Khoo Teck Puat Hospital1
Cigarette smoking is an ongoing global health problem which causes multiple chronic diseases and death. Considering the high smoking prevalence internationally and within Singapore, effective interventions are necessitated to reduce the prevalence of cigarette smoking and maintain public health. With the increasing trajectory of adolescent smoking and need for an evidence-based approach that targets the multidimensional drivers of adolescent smoking, the aim of this review is to elucidate targeted school-based strategies to holistically address influential factors of adolescent smoking behaviour.
A systematic literature review was conducted using a total of 12 research articles evaluating nine multifaceted school-based smoking cessation programs.
Through extraction, analysis, and synthesis of selected articles, two broad themes were elucidated – changes in smoking behaviour which was characterized by increased smoking cessation rate, and reduced smoking behaviour; as well as intrapersonal factors associated with smoking behaviour which was characterized by nicotine dependence levels, self-efficacy in smoking cessation, and smoking-related knowledge and attitude.
While variable-mediated effects of the mentioned factors were not examined, this review further suggests the importance of addressing these factors within the context of multifaceted interventions. Hence, this review suggests the integration of multiple school-based strategies targeted at barriers and facilitators to cessation to reduce adolescent smoking behaviour as solitary interventions may be inadequate. With the promising effects demonstrated and the compelling need to address adolescent smoking behaviour, Singapore may direct focus towards the establishment of population-specific, multi-component smoking cessation interventions.