Smoking in Children and Adolescents

Abstract

The information on child and adolescent smoking prevention and treatment has been analyzed in Cochrane Collaboration Systematic Reviews, which form the key information for this chapter. (1) Interventions in Schools: 94 RCTs were identified; (a) Providing Information: 2/10 were of low or moderate risk of bias and both of these had statistically significant results; (b) Social Competence: 2/3 were at low or moderate risk of bias and the pooled ORs were nonsignificant; (c) Social Influences: 23/56 were at low or moderate risk of bias and pooled ORs were nonsignificant; (d) Social Competence and Social Influences: 10/16 were at low or moderate risk of bias and pooled ORs were nonsignificant; (e) Multimodal (school and communities): 7/9 were at low or moderate risk of bias and 3/4 of those at low risk of bias had statistically significant results. (2) Interventions in Families: 22 RCTs were identified, and 16/22 were at low or moderate risk of bias; (a) Family Intervention vs. Control: 4/9 had statistically significant results; (b) Family vs. School Intervention: 1/5 had statistically significant results; (c) Family plus School Interventions vs. Family: 7/7 had nonsignificant results; (d) Family-Based Risk Reduction vs. Control: 2/2 had statistically significant results. (3) Social Competitions: no methodologically sound studies. (4) Community Interventions: 6/17 had random allocation, and of the 6, one had higher, one lower, and one lower smoking rates in 1 arm. No conclusions could be drawn. (5) Prevention of Tobacco Sales to Minors: 9/35 had random allocation, and of these 7/9 had statistically significant results. (6) Tobacco Advertising: All 9 had longitudinal designs and 7/9 had statistically significant results. (7) Family and Carer Interventions: 30/36 had random allocation and 10/30 had statistically significant results. (8) Tobacco Cessation: 13/15 had random allocation. Of the 13: (a) 5 used cognitive behavioral therapy and all 3 that used the “Not on Tobacco” intervention had statistically significant results; (b) Stages of Change Theory: 2/3 had statistically significant results; (c) Motivational Interviewing: 3/3 had statistically significant results; and (d) Nicotine Patches: 2/2 nonsignificant. (9) Smokeless Tobacco Cessation: 2/2 that used nicotine replacement plus behavioral therapy had statistically significant results. Keywords: tobacco; smoking; children; adolescents; prevention; cessation; randomized controlled trials; systematic reviews