Evaluation of School-Based Smoking-Cessation Interventions for Self-Described Adolescent Smokers

Department of Population, Family, and Reproductive Health, School of Public Health, Johns Hopkins University, Student Health and Wellness Center, Baltimore, Maryland 21218, USA.
PEDIATRICS (Impact Factor: 5.47). 09/2009; 124(2):e187-94. DOI: 10.1542/peds.2008-2509
Source: PubMed


The goal was to compare the efficacy of school-based, multisession, group smoking-cessation interventions versus a single group session in increasing quit rates among adolescent smokers.
Eight schools were assigned randomly to use 1 of 2 group smoking-cessation programs previously shown to increase quit rates among adolescents (Not on Tobacco [NOT] or Kickin' Butts). We reformatted the programs to twice-weekly 25- to 30-minute sessions delivered during lunch periods. Smoking status was assessed at end of program (EOP) and 1, 3, 6, and 12 months later. Self-reported quit status was confirmed with salivary cotinine levels.
A total of 407 students (56% black and 52% female; mean age: 16 years) participated. Kickin' Butts participants were no more likely to quit than control subjects. In the conservative analysis (students with missing follow-up data classified as smokers), NOT participants were 1.92 times (95% confidence interval [CI]: 1.09-3.40 times) more likely to self-report quitting at 1 month. In the Bayesian analysis (missing follow-up data imputed by using all available data), NOT participants were significantly more likely than control subjects to self-report quitting at EOP (relative risk [RR]: 1.26 [95% CI: 1.10-1.43]), 1 month (RR: 2.07 [95% CI: 1.68-2.56]), and 12 months (RR: 1.58 [95% CI: 1.22-2.04]). Cotinine-confirmed quit rates were significantly greater among NOT participants, compared with control subjects, at EOP and 1 month.
The reformatted NOT program had a modest effect on adolescents interested in quitting. Kickin' Butts, as reformatted for this project, did not have any effect on quit rates.

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