Evaluation of School-Based Smoking-Cessation Interventions for Self-Described Adolescent Smokers

OBJECTIVE: The goal was to compare the efficacy of school-based, multisession, group smoking-cessation interventions versus a single group session in increasing quit rates among adolescent smokers. METHODS: Eight schools were assigned randomly to use 1 of 2 group smoking-cessation programs previously shown to increase quit rates among adolescents (Not on Tobacco [NOT] or Kickin' Butts). We reformatted the programs to twice-weekly 25- to 30-minute sessions delivered during lunch periods. Smoking status was assessed at end of program (EOP) and 1, 3, 6, and 12 months later. Self-reported quit status was confirmed with salivary cotinine levels. RESULTS: A total of 407 students (56% black and 52% female; mean age: 16 years) participated. Kickin' Butts participants were no more likely to quit than control subjects. In the conservative analysis (students with missing follow-up data classified as smokers), NOT participants were 1.92 times (95% confidence interval [CI]: 1.09-3.40 times) more likely to self-report quitting at 1 month. In the Bayesian analysis ( missing follow-up data imputed by using all available data), NOT participants were significantly more likely than control subjects to self-report quitting at EOP (relative risk [RR]: 1.26 [95% CI: 1.10-1.43]), 1 month (RR: 2.07 [95% CI: 1.68-2.56]), and 12 months (RR: 1.58 [95% CI: 1.22- 2.04]). Cotinine-confirmed quit rates were significantly greater among NOT participants, compared with control subjects, at EOP and 1 month. CONCLUSIONS: The reformatted NOT program had a modest effect on adolescents interested in quitting. Kickin' Butts, as reformatted for this project, did not have any effect on quit rates. Pediatrics 2009;124:e187-e194