BACKGROUND: The Smokefree Class Competition, a school-based smoking prevention intervention, is widely disseminated in Europe. Participating classes commit themselves to be smoke-free and self-monitor their smoking status. Classes that remain smoke-free for 6 months can win prizes. Effects of the intervention on current smoking, initiation and progression of smoking were investigated. METHODS: Cluster randomised controlled trial. 84 schools (208 classes with 3490 students; mean age 12.6 years, 50.4% female) in Saxony-Anhalt, Germany, were randomly assigned to intervention or control condition. A baseline survey was conducted before the implementation of the programme, while post-test and follow-up surveys were carried out 7 (immediately after the end of the competition), 12 and 19 months after baseline. Effects of participation in the programme on current and lifetime smoking were analysed by multilevel models controlling for confounding variables. RESULTS: Inten/ention students smoking occasionally at baseline smoked less frequently than students taking not part in the intervention at 7 and 12 months after baseline. Persistent beneficial programme effects were also found for lifetime smoking: intervention students were less likely to progress from experimental to established use. CONCLUSION: Data suggest that Smokefree Class Competition reduces the probability of progressing from occasional and experimental stages of smoking to more established forms of use. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
BACKGROUND: The Smokefree Class Competition, the largest school-based smoking prevention programme in Europe, aims to create a class climate that denormalises smoking. An analysis was carried out to assess whether it increases bullying or perception of isolation. METHODS: A cluster randomised controlled trial was conducted, with two waves of assessment directly before the start and immediately after the end of the prevention programme. Some 3490 students were recruited from 84 secondary schools in Germany, of whom 3123 students (90%) provided data from both waves. Classes from the intervention group (IG) participated in the Smokefree Class Competition, committing themselves to stay smokefree for a period of 6 months, and self-monitoring their smoking status on a weekly basis. Classes that refrained from smoking were eligible for a prize draw. To test the hypotheses that participation in the competition might foster bullying, we measured students' self report of (1) being victimised, (2) engaging in bullying and (3) being isolated. RESULTS: There was a strong association between daily smoking and higher odds of bullying others at baseline (adjusted proportional OR 4.66; 95% CI 3.38 to 6.43). No significant pre–post differences across treatment assignment groups were found on any bullying measure using generalised linear latent and mixed models. For being isolated, the trends suggested that the programme, if anything, fostered lower levels of isolation at follow-up, especially for those who perceived high levels of isolation at baseline. CONCLUSION: Participation in the intervention had no effect on bullying or perceptions of isolation. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
OBJECTIVE: To evaluate the impact of a smoke-free class competition in elementary schools in Québec, Canada before widespread dissemination of the program across the province.
METHODS: In a quasiexperimental study design, 843 students in 27 schools exposed to "Mission TNT.06" were compared to 1213 students in 57 matched comparison schools. Baseline data were collected in grade 6 prior to implementation of the program. Follow-up data were collected in grade 7 after students had transitioned to secondary school.
RESULTS: The program improved knowledge about the harmful effects of second-hand smoke, but had no impact on knowledge about the harmful effects of smoking, attitudes about the acceptability of cigarettes, beliefs about the tobacco industry, or self-efficacy to resist peer pressure to smoke. After exposure to the program, intervention students were more likely to misreport their smoking status and to report unfavourable attitudes about classmates who smoke.
CONCLUSION: Mission TNT.06 may encourage young smokers to misreport their smoking status and to marginalise classmates who smoke. These findings prompted recommendations to conduct more in-depth evaluation of the smoke-free class competition before widespread dissemination of the program across the province.
OBJECTIVE: The objective of this study was to determine the cost-effectiveness of a school-based tobacco prevention programme.
STUDY DESIGN: Using data from a previous effectiveness study of the 'Smoke-free Class Competition' (SFC), an economic analysis was conducted to determine the cost-effectiveness of the SFC. Cost data were collected from financial statements of the operating agency, surveys of regional co-ordinators and participating classes (direct and productivity costs). The benefit was the product of the number of students prevented from becoming established smokers, based on a stochastic progression model extending the programme's outcome evaluation, and the (direct and indirect) value per prevented smoker.
INTERVENTION: To take part in the SFC, classes make the decision to be a non-smoking class for 6 months (from autumn to spring). The pupils themselves and their teachers monitor the smoking status of the pupils and report on it regularly. Classes that refrain from smoking can win a number of attractive prizes. In the school year 2001/2002, 150,566 German students participated in the SFC, representing approximately 4% of the total target population of 11-14-year-old German students. The effectiveness evaluation is based on 2,142 students who participated in the programme in the school year 1998/1999.
