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Community interventions for reducing smoking among adults.
R H Secker-Walker1, W Gnich, S Platt
1Health Promotion Research, University of Vermont, 1 South Prospect Street, Burlington, Vermont 05401-3444, USA. rseckerw@zoo.uvm.edu
The Cochrane Database of Systematic Reviews
|July 26, 2002
Summary
Community-wide smoking cessation programs show limited effectiveness in reducing smoking prevalence. Despite reinforcement and support, large-scale studies found minimal impact on smoking rates, indicating a need for revised strategies.
Area of Science:
- Public Health
- Behavioral Science
Background:
- Smoking behavior is influenced by social context.
- Community-wide programs aim to reduce smoking prevalence through multi-channel support and norm reinforcement.
Purpose of the Study:
- To evaluate the effectiveness of community interventions in reducing smoking prevalence among adult smokers.
Main Methods:
- Searched specialized databases (Cochrane, MEDLINE, EMBASE) and reference lists.
- Included controlled trials of community interventions targeting adult smokers.
- Primary outcome was measured by changes in smoking behavior.
Main Results:
- Thirty-two studies were included; only four used random assignment.
- Estimated net decline in smoking prevalence varied, with mixed results for men and women.
- Two rigorous studies (COMMIT, CART) showed limited evidence of significant impact on overall prevalence or quit rates for target groups.
Conclusions:
- Large, well-conducted community intervention studies failed to demonstrate a significant reduction in smoking prevalence.
- Community approaches remain vital for health promotion, but future program design must consider observed limited effects.
- Resource allocation and project scale should be informed by the demonstrated impact of such interventions.