeneity of design and outcomes, we computed pooled estimates only for those trials that could be analyzed together and for which statistical data were available. We predominantly synthesized the data using narrative systematic review. We grouped studies by intervention method (information; social competence; social influences; combined social influences/social competence; multi-modal programmes). Within each group, we placed them into three categories (low, medium and high risk of bias) according to validity using quality criteria for reported study design.Main resultsMain resultsOf the 94 randomized controlled trials identified, we classified 23 as category one (most valid). There was one category one study of information-giving and two of teaching social comeptence. There were thirteen category one studies of social influences interventions. Of these, nine found some positive effect of intervention on smoking prevalence, and four failed to detect an effect on smoking prevalence. The largest and most rigorous study, the Hutchinson Smoking Prevention Project, found no long-term effect of an intensive eight-year programme on smoking behaviour. There were three category one RCTs of combined social influences and social competence interventions: one provided significant results and one only for instruction by health educators compared to self-instruction.There was a lack of high quality evidence about the effectiveness of combinations of social influences and social competence approaches. There was one category one study providing data on social influences compared with information giving. There were four category one studies of multi-modal approaches but they provided limited evidence about the effectiveness of multi-modal approaches including community initiatives.Authors' conclusionsAuthors' conclusionsThere is one rigorous test of the effects of information-giving about smoking. There are well-conducted randomized controlled trials to test the effects of social influences interventions: in half of the group of best quality studies those in the intervention group smoke less than those in the control, but many studies failed to detect an effect of the intervention. There are only three high quality RCTs which test the effectiveness of combinations of social influences and social competence interventions, and four which test multi-modal interventions; half showed significant positive results.
Book Title	Cochrane Database of Systematic Reviews
Publisher	John Wiley & Sons, Ltd
Date	1996
URL	http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001293.pub2/abstract

 

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Community interventions for preventing smoking in young people

Abstract	Background: Cigarette smoking is one of the leading causes of preventable death in the world. Decisions to smoke are often made within a broad social context and therefore community interventions using coordinated, multi-component programmes may be effective in influencing the smoking behaviour of young people.ObjectivesObjectivesTo determine the effectiveness of multi-component community based interventions in influencing smoking behaviour, which includes preventing the uptake of smoking in young people.Search methodsSearch methodsThe Tobacco Addiction group's specialised register, Medline and other health, psychology and public policy electronic databases were searched, the bibliographies of identified studies were checked and raw data was requested from study authors. Searches were updated in August 2010.Selection criteriaSelection criteriaRandomized and non randomized controlled trials that assessed the effectiveness of multi-component community interventions compared to no intervention or to single component or school-based programmes only. Reported outcomes had to include smoking behaviour in young people under the age of 25 years.Data collection and analysisData collection and analysisInformation relating to the characteristics and the content of community interventions, participants, outcomes and methods of the study was extracted by one reviewer and checked by a second. Studies were combined in a meta-analysis where possible and reported in narrative synthesis in text and table.Main resultsMain resultsTwenty-five studies were included in the review and sixty-eight studies did not meet all of the inclusion criteria. All studies used a controlled trial design, with fifteen using random allocation of schools or communities. One study reported a reduction in short-term smoking prevalence (twelve months or less), while nine studies detected significant long-term effects. Two studies reported significantly lower smoking rates in the control population while the remaining thirteen studies showed no significant difference between groups. Improvements were seen in secondary outcomes for intentions to smoke in six out of eight studies, attitudes in five out of nine studies, perceptions in two out of six studies and knowledge in three out of six studies, while significant differences in favour of the control were seen in one of the nine studies assessing attitudes and one of six studies assessing perceptions.Authors' conclusionsAuthors' conclusionsThere is some evidence to support the effectiveness of community interventions in reducing the uptake of smoking in young people, but the evidence is not strong and contains a number of methodological flaws.
Book Title	Cochrane Database of Systematic Reviews
Publisher	John Wiley & Sons, Ltd
Date	1996
URL	http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001291.pub2/abstract

 

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Mass media interventions for preventing smoking in young people

Abstract	BackgroundBackgroundThe mass media have been used as a way of delivering preventive health messages. They have the potential to reach and to modify the knowledge, attitudes and behaviour of a large proportion of the community.ObjectivesObjectivesTo evaluate the effectiveness of mass media interventions to prevent smoking in young people in terms of reduced smoking uptake, in addition to secondary outcomes including improved smoking outcomes, attitudes, behaviours, knowledge, self-efficacy and perception.Search methodsSearch methodsWe searched the Cochrane Tobacco Addiction Group Specialised Register and conducted additional searches of MEDLINE and EMBASE in July 2010.Selection criteriaSelection criteriaRandomized trials, controlled trials without randomization and time series studies that assessed the effectiveness of mass media campaigns (defined as channels of communication such as television, radio, newspapers, bill boards, posters, leaflets or booklets intended to reach large numbers of people and which are not dependent on person to person contact) in influencing the smoking behaviour (either objective or self-reported) of young people under the age of 25 years.Data collection and analysisData collection and analysisInformation relating to the characteristics and the content of media interventions, participants, outcomes, methods of the study and risk of bias was abstracted by two independent reviewers. Studies were combined using qualitative narrative synthesis.Main resultsMain resultsSeven out of a total of 84 studies reporting information about mass media smoking campaigns met all of the inclusion criteria. All seven studies used a controlled trial design. Three studies concluded that mass media reduced the smoking behaviour of young people. All of the effective campaigns had a solid theoretical basis, used formative research in designing the campaign messages, and message broadcast was of reasonable intensity over extensive periods of time.Authors' conclusionsAuthors' conclusionsThere is some evidence that mass media can prevent the uptake of smoking in young people, however the evidence is not strong and contains a number of methodological flaws.
Book Title	Cochrane Database of Systematic Reviews
Publisher	John Wiley & Sons, Ltd
Date	1996
URL	http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001006.pub2/abstract

