Effects of School-based Smoking Prevention Education by Physician After Eight Years: A School Randomized Controlled Trial

Numerous studies have examined whether school-based smoking prevention education for minors reduces smoking rates, but consensus has not been established. Moreover, there are few reports about non-smoking classes offered by physicians with long-term results. Volunteer doctors have provided tobacco prevention classes in Kanazawa, Japan since 1998. The aim of this article is to assess whether the education by physicians was effective after eight years. A community area having 14 elementary schools was selected for this study. The study groups comprised randomized schools receiving the 45 minutes non-smoking education by physicians for 12-year-old sixth graders once a year and control schools with no intervention during three years from 2007 to 2009. A randomized controlled trial was conducted among 4,014 (1,615 educated and 2,399 control) students. After eight years, a questionnaire survey on the smoking behaviors of 20-year-old young adults within the community was conducted and 1,634 (631 educated and 1,003 control) replies were collected. The smoking rates of the two groups were compared. At the eight-year follow-up, the smoking rates in the educated group significantly decreased compared to those in the control, especially among males. The school-based smoking prevention education by physicians was effective in reducing the smoking rates among 12-year-old students 8 years later.