A meta-analysis of mediating effects on adolescent psychosocial smoking prevention programs in the United States

Adolescent psychosocial smoking prevention programs have been successful, but limited in the magnitude of program effects on the reduction of smoking behaviors. This is primarily due to the mixed results of independent studies with program variations. This systematic, quantitative research synthesis is designed to identify program key factors that are likely to increase program effects. The present study examined school-based psychosocial smoking prevention programs (1978-1997)among students in grades 6 to 12 in the United States. Theoretical formulations in this analysis of mediating effects posit that program impact on knowledge and/ or skills is associated with less smoking behaviors among program participants. Knowledge factors investigated in this study included health effects, social consequences, social influences, and social norms. Skill factors included affective skill, self-efficacy, assertiveness, self-control, problem solving, and refusal skill. The findings from this study highlight the importance of social consequences knowledge factor and assertive communication skill factor in decreasing adolescent smoking behaviors.