de Josselin de Jong Sanne, Candel Math, Segaar Dewi, Cremers Henricus-Paul, de Vries Hein
J Med Internet Res. 2014 Mar 21;16(3):e82. doi: 10.2196/jmir.2469.
Preventing smoking initiation among adolescents is crucial to reducing tobacco-caused death and disease. This study focuses on the effectiveness of a Web-based computer-tailored smoking prevention intervention aimed at adolescents.
The intent of the study was to describe the intervention characteristics and to show the effectiveness and results of a randomized controlled trial. We hypothesized that the intervention would prevent smoking initiation among Dutch secondary school students aged 10-20 years and would have the largest smoking prevention effect among the age cohort of 14-16 years, as smoking uptake in that period is highest.
The intervention consisted of a questionnaire and fully automated computer-tailored feedback on intention to start smoking and motivational determinants. A total of 89 secondary schools were recruited via postal mail and randomized into either the computer-tailored intervention condition or the control condition. Participants had to complete a Web-based questionnaire at baseline and at 6-month follow-up. Data on smoking initiation were collected from 897 students from these schools. To identify intervention effects, multilevel logistic regression analyses were conducted using multiple imputation.
Smoking initiation among students aged 10-20 years was borderline significantly lower in the experimental condition as compared to the control condition 6 months after baseline (OR 0.25, 95% CI 0.05-1.21, P=.09). Additional analyses of the data for the 14-16 year age group showed a significant effect, with 11.5% (24/209) of the students in the control condition reporting initiation compared to 5.7% (10/176) in the experimental condition (OR 0.22, 95% CI 0.05-1.02, P=.05). No moderation effects were found regarding gender and educational level.
The findings of this study suggest that computer-tailored smoking prevention programs are a promising way of preventing smoking initiation among adolescents for at least 6 months, in particular among the age cohort of 14-16 years. Further research is needed to focus on long-term effects.
International Standard Randomized Controlled Trial Number (ISRCTN): 77864351; http://www.controlled-trials.com/ISRCTN77864351 (Archived by WebCite at http://www.webcitation.org/6BSLKSTm5).
预防青少年开始吸烟对于减少烟草导致的死亡和疾病至关重要。本研究聚焦于一项针对青少年的基于网络的计算机定制化吸烟预防干预措施的有效性。
本研究旨在描述干预措施的特点，并展示一项随机对照试验的有效性和结果。我们假设该干预措施能够预防10至20岁荷兰中学生开始吸烟，并且在14至16岁年龄组中吸烟预防效果最大，因为该时期吸烟率最高。
干预措施包括一份问卷以及关于开始吸烟意图和动机决定因素的全自动计算机定制化反馈。通过邮政邮件招募了89所中学，并将其随机分为计算机定制化干预组或对照组。参与者必须在基线和6个月随访时完成一份基于网络的问卷。从这些学校的897名学生中收集了开始吸烟的数据。为了确定干预效果，使用多重填补法进行了多水平逻辑回归分析。
与对照组相比，在基线后6个月，10至20岁学生中实验组的开始吸烟率略低（比值比0.25，95%置信区间0.05 - 1.21，P = 0.09）。对14至16岁年龄组数据的进一步分析显示有显著效果，对照组中有11.5%（24/209）的学生报告开始吸烟，而实验组为5.7%（10/176）（比值比0.22，95%置信区间0.05 - 1.02，P = 0.05）。未发现性别和教育水平的调节作用。
本研究结果表明，计算机定制化吸烟预防项目是预防青少年开始吸烟的一种有前景的方法，至少在6个月内有效，特别是在14至16岁年龄组中。需要进一步研究关注长期效果。
国际标准随机对照试验编号（ISRCTN）：77864351；http://www.controlled-trials.com/ISRCTN77864351（由WebCite存档于http://www.webcitation.org/6BSLKSTm5）