RESULTS: In the school year 2001/2002, it is estimated that the SFC prevented 3,076 students from becoming established smokers, with net benefits of 5.59 Mio. Euro (direct net benefits) and 15.00 Mio. Euro (total net benefits). The direct benefit/cost ratio was 8.2 and the total benefit/cost ratio was 3.6.
CONCLUSIONS: Data suggest that the SFC is a cost-effective school-based intervention.
BACKGROUND: This study examines the effectiveness of the school-based campaign "Smoke-Free Class Competition" as a means of preventing young non-smokers from taking up smoking.
METHODS: Based on two measurements of the Heidelberg Children's Panel Study (1998 and 2000), a longitudinal sample of 1704 pupils was examined: 948 in the intervention group and 756 in the control group. In order to evaluate the effects of the intervention, we compared the smoking behavior in the intervention and the control group at two points in time, shortly before, and 18 months after the intervention, on an individual case basis.
RESULTS: (1) Stabilization of never-smoking rates: the proportion of pupils remaining a never-smoker at the follow-up is 62.1% in the intervention group and 61.5% in the control group (OR 1.02, 95% CI: 0.83-1.24); (2) Lowering of relapse rates among ex-smokers: the proportion of former smokers who had not started smoking again in the follow-up is 45.1% in the intervention group and 41.4% in the control group (OR 1.07, 95% CI: 0.77-1.49).
CONCLUSION: The "Smoke-Free Class Competition" did not prevent smoking among adolescents and does not appear to be an effective substitute to the complete ban of tobacco advertising, the abolition of vending machines and the creation of smoke-free environments in German schools.
Comments on a randomized controlled trial by A. Schulze et al (see record [rid]2006-01696-005[/rid]) which evaluated the effectiveness of the "Smoke-free Class Competition" a European low-level school-based smoking prevention campaign. This study has several methodological problems, which are not sufficiently discussed in the paper. This is especially disconcerting since the authors draw far-reaching conclusions for the implementation of school-based prevention programs in general. The major methodological problem with the paper is that the randomization failed. Furthermore, the authors either did not measure the short-term effects of the program or they do not report on it. The biggest problems of the paper are the far-reaching conclusions and recommendations of the authors. All experiences seem to indicate that programs directed to young people should be continued during adolescence and that one single campaign is very unlikely to have a long-term effect. Therefore, school-based prevention programs need to be embedded in a comprehensive tobacco prevention strategy, including different age appropriate programs and structural control measures. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
OBJECTIVE: To assess the effect of an antismoking intervention focusing on adolescents in lower education. Students with lower education smoke more often and perceive more positive norms, and social pressure to smoke, than higher educated students. An intervention based on peer group pressure and social influence may therefore be useful to prevent smoking among these students.
DESIGN: Group randomised controlled trial.
SETTING: 26 Dutch schools that provided junior secondary education.
SUBJECTS: 1444 students in the intervention and 1118 students in the control group, all in the first grade, average age 13 years.
INTERVENTION: Three lessons on knowledge, attitudes, and social influence, followed by a class agreement not to start or to stop smoking for five months and a class based competition.
MAIN OUTCOME MEASURES: Comparison of smoking status before and immediately after and one year after the intervention, using multilevel analysis.
RESULTS: In the intervention group, 9.6% of non-smokers started to smoke, in the control group 14.2%. This leads to an odds ratio of 0.61 (95% CI= 0.41 to 0.90) to uptake smoking in the intervention group compared with the control group. One year after the intervention, the effect was no longer significant.
CONCLUSIONS: In the short-term, an intervention based on peer pressure decreases the proportion of adolescents with lower education who start smoking. Influencing social norms and peer pressure would therefore be a promising strategy in terms of preventing smoking among adolescents. The results also suggest that additional interventions in later years are needed to maintain the effect.
BACKGROUND: The present study describes the evaluation of a primary smoking prevention programme called "be smart--don't start", left. The programme is carried out as a competition and classes that participate decide not to smoke for a period of 6 months. Classes that stay smoke-free for that period of time can win a number of attractive prizes. Aim of this study was to examine, whether the programme is effective in delaying the onset of smoking in adolescents from different types of school in Germany.
METHODS: In the years 1998/1999 a control-group study with repeated assessment was carried out. In the study, smoking status was assessed in 1677 pupils with a mean age of 12.8 years (SD = 0.97) on three occasions: prior to the beginning of the intervention, after the intervention and 6 months after the end of the intervention. Pupils came from four different types of school in Germany.
