School-based smoking prevention programs with the promise of long-term effects

Researchers and others have developed many school-based tobacco prevention programs over the past 30 years. Over a dozen reviews of approaches to tobacco control or substance abuse prevention published since the early 1990's have included school-based smoking prevention within their realm [1-17]. Some of these reviews were broad-based and non-systematic, and some were very systematic. Earlier reviews of this type always included school-based smoking prevention as a critical component of effective broad-based tobacco control. Many of the later reviews, especially after Lantz et al [7] tended not to include school-based prevention as an important component in broad-based tobacco control. Lantz et al [7] concluded that "The long term impact of school based educational interventions is of concern" (page 49). However, they then emphasize the need to combine school-based prevention with media programming, other tobacco control efforts, and other problem behavior prevention efforts. Dobbins et al [18] concluded that "there is reason for optimism regarding the effectiveness of prevention programs on smoking behavior and initiation, albeit in the short term." (page. 296).During this same period there were many reviews [18-28] and meta-analyses [25,29-35] of school-based smoking prevention. These reviews and meta-analyses have repeatedly reinforced the fact that informational and affective programs do not work to change behavior. Furthermore, meta-analyses have further (established the fact that some psychosocial programs and strategies, particularly those that are interactive programs based on the social influences approach (educating youth about social norms and influences and providing skills for resisting such influences), can be effective.However, findings in the field are sometimes confusing to practitioners and policy makers because some early or short psychosocial programs reported promising short-term effects that did not last [36-40]. In addition, some tested progra