 

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Tobacco cessation interventions for young people

Abstract	BackgroundBackgroundMost tobacco control programmes for adolescents are based around prevention of uptake, but teenage smoking is still common. It is unclear if interventions that are effective for adults can also help adolescents to quit. This is an update of a Cochrane review first published in 2006.ObjectivesObjectivesTo evaluate the effectiveness of strategies that help young people to stop smoking tobacco.Search methodsSearch methodsWe searched the Cochrane Tobacco Addiction Group's Specialized Register in August 2009. This includes reports for trials identified in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and PsyclNFO.Selection criteriaSelection criteriaWe included randomized controlled trials, cluster-randomized controlled trials and other controlled trials recruiting young people, aged less than 20, who were regular tobacco smokers. We included any interventions; these could include pharmacotherapy, psycho-social interventions and complex programmes targeting families, schools or communities. We excluded programmes primarily aimed at prevention of uptake. The primary outcome was smoking status after at least six months follow up, among those who smoked at baseline.Data collection and analysisData collection and analysisBoth authors independently assessed the eligibility of candidate trials and extracted data. Where meta-analysis was appropriate we estimated pooled odds ratios using a Mantel-Haenszel fixed effect method, based on the quit rates at longest follow up.Main resultsMain resultsTwenty four trials involving over 5000 young people met our inclusion criteria (eleven cluster-randomized controlled trials, eleven randomized controlled trials and two controlled trials). Many studies combined components from various theoretical backgrounds to form complex interventions.The majority used some form of motivational enhancement combined with psychological support such as cognitive behavioural therapy (CBT) and some were tailored to stage of change using the transtheoretical model (TTM). Two trials based mainly on TTM interventions achieved moderate long-term success, with a pooled odds ratio (OR) at one year of 1.70 (95% confidence interval (CI) 1.25 to 2.33). The eleven trials that included some form of motivational enhancement gave an estimated OR of 1.70 (95% CI 1.31 to 2.20). The six trials which included cognitive behavioural therapy did not individually achieve statistically significant results, but there was a marginally significant effect of pooling four studies using the Not on Tobacco programme (OR of 1.77, 95% CI 1.00 to 3.11) although 3 of the trials used abstinence for as little as 24 hours at six months as the cessation outcome. Neither of the small trials using NRT products detected statistically significant effects. A trial of bupropion alone, showed no significant effect for either a standard or lower dose.Authors' conclusionsAuthors' conclusionsComplex approaches show promise, with some persistence of abstinence (30 days point prevalence abstinence or continuous abstinence at six months), especially those incorporating elements sensitive to stage of change and using motivational enhancement and CBT. We await results of recent trials of Not on Tobacco trials and more data is needed on sustained quitting that allows for the episodic nature of much adolescent smoking. There were few trials with evidence about pharmacological interventions (nicotine replacement and bupropion), and none demonstrated effectiveness for adolescent smokers. There is not yet sufficient evidence to recommend widespread implementation of any one model.There continues to be a need for well-designed adequately powered randomized controlled trials of interventions for this population of smokers.
Book Title	Cochrane Database of Systematic Reviews
Publisher	John Wiley & Sons, Ltd
Date	1996
URL	http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003289.pub4/abstract

 

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Youth Risk Behavior Surveillance — United States, 1995

Abstract	ABSTRACT: Priority health-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, unhealthy dietary behaviors, and physical inactivity. The YRBSS includes both a national school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 35 state surveys, and 16 local surveys conducted among high school students from February through May 1995.In the United States, 72% of all deaths among school-age youth and young adults result from four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1995 YRBSS suggest that many high school students practice behaviors that may increase their likelihood of death from these four causes: 21.7% had rarely or never used a safety belt, 38.8% had ridden with a driver who had been drinking alcohol during the 30 days preceding the survey, 20.0% had carried a weapon during the 30 days preceding the survey, 51.6% had drunk alcohol during the 30 days preceding the survey, 25.3% had used marijuana during the 30 days preceding the survey, and 8.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among school-age youth and young adults also result from unintended pregnancies and sexually transmitted diseases, including HIV infection. YRBSS results indicate that in 1995, 53.1% of high school students had experienced sexual intercourse, 45.6% of sexually active students had not used a condom at last sexual intercourse, and 2.0% had ever injected an illegal drug. Among adults, 65% of all deaths result from three causes: heart disease, cancer, and stroke. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1995, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey, 39.5% had eaten more than two servings of foods typically high in fat content during the day preceding the survey, and only 25.4% had attended physical education class daily. YRBSS data are being used nationwide by health and education officials to improve national, state, and local policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and one of eight National Education Goals.
Publication	Journal of School Health
Date	1996
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1996.tb03394.x/abstract

