Ferri Marica, Allara Elias, Bo Alessandra, Gasparrini Antonio, Faggiano Fabrizio
Interventions, Best Practice and Scientific Partners, European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal.
Cochrane Database Syst Rev. 2013 Jun 5;2013(6):CD009287. doi: 10.1002/14651858.CD009287.pub2.
Substance-specific mass media campaigns which address young people are widely used to prevent illicit drug use. They aim to reduce use and raise awareness of the problem.
To assess the effectiveness of mass media campaigns in preventing or reducing the use of or intention to use illicit drugs amongst young people.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2013, Issue 1), including the Cochrane Drugs and Alcohol Group's Specialised Register; MEDLINE through PubMed (from 1966 to 29 January 2013); EMBASE (from 1974 to 30 January 2013) and ProQuest Dissertations & Theses A&I (from 1861 to 3 February 2013).
Cluster-randomised controlled trials, prospective and retrospective cohort studies, interrupted time series and controlled before and after studies evaluating the effectiveness of mass media campaigns in influencing drug use, intention to use or the attitude of young people under the age of 26 towards illicit drugs.
We used the standard methodological procedures of The Cochrane Collaboration.
We included 23 studies involving 188,934 young people, conducted in the USA, Canada and Australia between 1991 and 2012. Twelve studies were randomised controlled trials (RCT), two were prospective cohort studies (PCS), one study was both a RCT and a PCS, six were interrupted time series and two were controlled before and after (CBA) studies. The RCTs had an overall low risk of bias, along with the ITS (apart from the dimension 'formal test of trend'), and the PCS had overall good quality, apart from the description of loss to follow-up by exposure.Self reported or biomarker-assessed illicit drug use was measured with an array of published and unpublished scales making comparisons difficult. Pooled results of five RCTs (N = 5470) show no effect of media campaign intervention (standardised mean difference (SMD) -0.02; 95% confidence interval (CI) -0.15 to 0.12).We also pooled five ITS studies (N = 26,405) focusing specifically on methamphetamine use. Out of four pooled estimates (two endpoints measured in two age groups), there was evidence of a reduction only in past-year prevalence of methamphetamine use among 12 to 17 years old.A further five studies (designs = one RCT with PCS, two PCS, two ITS, one CBA, N = 151,508), which could not be included in meta-analyses, reported a drug use outcome with varied results including a clear iatrogenic effect in one case and reduction of use in another.
AUTHORS' CONCLUSIONS: Overall the available evidence does not allow conclusions about the effect of media campaigns on illicit drug use among young people. We conclude that further studies are needed.
针对年轻人的特定物质的大众媒体宣传活动被广泛用于预防非法药物使用。这些活动旨在减少使用并提高对该问题的认识。
评估大众媒体宣传活动在预防或减少年轻人非法药物使用或使用意图方面的有效性。
我们检索了Cochrane对照试验中央登记册（CENTRAL，Cochrane图书馆2013年第1期），包括Cochrane药物与酒精小组的专业登记册；通过PubMed检索MEDLINE（1966年至2013年1月29日）；检索EMBASE（1974年至2013年1月30日）以及ProQuest学位论文与综合索引数据库（1861年至2013年2月3日）。
整群随机对照试验、前瞻性和回顾性队列研究、中断时间序列研究以及前后对照研究，评估大众媒体宣传活动在影响26岁以下年轻人非法药物使用、使用意图或对非法药物态度方面的有效性。
我们采用了Cochrane协作网的标准方法程序。
我们纳入了23项研究，涉及188,934名年轻人，研究于1991年至2012年在美国、加拿大和澳大利亚进行。12项研究为随机对照试验（RCT），2项为前瞻性队列研究（PCS），1项研究既是RCT又是PCS，6项为中断时间序列研究，2项为前后对照（CBA）研究。RCT总体偏倚风险较低，中断时间序列研究（除“趋势的正式检验”维度外）也是如此，PCS总体质量良好，但暴露组失访情况描述欠佳。自我报告或生物标志物评估的非法药物使用通过一系列已发表和未发表的量表进行测量，难以进行比较。5项RCT（N = 5470）的汇总结果显示，媒体宣传活动干预无效果（标准化均数差（SMD）-0.02；95%置信区间（CI）-0.15至0.12）。我们还汇总了5项专门针对甲基苯丙胺使用的中断时间序列研究（N = 26,405）。在4项汇总估计值（在两个年龄组中测量了两个终点）中，有证据表明仅12至17岁青少年过去一年甲基苯丙胺使用流行率有所下降。另外5项研究（设计包括一项带有PCS的RCT、两项PCS、两项中断时间序列研究、一项CBA研究，N = 151,508），由于无法纳入荟萃分析，报告了不同的药物使用结果包括一例明显的医源性效应和另一例使用减少情况。
总体而言，现有证据无法得出关于媒体宣传活动对年轻人非法药物使用影响的结论。我们得出结论，需要进一步研究。
