Stay away from tobacco: a pilot trial of a school-based adolescent smoking prevention program in Beijing, China.

A quasiexperimental study was conducted to explore the efficacy of the program Stay Away from Tobacco (SAFT). Participants-from 11 classes with 381 students total in grades 7, 8, 10, and 11-were assigned by class to three groups (intervention group T with school teachers delivering the program, intervention group R with researchers delivering the program, and comparison group C). Data were collected at baseline, immediately after the intervention, and 6 months after the intervention. Self-reported smoking was the outcome measure. The 30-day smoking prevalence in group C increased from 4% at baseline to 10% at the 6-month follow-up, whereas this rate declined from 11% to 6% in group T, and from 9% to 1% in group R. For group T, the odds ratio (for 30-day smoking) and the regression coefficient (for indexed number of cigarettes smoked) assessing interactions between intervention and time were 0.20 (p < .001) and -.1605 (p < .05), respectively. The same statistics for group R were 0.09 (p < .001) and -.2406 (p < .01), respectively. The predicted smoking rate declined by 19% from baseline to 6-month follow-up in group T (11.5% vs. 9.3%), and the same rate declined by 26% in group R (11.1% vs. 8.2%). The results from this pilot trial suggest that SAFT can reduce cigarette smoking among middle and high school students through its effect on improving these students' refusal skills and changing their perceived mental and physical values from smoking. A full-scale evaluation is recommended.     

"Not safe" is not enough: smokers have a right to know more than there is no safe tobacco product

The right to health relevant information derives from the principles of autonomy and self direction and has been recognised in international declarations. Providing accurate health information is part of the basis for obtaining "informed consent" and is a recognised component of business ethics, safety communications, and case and product liability law. Remarkably, anti-tobacco and pro-tobacco sources alike have come to emphasise the message that there is "no safe cigarette" or "no safe tobacco product". We propose that the "no safe" message is so limited in its value that it represents a violation of the right to health relevant information. There is a need to go beyond saying, "there is no safe tobacco product" to indicate information on degree of risks. The "no safe tobacco" message does not contradict, for example, the mistaken belief that so called light or low tar cigarettes are safer choices than higher tar cigarettes. We encourage a kind of "rule utilitarian" ethical position in which the principle of truth telling is observed while trying to produce the greatest good for the greatest number of people. Although harm reduction approaches to easing the burden of tobacco related diseases are founded on science based comparative risk information, the right to health information is independently related to the need to promote health literacy. This right should be respected whether or not harm reduction policies are judged advisable.