 

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Pro-Innovation Bias: The Case of the Giant Texas SmokeScream

Abstract	ABSTRACT: A common approach to promoting improvements in school health instruction involves development and dissemination of new curricula and teaching materials. Ironically, potential effects of innovative materials on student outcomes and actual teacher instructional practices rarely are considered important in decisions concerning use of new material. This study examined the impact of a new curricular innovation, the Giant Texas SmokeScream (GTSS), on 512 middle grade students' knowledge, perceptions, and behavioral intent about smoking. The data provided a basis for discussion of what Rogers labeled “pro-innovation bias.” Data indicated the program had no effect on students. The GTSS program itself, although popular with schools, was questioned as being atheoretical in its approach to health education and ineffective in its outcomes. These data illustrate the need for programs to be based on sound theory and evaluated rigorously prior to general adoption. Additionally, program evaluations focused solely on student effects are insufficient in their assessment of adoption and implementation practices.
Publication	Journal of School Health
Date	1996
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1996.tb08288.x/abstract

 

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East Yorkshire reaches the parts other schemes miss: Using a survey of 'smoking' information to boost the Health Award

Abstract	East Yorkshire reaches the parts other schemes miss: Using a survey of 'smoking' information to boost the Health Award
Publication	Education and Health
Date	1996
URL	/sheux/EH/eh135gw.pdf

 

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Peer tutoring seems to work - but why?

Publication	Education and Health
Date	1996
URL	/sheux/EH/eh135dr.pdf

 

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A Smoking Intervention Program for Primary Four Students in Hong Kong: What it can and cannot achieve

Abstract	The study aimed to assess the feasibility of a smoking prevention intervention program in primary schools in Hong Kong; increase awareness of the purpose of tobacco advertising; record any changes in attitude towards smoking; and measure the effects of the program on the children's knowledge of the harmful effects of smoking on health. Six classes from two primary schools in Hong Kong were involved in the study. The sample of 205 pupils in Primary 4, aged 9-10 years, were presented with a smoking prevention program of three lessons, including homework assignments.The intervention was evaluated by the analysis of pre-and post-test results and through personal interviews with the teachers. There were statistically significant changes in the responses of the children between pre-and post-tests, with a reduction in “don't know” answers and increase, in most cases, in correct responses. There were more improvements in knowledge than in attitude. There were no significant changes in the responses to questions about current behavior or future intention to smoke.School-based smoking prevention programs for primary schools in Hong Kong should be further developed and evaluated. Additional studies with larger numbers of children need to be conducted and implementation should occur quickly once efficacy has been demonstrated by evaluation. We hypothesize that a longer, spiral curriculum spanning Primary 4, 5 and 6 would be more effective in preventing the uptake of smoking, although this shorter program is a feasible and acceptable alternative to the absence of any program.
Publication	Asia-Pacific Journal of Public Health
Date	January 01 , 1995
URL	http://aph.sagepub.com/cgi/content/abstract/8/1/13

 

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Targeting adult smokers through a multi‐ethnic public school system

Publication	Journal of Cancer Education
Date	1995
URL	http://www.tandfonline.com/doi/abs/10.1080/08858199509528342

 

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Patterns of Cigarette Use Among Black and White Adolescents

Abstract	The authors compared peer and familial correlates of smoking among black and non-Hispanic white teenagers. Some earlier school-based studies suggested that black teens are predominately peer-driven smokers and not especially influenced by parental smoking behavior. Using national and California-based survey data, the authors applied logistic regression analysis to corroborate earlier research indicating, among both samples of black teens, that smoking was significantly associated with having best friends and siblings who smoke, and parental smoking did not correlate significantly with smoking. For the non-Hispanic white sub-samples, the evidence was less clear. Logistic regression data also showed adolescent smoking primarily as a peer- and sibling-influenced activity.
Publication	The American Journal on Addictions
Date	1995
URL	http://onlinelibrary.wiley.com/doi/10.3109/10550499509038106/abstract

 

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Feasibility of School-Based Smoking Cessation Programs

Abstract	ABSTRACT: This study obtained input from Australian student smokers approximately 15 years old, which may be useful in designing school-based smoking cessation programs. The sample was analyzed by previous quitting experience and intentions to quit. The order of preference for assistance options and incentives for quitting was similar across all groups: however, those who previously attempted to quit (previous quitters) and those who intended to quit (intenders) in the future were significantly more likely than non-quitters and non-intenders to find assistance options for quitting acceptable. The potential for saving money emerged as an important variable in convincing all groups of smokers not to smoke, and using personal willpower and cutting down slowly were identified as important in actual attempts to quit. The need for programs to be free and for friends to be supportive also was evident across all groups.
Publication	Journal of School Health
Date	1995
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1995.tb08208.x/abstract

 

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Does Life Education's drug education programme have a public health benefit?

