Smoke-free class competition may delay the onset of smoking in adolescence
- Jøsendal, Ola MSc
BACKGROUND
Age at onset is one of the most important predictors of later smoking. During the 1990s, smoking prevalence increased among adolescents in Canada, the United States and Europe. A number of school-based health promotion campaigns have been trialled.
OBJECTIVE
To assess whether the 'Smoke-free Class Competition' delays the onset of smoking in German adolescents.
SETTING
Hamburg and Berlin, Northern Germany; November 1988 to April 1999.
METHOD
Cohort study.
PARTICIPANTS
One hundred and thirty-one classes with 2142 pupils; mean age 12.9 years.
INTERVENTION
Fliers were sent to schools inviting classes to participate. If more than 90% of pupils in a class agreed, they were registered as part of the programme. Each class was asked to decide whether they wanted to be a 'smoke-free class' for 6 months (intervention group). A class was considered smoke-free if no more than 10% of pupils had smoked in the previous week. Classes monitored their smoking behaviour, reporting to their teachers regularly. Classes in which pupils refrained from smoking participated in a prize draw.
MAIN OUTCOMES
Self-assessed smoking status at baseline, one month and one year.
MAIN RESULTS
At one month, smoking had decreased from baseline by 0.2% in the intervention group and increased by 7.5% in the comparison group (odds ratio 2.2, p < 0.0001). At one year, both groups had increased smoking, but this was less marked in the intervention group (odds ratio 1.5, p < 0.01). Non-smokers in the intervention group were less likely to start smoking than controls during the competition (7.8% versus 13.9%, odds ratio 2.0, p < 0.001) and at one year follow-up (17% versus 21%, odds ratio 1.4, p < 0.05).
AUTHORS' CONCLUSIONS
The Smoke-free Class Competition may reduce or delay the onset of smoking in adolescence.