Abstract
BackgroundDespite a decline in child and adult smoking prevalence, young people who smoke (even occasionally) can rapidly become addicted to nicotine, with most adult smokers initiating smoking before they are 18. Schools have long been a popular setting to deliver youth smoking prevention interventions, but evidence of the effectiveness of school-based prevention programmes is mixed, and outcomes vary by the type of programme delivered. Existing systematic reviews that explore the factors contributing to the success or failure of school-based smoking prevention programmes often exclude qualitative studies, due to a focus on intervention effectiveness which qualitative research cannot answer. Instead, qualitative research is focussed on the experiences and perceptions of those involved in the programmes. This systematic review will address this gap by updating a 2009 review to examine qualitative studies. The aim is to generate deeper insight to help target resources which have the potential to save lives by preventing smoking initiation among children and young people.MethodsThis systematic review will be searching the following databases: the Cochrane Library, MEDLINE, EMBASE, PsycINFO, HMIC, ERIC, ASSIA, Web of Science and CINAHL. In order to identify additional references, we will consult the reference lists of a sample of systematic reviews and search relevant organizational websites in order to identify appropriate grey literature. The search strategy will include key words and database-specific subject headings relating to smoking, children and young people, health promotion and school. Authors will independently screen, assess data quality and extract data for synthesis. Study findings will be synthesised thematically using ‘best-fit framework syntheses’. This allows for an existing set of themes to be used as a starting point to map or code included studies. These themes are then adapted as coding takes place to accommodate new emerging themes.DiscussionThis review will focus on qualitative studies that seek to examine the barriers and facilitators to the delivery of school-based smoking prevention programmes in order to inform the design of future theory-based interventions in schools to prevent children and young people from smoking.Systematic review registrationPROSPERO CRD42014015483
Highlights
Despite a decline in child and adult smoking prevalence, young people who smoke can rapidly become addicted to nicotine, with most adult smokers initiating smoking before they are 18
Outcomes The outcome of this review is to explore the facilitators and barriers to the delivery of school-based interventions to prevent smoking uptake in children and young people
Much has been written about the effectiveness of school-based interventions to prevent children and young people from smoking, with mixed results depending on the type of programme delivered [13, 14, 29, 30]
Summary
Despite a decline in child and adult smoking prevalence, young people who smoke (even occasionally) can rapidly become addicted to nicotine, with most adult smokers initiating smoking before they are 18. Existing systematic reviews that explore the factors contributing to the success or failure of school-based smoking prevention programmes often exclude qualitative studies, due to a focus on intervention effectiveness which qualitative research cannot answer. Recent findings (2013/2014) from the Health Behaviour of School-aged Children survey (which provides health and well-being data from young people, aged 11, 13 and 15, and from 43 countries across Europe and North America) found that on average, 22% of boys and 13% of girls who had ever smoked a cigarette did so before the age of 13 or younger [4]. By the age of 13, this increases to 4 and 3%, and by the age of 15, to 12% and 11%, respectively [5]
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