Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb 6;13(2):e0192489.
doi: 10.1371/journal.pone.0192489. eCollection 2018.

Systematic review of school tobacco prevention programs in African countries from 2000 to 2016

Akihiro Nishio  1   2 , Junko Saito  2   3 , Sachi Tomokawa  2   4 , Jun Kobayashi  2   5 , Yuka Makino  2 , Takeshi Akiyama  2   6 , Kimihiro Miyake  2   4 , Mayumi Yamamoto  1
Affiliations

Systematic review of school tobacco prevention programs in African countries from 2000 to 2016

Akihiro Nishio et al. PLoS One. .

Abstract

Background: The World Bank has reported that global smoking rates declined from 2000 to 2012, with the only exception found in males in Sub-Saharan Africa. Sub-Saharan Africa is considered to be in stage one of the tobacco epidemic continuum. To address this problem, school-based programs for smoking prevention are considered cost-effective and promising. Since tobacco prevention programs are influenced by social competence or customs of each country, tobacco prevention programs that have success in Western countries are not always effective in African countries. Therefore, the current study systematically reviewed relevant literature to examine the effects of these types of programs in African countries.

Method: Online bibliographic databases and a hand search were used. We included the studies that examined the impact of school-based programs on preventing tobacco use in Africa from 2000 to 2016.

Results: Six articles were selected. Four were conducted in South Africa and two were performed in Nigeria. Four programs were systematically incorporated into annual curriculums, targeting 8th to 9th graders, while the other two were temporary programs. All programs were based on the hypothesis that providing knowledge and/or social skills against smoking would be helpful. All studies utilized smoking or polydrug use rates to compare outcomes before/after intervention. There were no significant differences between intervention and control groups in three studies, with the other three demonstrating only partial effectiveness. Additionally, three studies also examined change of knowledge/attitudes towards smoking as an outcome. Two of these showed significant differences between groups.

Conclusion: All RCTs studies showed no significant change of smoking-rate by the intervention. The effectiveness of intervention was observed only in some sub-group. The cohort studies showed school-based interventions may be effective in improving knowledge and attitudes about smoking. However, they reported no significant change of smoking-rate by the intervention.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of the review.
Fig 2
Fig 2. Risk of bias for RCT studies.
Fig 3
Fig 3. Risk of bias for non-RCT studies.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. American Cancer Society. Cancer facts and figures. 2005. Available from: http://our.cancer.org/downloads/STT/CAFF2005f4PWSecured.pdf.
    1. U.S. Department of Health and Human Services. The health consequences of smoking: a report of the surgeon general. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health; 2004.
    1. Eriksen M, Mackay J, Ross H. The Tobacco Atlas, Fourth Edition Atlanta Georgia: American Cancer Society, Inc.; 2012. Available from: http://tobaccoatlas.org/uploads/Images/PDFs/Tobacco_Atlas_2ndPrint.pdf.
    1. World Health Organization. Tobacco key facts. 2009. Available from: http://www.who.int/topics/tobacco/facts/en/index.html.
    1. World Health Organization. The MMPOWER package: WHO report on the global tobacco epidemic. Geneva: World Health Organization; 2008. p.1–19.

Publication types