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Long-term effects of a home-based smoking prevention program on smoking initiation: a cluster randomized controlled
Marieke Hiemstra1, Linda Ringlever1, Roy Otten1
1Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
Objective:
The aims of the study were to evaluate the long-term effects of a home-based smoking prevention program 'Smoke-free Kids' during preadolescence on smoking initiation during adolescence and to test the potential moderating role of parental smoking, socioeconomic status, and asthma.
Method:
In 2008, 1478 9-11year old children and their mothers were recruited from 418 elementary schools in the Netherlands. An independent statistician randomly allocated schools to one of the two conditions using a 1:1 ratio (single blind): 728 children in the intervention and 750 in the control condition. The intervention condition received five activity modules, including a communication sheet for mothers, by mail at four-week intervals and one booster module one year after baseline. The control condition received a fact-based intervention only. Intention-to-treat analysis was performed on 1398 non-smoking children at baseline.
Results:
In the intervention 10.8% of the children started smoking compared to 12% in the control condition. This difference was non-significant (odds ratio=0.90, 95% confidence interval=0.63-1.27). No moderating effects were found.
Conclusion:
No effects on smoking initiation after 36months were found. Perhaps, the program was implemented with children that were too young. Programs closer to the age of smoking onset should be tested.
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