RESULTS: After the intervention, in the control group 13.1 % of the pupils reported to have smoked during the previous 4 weeks, compared to 7.6 % in the intervention group (OR = 1.84 (1.31-2.58), p < 0.001). In the follow-up assessment, 20,9 % in the control group and 16,4 % in the intervention group reported to have smoked (OR = 1.34 (1.03-1.75), p < 0.05). With regard to different school types, the effect on the "Gesamtschulen" (comprehensive school; high school) was the strongest.
CONCLUSION: The results suggests an effect of the intervention on the delay of onset of smoking in pupils.
BACKGROUND: This paper examines the effectiveness of the "Smokefree Class Competition" with regard to primary and secondary prevention of smoking in adolescents. Each participating class has to decide if they want to be a "Smokefree Class" for the six-month period from fall to spring. Classes monitor their (non-)smoking behaviour and report it to the teacher regularly. Classes in which pupils refrain from smoking for this period of time participate in a prize draw, where they can win a number of attractive prizes.
METHODS: A control group study with repeated measurements was carried out in order to evaluate the effectiveness of the competition. The sample consisted of 131 participating and non-participating classes ( N of the pupils = 2,142; mean age 12.9 years, SD = 0.98). Smoking status was assessed on two occasions: (a) prior to the beginning of the competition, and (b) 6 month after the end of the competition.
RESULTS: With regard to the smoking status at baseline no differences could be found between the experimental and the control group (15.2 % vs. 18.5 % smoking pupils). In the follow-up measurement, pupils in the control group showed significantly higher prevalences of smoking than the experimental group in the post-measurement period (32.9 % vs. 25.5 % smoking pupils). More pupils in the experimental group stayed smokefree compared to the control group. No differential effects on smoking cessation could be found.
CONCLUSIONS: The results show that participation in the competition could delay the onset of smoking in adolescents (primary prevention). The competition is not effective in smoking cessation in youth.
BACKGROUND: This paper examines the effectiveness of the "Smoke-Free Class Competition" in delaying the onset of smoking in adolescence. Each participating class must decide if they want to be a "smoke-free class" for the 6-month period from fall to spring. Classes monitor their (non-)smoking behavior and report it to the teacher regularly. Classes in which pupils refrain from smoking for this period of time participate in a prize draw, in which they can win a number of attractive prizes.
METHODS: To evaluate the effectiveness of the competition, a sample of 131 participating and nonparticipating classes (number of pupils 2,142; mean age 12.9 years, SD = 0.98) was compared with regard to their smoking behavior. Smoking status was determined by self-assessment on three occasions: (a) prior to the beginning of the competition, (b) 1 month after the competition, and (c) 1 year after the start of the competition.
RESULTS: From pretest to posttest smoking increased by 7.5% in the comparison group, while it decreased by 0.2% in the intervention group (OR = 2.19; P < 0.001). In the follow-up measurement, a clear increase in smoking prevalence occurs in all groups; however, the pupils in the intervention condition still have a significant lower increase of smoking (OR = 1.45; P < 0.01). Moreover, with regard to the nonsmokers at baseline, pupils in the comparison group showed significantly higher prevalences in smoking than the intervention group in the postmeasurement, 7.8 versus 13.9% (OR = 1.98; P < 0.001), as well as in the in the follow-up-measurement, 17 versus 21.3% (OR = 1.36; P < 0.05).
CONCLUSIONS: The results suggest that the participation in the competition could delay the onset of smoking in adolescence.
The Smokefree Class Competition, a school-based smoking prevention intervention, is widely disseminated in Europe. Participating classes commit themselves to be smoke-free and self-monitor their smoking status. Classes that remain smoke-free for 6 months can win prizes. Effects of the intervention on current smoking, initiation and progression of smoking were investigated.
METHODS:
Cluster randomised controlled trial. 84 schools (208 classes with 3490 students; mean age 12.6 years, 50.4% female) in Saxony-Anhalt, Germany, were randomly assigned to intervention or control condition. A baseline survey was conducted before the implementation of the programme, while post-test and follow-up surveys were carried out 7 (immediately after the end of the competition), 12 and 19 months after baseline. Effects of participation in the programme on current and lifetime smoking were analysed by multilevel models controlling for confounding variables.
RESULTS:
Inten/ention students smoking occasionally at baseline smoked less frequently than students taking not part in the intervention at 7 and 12 months after baseline. Persistent beneficial programme effects were also found for lifetime smoking: intervention students were less likely to progress from experimental to established use.
CONCLUSION:
Data suggest that Smokefree Class Competition reduces the probability of progressing from occasional and experimental stages of smoking to more established forms of use. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
