A Systematic Review and Meta-analysis of School-Based Preventive Interventions Targeting E-Cigarette Use Among...

Area of Science:

• Public Health
• Adolescent Health
• Preventive Medicine

Background:

• E-cigarette use among adolescents is a significant public health concern.
• School-based interventions are a common strategy to prevent adolescent substance use.
• The efficacy of these interventions specifically for e-cigarette use requires systematic evaluation.

Purpose of the Study:

• To systematically review and meta-analyze the effectiveness of school-based preventive interventions targeting adolescent e-cigarette use.
• To assess the impact on e-cigarette use, tobacco use, knowledge, intentions, and attitudes.

Main Methods:

• Systematic review and meta-analysis of studies published between January 2000 and June 2023.
• Searched multiple databases (Medline, Embase, PsycINFO, Scopus, CINAHL, Cochrane) and clinical trial registries.
• Included 11 studies with randomized controlled trial, cluster RCT, or quasi-experimental designs targeting adolescents in secondary schools.

Main Results:

• No significant evidence of prevention of e-cigarette use at longest follow-up (6-36 months); however, subgroup analyses showed effects at post-test and with <12-month follow-up.
• No effect on overall tobacco use at longest follow-up, but reductions in past 30-day tobacco use were observed.
• Short-term improvements in knowledge, intentions, and attitudes were noted, but some interventions had null or iatrogenic effects.

Conclusions:

• School-based interventions have potential but yield mixed results for preventing adolescent e-cigarette use.
• Evidence quality is low-to-moderate, indicating a need for more high-quality research.
• Schools require support to adopt effective, evidence-based preventive programs.