Abstract	The Life Education organization offers a drug education programme to an estimated one million Australian primary schoolchildren. It is believed the programme delays experimentation with or initiation into smoking, alcohol use and the taking of analgesics. This study examined the short-term public health effects on 3000 11-and 12-year-old students, of whom 1700 were exposed to 5 consecutive years of the programme. The other 1300 students were not exposed to the programme. After controlling for the known predictors of social drug use there was no evidence that Life Education students, when compared with students receiving conventional school-based drug education, were less likely to have smoked, were less likely to have drunk or were less likely to have used analgesics. Indeed, the evidence suggested that Life Education-students were slightly more likely to use these substances, and that the programme had different effects on boys' and girls' drug use. Given that these findings are consistent with previous research evaluating similar drug education programmes, it is hypothesized they are most likely to do with the design of the programme itself.
Publication	Addiction
Date	1995
URL	http://onlinelibrary.wiley.com/doi/10.1046/j.1360-0443.1995.9022056.x/abstract

 

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Diffusion of Innovations in Schools: A Study of Adoption and Implementation of School-Based Tobacco Prevention Curriculum.

Abstract	This study examined the extent of implementation of school health education curricula (smoking prevention) in 21 school districts, identifying factors that affected implementation. Middle school teachers received training on curriculum use. Results indicated that larger organizational size, teacher training, and a favorable organizational climate were the strongest predictors of curriculum implementation. (SM)
Publication	American Journal of Health Promotion
Date	1995
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ502342

 

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Southwest Cardiovascular Curriculum Project: Study Findings for American Indian Elementary Students.

Abstract	This article describes the Southwestern Cardiovascular Curriculum, a school-based, culturally relevant curriculum designed to prevent tobacco use and promote a good diet. Comparisons of American Indian students in participating and nonparticipating schools indicated that participants had significant increases in knowledge, better diets, increased exercise rates, and decreased smoking rates. (SM)
Publication	Journal of Health Education
Date	1995
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ507616

 

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Youth Risk Behavior Surveillance - United States, 1993.

Abstract	This report summarizes results from the national survey, 24 state surveys, and 9 local school-based surveys of U.S. high school students. Categories of behaviors monitored are: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, dietary behaviors, and physical activity. (SM)
Publication	Journal of School Health
Date	1995
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ510939

 

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10 years of surveys of young smokers

Publication	Education and Health
Date	1995
URL	/sheux/EH/eh131jb.pdf

 

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Authoritative Parenting, Child Competencies, and Initiation of Cigarette Smoking

Abstract	School-based social influence programs to prevent adolescent smoking are having limited success in the long term. Intervening earlier in the process of smoking onset, during the childhood years, may be required to prevent adolescent smoking. Child socialization variables, specifically parenting behaviors and child competencies, may be important to understanding the earliest phase of smoking onset. This study tested hypotheses of association between authoritative parenting behaviors, enhanced child competencies, and relatively low rates of initiation of cigarette smoking. Analyzing cross-sectional survey data from 937 students in Grades 3 to 8, we found general support for the study hypotheses: Authoritative parenting was positively associated with child competencies ; children's competency levels were inversely related to their rates of smoking intention, initiation, and experimentation; authoritative parenting was inversely related to rates of child smoking intention and behaviors; and authoritative parenting and parent smoking status had independent associations with child initiation of cigarette smoking. These results indicate that child socialization variables merit further investigation for their potential role in the development of early intervention programs for smoking prevention.
Publication	Health Education & Behavior
Date	April 01 , 1994
URL	http://heb.sagepub.com/cgi/content/abstract/21/1/103

 

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Guidelines for School Health Programs to Prevent Tobacco Use and Addiction

Abstract	ABSTRACT: Tobacco use is the leading cause of preventable death in the U.S. Most daily smokers (82%) began smoking before age 18, and more than 3,000 young persons begin smoking each day. School programs designed to prevent tobacco use could become one of the most effective strategies available to reduce U.S. tobacco use. The following guidelines summarize school-based strategies most likely to be effective in preventing tobacco use among youth. They were developed by CDC in collaboration with experts from 29 national, federal, and voluntary agencies and with other leading tobacco-use prevention authorities to help school personnel implement effective tobacco-use prevention programs. These guidelines are based on an in-depth review of research, theory, and current practice in school-based tobacco-use prevention. The guidelines recommend that all schools: a) develop and enforce a school policy on tobacco use, b) provide instruction about the short-term and long-term negative physiologic and social consequences of tobacco use, social influences on tobacco use, peer norms regarding tobacco use, and refusal skills, c) provide K-12 tobacco-use prevention education, d) provide program-specific training for teachers, e) involve parents or families in support of school-based programs to prevent tobacco use, f) support cessation efforts among students and all school staff who use tobacco, and g) assess the tobacco-use prevention program at regular intervals. (J Sch Health. 1994; 64(9): 353–360)
Publication	Journal of School Health
Date	1994
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1994.tb06204.x/abstract

 

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A Comprehensive Multi-Media Program to Prevent Smoking among Black Students.

Abstract	Implemented program to decrease incidence of new smokers among black adolescents. Program combined school-based curriculum with comprehensive media intervention. There were two experimental conditions: one group participated in school-based intervention and was prompted to participate in multimedia intervention; other group had access to multimedia intervention but was not prompted to participate. Rate of smoking decreased for all participants. (Author/NB)
Publication	Journal of Drug Education
Date	1994
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ511288

 

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The Effect of Two Types of Teacher Training on Implementation of Smart Choices: A Tobacco Prevention Curriculum.

Abstract	This study examined strategies to increase diffusion of a school-based tobacco prevention program (Smart Choices), comparing the impact on curriculum implementation of either video or workshop teacher training approaches. Fewer video trained teachers implemented the curriculum, but overall completeness and fidelity of implementation for those who did were comparable for both groups. (Author/SM)
Publication	Journal of School Health
Date	1994
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ500443

 

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Parental Participation in Drug Abuse Prevention: Results from the Midwestern Prevention Project.

