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Primary Care–Relevant Interventions for Tobacco Use Prevention and Cessation in Children and Adolescents: A Systematic Evidence Review for the U.S. Preventive Services Task Force
Abstract
BACKGROUND: Interventions to prevent smoking uptake or encourage cessation among young persons might help prevent tobacco-related illness. PURPOSE: To review the evidence for the efficacy and harms of primary care-relevant interventions that aim to reduce tobacco use among children and adolescents. DATA SOURCES: Three systematic reviews that collectively covered the relevant literature; MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, and the Database of Abstracts of Reviews of Effects through 14 September 2012; and manual searches of reference lists and gray literature. STUDY SELECTION: Two investigators independently reviewed 2453 abstracts and 111 full-text articles. English-language trials of behavior-based or medication interventions that were relevant to primary care and reported tobacco use, health outcomes, or harms were included. DATA EXTRACTION: One investigator abstracted data from good- and fair-quality trials into an evidence table, and a second checked these data. DATA SYNTHESIS: 19 trials (4 good-quality and 15 fair-quality) that were designed to prevent tobacco use initiation or promote cessation (or both) and reported self-reported smoking status or harms were included. Pooled analyses from a random-effects meta-analysis suggested a 19% relative reduction (risk ratio, 0.81 [95% CI, 0.70 to 0.93]; absolute risk difference, -0.02 [CI, -0.03 to 0.00]) in smoking initiation among participants in behavior-based prevention interventions compared with control participants. Neither behavior-based nor bupropion cessation interventions improved cessation rates. Findings about the harms related to bupropion use were mixed. LIMITATIONS: No studies reported health outcomes. Interventions and measures were heterogeneous. Most trials examined only cigarette smoking. The body of evidence was largely published 5 to 15 years ago. CONCLUSION: Primary care-relevant interventions may prevent smoking initiation over 12 months in children and adolescents.
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“among participants in behavior-based prevention interventions with no impact on cessation rates [37].”
From Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews (2016) · cites this paper as [37]
In the citing paper
“However, the interventions and measures were reported to be heterogeneous.”
From Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews (2016) · cites this paper as [37]
In the citing paper
“Evidence from primary care relevant interventions (including coordinated, multicomponent interventions that combine mass media campaigns, price increases, school-based policies and programs, and statewide or community-wide changes in policies and norms) suggests a significant reduction in smoking initiation (RR: .81; 95% CI: .70–.93) among participants in behavior-based prevention interventions”
From Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews (2016) · cites this paper as [37]
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Metadata
- Authors
- Patnode, C. D., O'Connor, E., Whitlock, E. P., Perdue, L. A., Soh, C., & Hollis, J.
- Affiliations
- From the Oregon Evidence-based Practice Center, Portland, Oregon.
- ORCID
- Perdue, Leslie A.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2013-02-19
- Volume
- 158
- Issue
- 4
- Pages
- 253-260
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2139304630
- Cited by
- 70
- References
- 35
- Citations by year
- 2025: 1 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 5 · 2019: 5 · 2018: 8 · 2017: 8 · 2016: 8 · 2015: 14 · 2014: 6 · 2013: 8
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (HHS-290-2007-10057-I)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
- Keywords
- tobacco use prevention, smoking cessation, children, adolescents, primary care intervention, smoking initiation, bupropion, USPSTF recommendations
- MeSH terms
- Smoking Prevention, Adolescent, Adolescent Behavior, Child, Counseling, Humans, Primary Health Care, Smoking, Smoking Cessation, Bupropion
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