METHODS: Thirty-five high schools were pair-matched and randomly
assigned to 1 of 2 conditions, each of which consisted of 4 visits with
the school nurse: (1) counseling intervention using the 5 A’s model and
cognitive-behavioral techniques; or (2) an information-attention control
condition. Adolescents (n1068) who reported past 30-day smoking
and interest in quitting completed surveys at baseline and at 3 and
12 months and provided saliva samples for biochemical validation of
reported smoking abstinence.
RESULTS: Intervention condition participants were almost twice as
likely to be abstinent per self-report at 3 months (odds ratio: 1.90 [95%
confidence interval: 1.12–3.24]; P .017) compared with control participants;
at 12 months there were no differences. The difference at 3
months was driven by quit rates in male students (15.0% [intervention]
vs 4.9% [control]; odds ratio: 3.23 [95% confidence interval: 1.63– 6.43];
P.001); there was no intervention effect in female students at either
time point (6.6% vs 7.0% at 3 months and 16.6% vs 15.5% at 12 months)
and no intervention effect in male students at 12 months (13.9% vs
13.2%). Smoking amount and frequency decreased significantly in intervention
compared with control schools at 3 but not at 12 months.
CONCLUSIONS: A school nurse– delivered smoking-cessation intervention
proved feasible and effective in improving short-term abstinence
among adolescent boys and short-term reductions in smoking amount
and frequency in both genders. Additional research is needed to enhance
both cessation and maintained abstinence.