Abstract	Examined the relationship between parent participation in a school-based drug and alcohol abuse prevention program for adolescents and adolescent drug use. Results of an 18-month follow-up survey found that parent participation in the program was negatively associated with adolescent use of alcohol and cigarettes. (MDM)
Publication	Journal of Research on Adolescence
Date	1994
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ485365

 

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Participation in a Telephone-Based Tobacco Use Prevention Program for Adolescents.

Abstract	This study investigated the usefulness of a telephone-based intervention in circumventing participant biases in school-based tobacco use prevention programs. Researchers attempted to conduct telephone interventions with ninth graders and found it difficult to reach a large portion of targeted individuals. Results provided data on which adolescents were hardest to reach with the intervention. (SM)
Publication	American Journal of Health Promotion
Date	1994
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ498381

 

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The Use of Archival Data To Select and Assign Schools in a Drug Prevention Trial

Abstract	School-based prevention trials typically face large variations in school composition and levels ofpreintervention behavior. Such variations may inhibit efforts to maximize internal and external validity. This article presents a method for using school-level attributes in sample description and random assignment of schools to conditions. The utility of the archival data was examined using multivanate canonical techniques. The authors found that a small set of attributes could efficiently predict the observed school-level variations in smoking and other drug use. It is recommended that these attributes be used by other school-based studies to enhance experimen talfield studies.
Publication	Evaluation Review
Date	April 01 , 1993
URL	http://erx.sagepub.com/cgi/content/abstract/17/2/159

 

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Psychosocial Correlates of Adolescent Cigarette Smoking: Personality or Environment

Abstract	Adolescent cigarette smoking is a problem of increasing magnitude in the Australian population, and programs based on psychological strategies designed to prevent the onset of smoking among adolescents have been universally disappointing in their capacity to achieve this outcome. Much of the blame for this may be attributed to a failure to comprehensively understand the psychosocial factors leading to the dis cretionary human behaviour of smoking. This study investigated a combination of such psychosocial factors in relation both to present adolescent smoking behaviour and to future intentions of adolescents to smoke. Data were collected from a large and representative sample of Australian adolescents attending high schools and secondary colleges in three Australian cities. The findings suggest that social context is a stronger correlate of both present and future intended adolescent smoking than is personality, though there are sex differences in the data which caution against the view that a single set of psychosocial variables is universally associated with smoking behaviour in all adolescents. Moreover, the data suggest that self-reported future intention to smoke is an unreliable indicator of smoking behaviour in the future. The results are discussed with particular reference to their potential to guide psychological strategies for adolescent smoking prevention.
Publication	Australian Journal of Psychology
Date	1993
URL	http://onlinelibrary.wiley.com/doi/10.1080/00049539308259124/abstract

 

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Prevalence and Sociobehavioral Correlates of Tobacco Use Among Hispanic Children: The Tobacco Resistance Activity Program

Abstract	ABSTRACT: To examine tobacco use patterns and its sociobehavioral correlates among Hispanic in-school youth, a tobacco use and knowledge survey was administered to 660 children from fourth through sixth grade classes, of which 69% (n = 453) were of Hispanic origin. Male Hispanics were more exposed to previous tobacco use (38% vs. 20%, p < .01), reported more current smoking, had more smoking friends, received more cigarette offers, and wanted to try a cigarette compared to females (all p < .05). Also, more previous alcohol use was noted in the previous tobacco users, indicating its potential as a “gateway drug.” From multivariate analyses, being offered cigarettes was the strongest environmental indicator of previous tobacco usage, followed by having adult smokers in the house, smoking friends, (all p < .01), and being around other smoking youth (p < .05). This study offers additional knowledge about factors that may cause Hispanic youth to initiate smoking, and suggests the need to address peer and social influences in school-based substance abuse programs. (J Sch Health. 1993;63(9):391–396)
Publication	Journal of School Health
Date	1993
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1993.tb06170.x/abstract

 

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The Linkage Approach Applied to a School-Based Smoking Prevention Program in the Netherlands

Abstract	ABSTRACT: Effective diffusion strategies are necessary to enhance use of innovative health promotion programs. One strategy uses the linkage approach to innovation-development and diffusion planning. The linkage approach enhances collaboration among three systems: resource system (university-based researchers), linkage system (district health educators), and user system (teachers). This article illustrates how the linkage approach was applied in a smoking prevention research project. Identification of the linkage system and the collaborative process between the resource system and linkage system are described. Results from a process evaluation indicated the linkage approach was feasible in a school-based smoking prevention project.
Publication	Journal of School Health
Date	1993
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1993.tb07148.x/abstract

 

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Effects of air pollution on the respiratory tract of children.

