抵制烟草教育（EAT）：一项针对德国中学的由医学生开展的跨国吸烟预防项目的准实验性前瞻性评估。
Education Against Tobacco (EAT): a quasi-experimental prospective evaluation of a multinational medical-student-delivered smoking prevention programme for secondary schools in Germany.
作者信息
Brinker Titus J, Stamm-Balderjahn Sabine, Seeger Werner, Klingelhöfer Doris, Groneberg David A
机构信息
Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt, Germany Universities of Giessen and Marburg Lung Center, Gießen, Germany.
Institute of Medical Sociology and Rehabilitation Science, Charité University Medicine, Berlin, Germany.
出版信息
BMJ Open. 2015 Sep 18;5(9):e008093. doi: 10.1136/bmjopen-2015-008093.
OBJECTIVES
To evaluate the multinational medical-student-delivered tobacco prevention programme for secondary schools for its effectiveness to reduce the smoking prevalence among adolescents aged 11-15 years in Germany at half year follow-up.
SETTING
We used a prospective quasi-experimental study design with measurements at baseline (t1) and 6 months postintervention (t2) to investigate an intervention in 8 German secondary schools. The participants were split into intervention and control classes in the same schools and grades.
PARTICIPANTS
A total of 1474 eligible participants of both genders at the age of 11-15 years were involved within the survey for baseline assessment of which 1200 completed the questionnaire at 6-month follow-up (=longitudinal sample). The schools participated voluntarily. The inclusion criteria were age (10-15 years), grade (6-8) and school type (regular secondary schools).
INTERVENTION
Two 60 min school-based modules delivered by medical students.
PRIMARY AND SECONDARY OUTCOME MEASURES
The primary end point was the difference from t1 to t2 of the smoking prevalence in the control group versus the difference from t1 to t2 in the intervention group (difference of differences approach). The percentage of former smokers and new smokers in the two groups were studied as secondary outcome measures.
RESULTS
In the control group, the percentage of students who claimed to be smokers doubled from 4.2% (t1) to 8.1% (t2), whereas it remained almost the same in the intervention group (7.1% (t1) to 7.4% (t2); p=0.01). The likelihood of quitting smoking was almost six times higher in the intervention group (total of 67 smokers at t1; 27 (4.6%) and 7 (1.1%) in the control group; OR 5.63; 95% CI 2.01 to 15.79; p<0.01). However, no primary preventive effect was found.
CONCLUSIONS
We report a significant secondary preventive (smoking cessation) effect at 6-month follow-up. Long-term evaluation is planned.
目的
评估由多国医学生实施的针对中学的烟草预防项目，以确定其在德国11至15岁青少年中半年随访时降低吸烟率的有效性。
设置
我们采用前瞻性准实验研究设计，在基线（t1）和干预后6个月（t2）进行测量，以调查德国8所中学的一项干预措施。参与者在同一学校和年级被分为干预班和对照班。
参与者
共有1474名年龄在11至15岁的符合条件的男女参与者参与了基线评估调查，其中1200人在6个月随访时完成了问卷（=纵向样本）。学校自愿参与。纳入标准为年龄（10至15岁）、年级（6至8年级）和学校类型（普通中学）。
干预
由医学生提供两个60分钟的校内模块。
主要和次要结局指标
主要终点是对照组从t1到t2的吸烟率差异与干预组从t1到t2的吸烟率差异（差异差异法）。研究两组中既往吸烟者和新吸烟者的百分比作为次要结局指标。
结果
在对照组中，自称吸烟者的学生百分比从4.2%（t1）翻倍至8.1%（t2），而干预组几乎保持不变（7.1%（t1）至7.4%（t2）；p=0.01）。干预组戒烟的可能性几乎高出六倍（t1时共有67名吸烟者；对照组分别为27人（4.6%）和7人（1.1%）；OR 5.63；95%CI 2.01至15.79；p<0.01）。然而，未发现一级预防效果。
结论
我们报告了在6个月随访时有显著的二级预防（戒烟）效果。计划进行长期评估。
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