Home > Incentives for preventing smoking in children and adolescents.

Hefler, Marita and Liberato, Selma and Thomas, David (2017) Incentives for preventing smoking in children and adolescents. Cochrane Database of Systematic Reviews, 6, DOI: 10.1002/14651858.CD008645.pub3.

External website: http://onlinelibrary.wiley.com/doi/10.1002/1465185...


Most smokers start smoking before they are 18 years old. Starting smoking earlier in life means a smoker will smoke for more years than someone who starts smoking later, which increases the health risks of smoking. Given the high amount of tobacco use among young people and the poor health outcomes that may result, finding ways to prevent young people from smoking is a public health priority. One new approach to stopping young people from starting to smoke is the use of incentives, where young people or groups of young people are rewarded for being smoke-free. The aim of this review was to assess the effect of incentives on stopping children and adolescents (aged 5 to 18 years) from starting to smoke.

Study characteristics

This is an update of a previous review. The first version was published in 2012 and included seven studies. For this update we searched for new studies in December 2016 and found one. This review now includes eight trials. Seven of these were trials of the 'Smokefree Class Competition' (SFC), which has been widely used throughout Europe. In this competition, classes (generally between the ages of 11 and 14 years) promise to be smoke-free for a six-month period. They report regularly on their smoking status, and if 90% or more of the class are non-smokers at the end of the six months, the class goes into a competition to win prizes. In the one trial that did not test the SFC, classes with the smallest percentage of students smoking at the school year's end were given rewards.

Key results

We assessed the results from seven trials of SFC and found that the competition did not have a significant impact on whether or not young people started smoking. As there was only one trial that was not of the SFC, we concluded that we do not have enough information to evaluate whether this programme was effective in preventing young people from starting to smoke. Potential negative effects of the SFC have not been widely researched, but the available data suggest that the SFC programme does not have any significant negative effects.

Quality of the evidence

We judged the overall quality of evidence to be low or very low, because it is based on a small number of studies, with imprecise effects and with a high or uncertain risk of bias.

Item Type
Publication Type
International, Review, Article
Drug Type
Tobacco / Nicotine
Intervention Type
June 2017
Identification #
DOI: 10.1002/14651858.CD008645.pub3
John Wiley & Sons, Ltd
Place of Publication

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