Abstract	The effects of air pollution on pulmonary function and respiratory status was evaluated in 1,626 school aged children from a European Alpine region. Based on measurements of SO2, NO2 and O3 as well as infrared imaging and lichen mapping, three zones of exposure were defined. Results of standardized respiratory questionnaires, medical examinations, and lung function tests were compared among the children in the three different exposure zones. After controlling for age, sex, height, socioeconomic status, and exposure to environmental tobacco smoking, areas of increased SO2 and NO2 as well as areas of increased ozone (max. half hourly mean value, 146 ppb) were significantly associated with decrements of forced expiratory volume in 1 s (FEV1) and flow rates at 50 and 75% of vital capacity (FEF50 FEF75). In addition, areas with increased ozone had a higher prevalence of asthma In all regions, maternal smoking was associated with reduced expiratory flow rates and increased prevalence of asthma. The results provide evidence that outdoor pollution and exposure to passive smoking are risk factors for childhood respiratory health. © 1993 Wiley-Liss, Inc.
Publication	Pediatric Pulmonology
Date	1993
URL	http://onlinelibrary.wiley.com/doi/10.1002/ppul.1950150203/abstract

 

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The associations between childhood asthma and atopy, and parental asthma, hay fever and smoking

Abstract	Summary. The aim of this analysis was to examine the degree to which a life time prevalence of asthma in a 7-year-old child is statistically associated with atopic conditions of the child, and with parental asthma, hay fever and smoking. In 1968, 8585 children who were born in 1961 and who were attending school in Tasmania were surveyed. This comprised 99% of the eligible population. The prevalence of a history of asthma in the 7-year-olds was 16.2% (males 19.0%, females 13.2%). Multiple logistic regression analysis showed that a history of asthma in a 7-year-old was associated with the child being male (odds ratio [OR] 1.56; 99% confidence interval 1.30–1.86), having a history of hay fever (3.86; 3.12–4.78), eczema (2.04; 1.63–2.55), hives (1.34; 1.09–1.65) or allergy to foods or medicines (1.70; 1.26–2.30), the child's mother or father having a history of asthma (2.63; 2.08–3.31 or 2.52; 1.99–3.19, respectively), and the mother being a smoker (1.26; 1.05–1.51). Parental hay fever and paternal smoking were not independently associated with childhood asthma. The strength of association between childhood asthma and parental asthma was independent of the sex of either the parent or the child, and of atopic conditions in the child. In the 133 children for whom both parents were asthmatic, 65 (49%) had a history of asthma. These findings, based on a population survey, are consistent, not only with a childhood history of asthma being strongly associated with atopy, but also with the existence of strong unmeasured determinants common to family members, the effects of which are not mediated via atopy. The risk for asthma being independent of both the sex of the child and of the parent, is consistent with a genetic aetiology for susceptibility to asthma.
Publication	Paediatric and Perinatal Epidemiology
Date	1993
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3016.1993.tb00602.x/abstract

 

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Implementing a Middle School Health Promotion Research Project: Lessons Our Textbook Didn't Teach Us.

Abstract	Difficulties accompanying large-scale field tests of a health promotion program in middle schools are reviewed, focusing on Healthy for Life, a health promotion research project that recruited 22 schools. The practical lessons and strategies of program recruitment and implementation are useful for anyone planning school-based programs or research. (SLD)
Publication	Evaluation and Program Planning
Date	1993
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ471918

 

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Can families be bad for your health?

Publication	Education and Health
Date	1993
URL	/sheux/EH/eh111df.pdf

 

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Recruiting the young smoker

Publication	Education and Health
Date	1993
URL	/sheux/EH/eh111cn.pdf

 

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Seeking a non-smoking lifestyle in an East London youth club

Publication	Education and Health
Date	1992
URL	/sheux/EH/eh104tm.pdf

 

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A Smoking Survey of College Students in India: Implications for Designing an Antismoking Policy

Abstract	A survey of 599 college students was conducted in Andhra Pradesh, India, to formulate an anti-smoking policy for youth. There were 64.6% boys and 35.4% girls between 15 and 22 years, and 8.2% of students (n = 49, 48M + 1F) were smokers. It is a taboo for girls to smoke. There is no current anti-smoking policy and one is proposed based on the smoking survey results. The policy includes parental pressure to curb smoking, and a ban on (1) advertising of tobacco products, (2) smoking in public places and (3) teachers smoking in school. An increase in the price of cigarettes was approved by a majority of the students. The survey revealed a gap in the knowledge of students about the ill effects of smoking, which can be rectified by health education programs.
Publication	Cancer Science
Date	1991
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1349-7006.1991.tb01821.x/abstract

 

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Adolescent health behaviour and similarity-attraction: Friends share smoking habits (really), but much else besides

Abstract	Smoking habits and related attitudes were assessed in a sample of 4059 11- to 16-year-olds who also identified their best friends from among their fellow respondents. Subjects' responses were directly collated with those of their friends and indicated a clear covariation of smoking status (controlling for sex and age) as anticipated from previous research in which adolescents have been asked to report on the smoking habits of their friends. Such covariation, however, was not specific to smoking habits, but generalized to related measures of attitude and normative beliefs, alcohol use, health locus of control, school performance, spending habits and socio-economic status. Similarities on these other attributes were much the same, whether or not friends shared each others' smoking habits. It is concluded that these data argue against a simplistic view of unidirectional ‘peer group influence’ and invite an interpretation of friendship choice based on multiple dimensions of similarity.
Publication	British Journal of Social Psychology
Date	1991
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.2044-8309.1991.tb00950.x/abstract

 

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16-19 year olds get 'smokerlysed'

Publication	Education and Health
Date	1991
URL	/sheux/EH/eh93pb.pdf

 

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The Smokefree message: emphasising the positive in New Zealand.

