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CSU 35/2010: SCHOOL-BASED PREVENTION PROGRAMME ON ADOLESCENT CIGARETTE SMOKING

Sunday, 28th of March 2010

Th text is on the Net at http://ije.oxfordjournals.org/cgi/content/abstract/dyq001v1?etoc

BD

Xiaozhong Wen^1,2, Weiqing Chen^1,*, Kim M Gans³, Suzanne M Colby⁴, Ciyong Lu¹, Caihua Liang² and Wenhua Ling⁵

¹Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China, ²Department of Community Health, Brown University, Providence, RI, USA, ³Department of Community Health, Institute for Community Health Promotion, Brown University, Providence, RI, USA, ⁴Department of Community Health, Center for Alcohol & Addiction Studies, Brown University, Providence, RI, USA and ⁵Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China

*Corresponding author. Professor of Epidemiology, Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou (510080), Guangdong Province, PR China. E-mail: chenwq@mail.sysu.edu.cn

Abstract

Background The prevalence of adolescent smoking has been increasing rapidly in China. Theory-based smoking prevention programmes in schools may be an effective approach in preventing smoking among Chinese adolescents.

Methods A school-level cluster randomized controlled trial was conducted among 7th and 8th grade students (N = 2343) in four junior high schools in southern China during 2004–06. The theory-based, multi-level intervention was compared with the standard health curriculum. Outcome measures comprised changes in students’ smoking-related knowledge, attitudes and behaviour.

Results The mean knowledge scores from baseline to the 1- and 2-year follow-ups increased more in the intervention group than in the control group, whereas there was little change in attitude scores. At the 1-year follow-up (the total sample), the interventions reduced the probability of baseline experimental smokers’ escalating to regular smoker [7.9 vs 18.3%; adjusted odds ratio (OR) 0.34, 95% confidence interval (CI) 0.12–0.97, P = 0.043], but did not reduce the probability of baseline non-smokers’ initiating smoking (7.9 vs 10.6%; adjusted OR 0.86, 95% CI 0.54–1.38, P = 0.538). At the 2-year follow-up (only 7th grade students), similar proportions of baseline non-smokers initiated smoking in the intervention group and the control group (13.5 vs 13.1%), while a possibly lower proportion of baseline experimental smokers escalated to regular smoking in the intervention group than the control group (22.6 vs 40.0%; adjusted OR 0.43, 95% CI 0.12–1.57, P = 0.199).

Conclusions This multi-level intervention programme had a moderate effect on inhibiting the escalation from experimental to regular smoking among Chinese adolescents, but had little effect on the initiation of smoking. The programme improved adolescents’ smoking-related knowledge, but did not change their attitudes towards smoking.