La prevención del tabaquismo en los jóvenes: Realidades y retos para el futuro

In recent years it was joined enough evidence about the most effective smoking prevention programmes and strategies. By this reason, it is possible to point some conditions that must observe strategies in this issue. The epidemiologie of the smoking onset reported the first consumption in the first part of Compulsory Secondary school and shows that the main variables that explain the smoking behaviour are personnel, sociocultural and environmental determinants. According with these factors, it is possible to design preventive programmes adressed to the classroom (school-based), media interventions, community-based strategies through intermediaires and smoking policy measures and regulations in public places and also to control tobacco distribution and sales. It's possible to select a little number of school-based preventive programmes, that had showed to be effective at short, medium and long term. Over six months, the efectiveness of programmes to reduce smoking decrease. It is accepted today that they exist few good preventive programmes, but sufficiently excellent, so it permits to foresee few improvements in this school-based strategies. The efforts for the future have to be concentrated in offering multimodal strategies: for classrooms, for the school environment and out-school community, to increase the total efectiveness of the interventions. In Spain, some programmes were developed with rigorous contents, but with low evidence of what really works and has preventive effect. In last decades, even with lack of enough rigorous studies, the first smoking cessation programmes for young people were designed. The most effective methodology seams to be the cognitive-behavioural therapy in the way of cessation groups.