Publication	Education and Health
Date	1991
URL	/sheux/EH/eh95jg.pdf

 

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Evaluating the Statewide Dissemination of Smoking Prevention Curricula: Factors in Teacher Compliance

Abstract	ABSTRACT: As part of a larger study to evaluate the impact of a state-levied tax increase on tobacco products and the allocation of funds for smoking education, 81 schools were assigned randomly to one of four recommended smoking prevention programs for adolescents. The four programs differed in amount of program structure and extent of teacher training required. A one-session observation was made of 106 teachers in the 81 schools to assess the percentage of time allocated to recommended activities — those based on the social influences model. Data suggest an explicit curriculum with designed activities and face-to-face teacher training results in greater compliance to prescribed program components. (J Sch Health. 1990;60(10):501–504)
Publication	Journal of School Health
Date	1990
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1990.tb05890.x/abstract

 

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Illuminating Negative Results in Evaluation of Smoking Prevention Programs

Abstract	ABSTRACT: Evaluation of program implementation can help illuminate negative results of school-based smoking prevention programs. In three conventional quasiexperimental evaluations, no statistically significant impacts of smoking prevention programs on children's knowledge, attitudes, intentions, or behavior were detected. Complementary evaluations of program implementation along several dimensions using naturalistic methods suggested reasons for null effects were different at each site. These data were used to form hypotheses and recommendations for future interventions.
Publication	Journal of School Health
Date	1990
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1990.tb05973.x/abstract

 

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A Meta-Analysis of the California School-Based Risk Reduction Program.

Abstract	Performed meta-analysis upon eight California school-based risk reduction programs designed to deter fourth through eighth grade students from the use of tobacco, alcohol, and other drugs. Found that information-focused interventions had more impact upon knowledge but less upon attitudes and behavior whereas alternative interventions had less impact upon knowledge but more upon attitudes and behavior. (Author/PVV)
Publication	Journal of Drug Education
Date	1990
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ419601

 

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School-Based Cardiovascular Health Promotion: The Child and Adolescent Trial for Cardiovascular Health (CATCH).

Abstract	Describes objectives of the Child and Adolescent Trial for Cardiovascular Health multisite intervention study which develops behavioral school health education plans. It targets third through fifth graders, stressing cardiovascular health behaviors (e.g., eating habits, physical activity, and smoking). Curricula, school environmental change, and family involvement programs are developed for each behavioral focus. (Author/SM)
Publication	Journal of School Health
Date	1990
URL	http://www.eric.ed.gov/ERICWebPortal/detail? accno=EJ422148

 

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The first three years of 'Smoking and Me'.

Publication	Education and Health
Date	1990
URL	/sheux/EH/eh82mw.pdf

 

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Is health education hooked on addiction?

Publication	Education and Health
Date	1990
URL	/sheux/EH/eh84dr.pdf

 

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Pupils learn to be 'smoking educators'.

Publication	Education and Health
Date	1990
URL	/sheux/EH/eh85mr.pdf

 

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Essential Elements of School-Based Smoking Prevention Programs

Abstract	ABSTRACT: The current status of adolescent tobacco use in the United States is discussed in the context of the identification of those elements considered necessary for successful school-based smoking prevention programs. Also described are the conclusions of a National Cancer Institute-convened expert advisory panel charged with the task of addressing: What are the essential elements of a school-based smoking prevention program? The panel focused on nine areas in which sufficient data and experience existed to reach a preliminary conclusion or make a recommendation. The nine areas are: program impact, focus, context, and length; ideal age at intervention; need for peer and parental involvement; teacher training; and program implementation. The panel concluded U.S. school-based smoking prevention programs have had consistently positive effects, though these effects have been modest and often limited to delaying the onset of tobacco use. Though the panel felt many programs are suitable for dissemination, several research recommendations also are described.
Publication	Journal of School Health
Date	1989
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1989.tb04698.x/abstract

 

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Vocational Education Students: A Difficult-to-Reach Population at Risk for Smoking-Related Cancer

Abstract	ABSTRACT: Vocational education high school students comprise a significant proportion of the school-based population. Recent studies indicate vocational education students are at greater risk for cigarette smoking behavior than their non-vocational education counterparts. Vocational students have higher prevalence rates of smoking than do non-vocational students and are more likely to report that they expect to be smoking in the future. Characteristics of adolescents who participate in vocational education and their cigarette smoking behavior are reviewed, as well as the need to develop, implement, and evaluate new educational approaches designed to prevent cigarette smoking and the use of other tobacco products in this difficult-to-reach population.
Publication	Journal of School Health
Date	1989
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1989.tb04701.x/abstract

 

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Preventing Smoking Behavior in School Children: An Initial Test of a Cognitive-Development Program1

Abstract	A three-session smoking prevention program based on a cognitive-developmental stage model was developed and pilot-tested with 315 sixth through eighth grade students in an urban public school. A media component focusing on experiences associated with different stages of smoking was followed by a structural discussion that linked cognition about symptoms with skills to resist influences to smoke. The control group viewed three commonly used smoking prevention films, made written comments on the films, and participated in an unstructured discussion. Students exposed to the experimental program showed superior gains in accurate interpretations of symptoms, adaptation to symptoms, and addiction. Significantly fewer students exposed to the experimental program made the transition from a first try to occasional or regular smoking at an 18 month follow-up. Change in understanding of symptoms mediated treatment effects. Obtaining these results with only a three-session program, using an active treatment control, a within school design, and an urban, racially balanced population, supports the inclusion of a cognitive-developmental component in smoking prevention.
Publication	Journal of Applied Social Psychology
Date	1989
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1559-1816.1989.tb00270.x/abstract

