A non-randomized controlled effectiveness study of a smoking cessation intervention for adolescents

Despite a remarkable decrease of smoking prevalence among German teenagers over the last 20 years, a substantial number of adolescents report current cigarette use, especially youth with low socioeconomic status. This study investigated the effectiveness of a school-based psychosocial adolescent smoking cessation intervention under real-world conditions. Methods: The intervention consisted of six sessions of school-based group counseling, using motivational enhancement and cognitive-behavioral content, along with 4 weeks of follow-up care by text messaging and phone calls. A total of 47 smoking cessation classes were implemented in secondary schools all over Germany. The intervention group (IG) consisted of 272 currently smoking students nested in 41 schools, and the control group (CG) comprised 240 currently smoking students nested in 10 schools. Assignment to IG and CG was non-randomized. Logistic regression analyses (complete case, intention to treat, and full-information-maximum-likelihood) were conducted to test group differences in past 30-day smoking abstinence at 6-month follow-up. Baseline differences between IG and CG and intraclass correlation were accounted for in the analyses. Results: There were no differences in school characteristics between IG and CG schools at baseline. At 6-month follow-up, the IG had a significantly higher abstinence rate than the CG (Intent-totreat analysis: 14 % IG vs. 5 % CG; adjusted odds ratio = 2.73; 95 % confidence interval: 1.19 - 6.27). Results were consistent for complete case and full-information-maximum-likelihood analyses. Conclusions: Results suggest that school-based psychosocial interventions can be feasible and effective for smoking cessation among adolescents in schools with a higher proportion of youth with low socioeconomic status.