What Works to Prevent Adolescent Smoking? A Systematic Review of the National Cancer Institute's Research‐Tested Intervention Programs

BACKGROUND: Cigarette use remains the leading preventable cause of death in the United States. Although school is an ideal setting for antismoking interventions, school-based programs have not been successful in the long term. The purpose of this study was to explore characteristics of programs deemed to be successful short-term Research-Tested Intervention Programs (RTIPs) by the National Cancer Institute (NCI). METHODS: To identify adolescent smoking prevention programs, 2 independently working researchers applied specified selection criteria to all programs in the NCI's RTIP database. Selected programs were abstracted using a structured form for general information, participants, interventions, outcomes, and quality. Extracted data were then assessed for common themes and contrasts in each category. RESULTS: As of June 2008, 18 studies met the NCI's standards for RTIPs preventing smoking among adolescents. After selection criteria were applied, only 5 programs remained. Each independently working researcher arrived at the same pool of programs. In chronological order according to date of publication of outcomes evaluation, the 5 programs ultimately included were Project Towards No Tobacco Use, Pathways to Health, Native FACETS, Kentucky Adolescent Tobacco Prevention Project, and Sembrando Salud. The majority of these programs were targeted toward a particular sociodemographic group (eg, American Indians, Hispanic migrant communities). CONCLUSIONS: New school-based programs are needed to address current issues in tobacco control. To improve chances of success, these programs may wish to target certain specific high-risk demographic groups, use professional health educators and/or trained community members, and build in methods of updating material.