 

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A 5-year national programme to reduce smoking by teenagers

Publication	Education and Health
Date	1989
URL	/sheux/EH/eh74ac.pdf

 

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A meta-analysis and theoretical review of school based tobacco and alcohol intervention programs

Publication	Psychology & Health
Date	1988
URL	http://dx.doi.org/10.1080/08870448808400344

 

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Promoting Child Health in a Smoke-Free School: Suggestions for School Health Personnel

Abstract	ABSTRACT: Health effects of involuntary smoking on school-age children are outlined and suggestions are offered for schools to become smoke-free environments for students, faculty, and staff. Suggestions are offered for developing and implementing strategies for smoke-free schools. A data base exists to support health reasons for eliminating smoking in schools, but it is necessary to build on this information to convince school personnel that smoking in schools offers no positive returns and should be eliminated. School health personnel are encouraged to lead the campaign.
Publication	Journal of School Health
Date	1988
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1988.tb02313.x/abstract

 

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Reducing Adolescent Smoking: A Comparison of Peer-led, Teacher-led, and Expert Interventions

Abstract	ABSTRACT: To test the effectiveness of a psychosocial strategy of smoking deterence on seventh grade students, the School Health Education Development project implemented peer-led, teacher-led, and expert-led interventions in six Vermont schools. Four additional schools served as control groups. The teacher-led approach reduced the rate of smoking onset and the intention to smoke in the future among highly vulnerable females but not among males. The peer-led approach reduced the behavioral intention to smoke for both sexes but did not affect current smoking behavior. The expert-led approach did not produce favorable effects. Both the peer-led and teacher-led interventions had positive, though not significant, effects on student perception of locus of control. In the control schools, females experienced higher levels of smoking onset than males. Generally, the study points toward further development of a teacher-led approach to smoking deterence based on the theory of adolescent psychosocial development and the principle of continuous reinforcement.
Publication	Journal of School Health
Date	1986
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1986.tb05707.x/abstract

 

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The Efficacy of Peer Leaders in Drug Abuse Prevention

Abstract	ABSTRACT: The results from school-based, peer-led psychosocial smoking prevention programs suggest that this approach is effective in reducing smoking onset rates. This paper provides a theoretical rationale for using peer leaders as a major strategy in school-based drug abuse prevention programs and reviews the available literature assessing the impact of peer leadership in such programs. Furthermore, some of the practical issues involved in selecting and training peer leaders and teachers are discussed, and process evaluation data from studies conducted at the University of Minnesota are presented. The authors conclude that peer leadership can be an effective vehicle for drug abuse prevention among adolescents. However, increased research is necessary to clarify the conditions under which the impact of peer leaders is enhanced.
Publication	Journal of School Health
Date	1986
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1986.tb05783.x/abstract

 

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Substance Abuse Prevention Research: Recent Developments and Future Directions

Abstract	ABSTRACT: Substance abuse continues to be one of the most serious problems facing communities throughout the United States. Existing school-based prevention programs have produced disappointing results when carefully evaluated. However, promising research has been conducted during the past eight years with two new prevention models that focus on the psychosocial factors believed to promote substance abuse. One, the social infuence model, is designed to increase adolescents' ability to resist social influences to smoke, drink, or use drugs. The other model, though also designed to increase adolescents' resistance to pro-substance use social influences, focuses primary attention on the development of an array of cognitive-behavioral personal and social skills. More than 20 research studies testing programs based on these two prevention models have demonstrated significant reductions in substance use. Though future research is clearly needed, the results of these studies provide considerable cause for optimism.
Publication	Journal of School Health
Date	1986
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1986.tb05775.x/abstract

 

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Approaches to Adolescent Smoking Cessation and Education

Publication	Special Services in the Schools
Date	1985
URL	http://www.tandfonline.com/doi/abs/10.1300/J008v01n03_04

 

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Smoking Behavior and the Tobacco Crop

Abstract	The purpose of the study was to measure the influence of the physical and economic presence of the tobacco crop on the smoking behavior and related attitudes of adolescents in tobacco raising regions. A stratified random sample of all grades five-12 from the schools in four Kentucky counties yielded a sample size of 1,322 students. A variable called Tobacco Crop Intensity (TCI), based on pounds of tobacco sold per population and land area, was defined. It was determined that the counties were polarized on this variable; two counties have a much more significant crop. Students from the pairs of counties were surveyed and compared. Results indicate that young people living in the counties with high intensity tobacco production or whose parents grow tobacco were twice as likely to smoke cigarettes; some of their attitudes and beliefs indicate a greater predisposition to cigarette smoking. Implications for government agricultural and educational policy are discussed.
Publication	Journal of School Health
Date	1984
URL	http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.1984.tb09746.x/abstract

 

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Smoking

SHEU Literature search

http://sheu.org.uk

Thanks to Zotero and Jason Priem

SEE ALSO LINKS TO "Drugs"

Please contact David McGeorge

Last updated July 03 2012