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Open Access Effects of a School Tobacco Policy on Student Smoking and Snus Use

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This article is Open Access under the terms of the Creative Commons CC BY-NC-ND licence.

Objective: A school tobacco policy (STP) commonly is used to reduce smoking among adolescents, but the effectiveness of such programs is unclear. We evaluated the impact of an STP on tobacco use in 4 schools. Methods: The study included 4 intervention and 4 control schools, located in the inner city of Stockholm, Sweden. Schools self-selected for assignment to either an intervention program or a comparison group. In total, the study was comprised of 2671 students in grades 9 and 11, ages 15 to 18, and 1998 students (75%) responded to the questionnaire. We used a repeated cross-sectional design with assessment of tobacco use prevalence before implementation of the STP in 2016 and after 2 years under the program, in 2018. Results: Two years after the STP, the intervention school in grade 9 showed a lower prevalence (13.5% vs 1.6%) in the proportion of students who reported smoking (χ2 = 4.54; p < .05) whereas the proportion reporting snus use was practically unchanged. We found no statistically significant impact of the STP for grade 11. Conclusions: The results are promising with regard to smoking, when the STP is implemented in early adolescence.


Document Type: Research Article

Publication date: July 1, 2020

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  • Health Behavior and Policy Review is a rigorously peer-reviewed scholarly bi-monthly publication that seeks manuscripts on health behavior or policy topics that represent original research, including papers that examine the development, advocacy, implementation, or evaluation of policies around specific health issues. The Review especially welcomes papers that tie together health behavior and policy recommendations. Articles are available through subscription or can be ordered individually from the Health Behavior and Policy Review site.
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