Cluster randomised controlled trial of expert system based on the transtheoretical ("stages of change") model for smoking prevention and cessation in schools
- PMID: 10514156
- PMCID: PMC28247
- DOI: 10.1136/bmj.319.7215.948
Cluster randomised controlled trial of expert system based on the transtheoretical ("stages of change") model for smoking prevention and cessation in schools
Abstract
Objectives: To examine whether a year long programme based on the transtheoretical model of behaviour change, incorporating three sessions using an expert system computer program and three class lessons, could reduce the prevalence of teenage smoking.
Design: Cluster randomised trial comparing the intervention to a control group exposed only to health education as part of the English national curriculum.
Setting: 52 schools in the West Midlands region.
Participants: 8352 students in year 9 (age 13-14 years) at those schools.
Main outcome measures: Prevalence of teenage smoking 12 months after the start of the intervention.
Results: Of the 8352 students recruited, 7444 (89.1%) were followed up at 12 months. The intention to treat odds ratio for smoking in the intervention group relative to control was 1.08 (95% confidence interval 0.89 to 1.33). Sensitivity analysis for loss to follow up and adjustment for potential confounders did not alter these findings.
Conclusions: The smoking prevention and cessation intervention based on the transtheoretical model, as delivered in this trial, is ineffective in schoolchildren aged 13-14.
Comment in
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Failure of an intervention to stop teenagers smoking. Not such a disappointment as it appears.BMJ. 1999 Oct 9;319(7215):934-5. doi: 10.1136/bmj.319.7215.934. BMJ. 1999. PMID: 10514139 Free PMC article. No abstract available.
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Stages of change model for smoking prevention and cessation in schools. Authors applied adult dose for smoking to adolescents when smoking behaviour is different in the two.BMJ. 2000 Feb 12;320(7232):447. BMJ. 2000. PMID: 10669459 Free PMC article. No abstract available.
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Behavioural counselling in general practice about risk of CHD. Study was grossly underpowered.BMJ. 2000 Jul 1;321(7252):49; author reply 50. doi: 10.1136/bmj.321.7252.49/b. BMJ. 2000. PMID: 10939818 Free PMC article. No abstract available.
References
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- Secretary of State for Health; Secretary of State for Scotland; Secretary of State for Wales; Secretary of State for Northern Ireland. Smoking kills. A white paper on tobacco. London: Stationery Office; 1998.
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- Stead M, Hastings G, Tudor-Smith C. Preventing adolescent smoking: a review of options. Health Ed J. 1996;55:31–54.
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- Michell L. Smoking prevention programmes for adolescents. Oxford: Directorate of Health Policy and Public Health, Anglia and Oxford Regional Health Authority; 1994.
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