Why are school-based, youth-centred smoking interventions not as effective as we hoped? Some ideas for research

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Abstract
School-based youth-centred interventions have generally had little or no effect on youth behaviour with regard to smoking. This paper presents some possible reasons why such programmes fail, based largely on the author's own experience, which might provide starting points for research in this important field. Smokers and potential smokers are most likely to be absent from school; many smokers reject school values; children learn remarkably little from lessons; those who learn best are academic and least likely to smoke; the needs of specific target groups cannot be met in a general classroom context; children are not considered to be mature enough to make other major life decisions; social influences are very strong; warnings of risk can make smoking appear even more attractive; smoking education is affective and requires a lot of time, which makes it a problem for the school curriculum; teachers are often unfamiliar with the theories and methods needed and modify the programmes; smoking is still an acceptable adult behaviour. If such interventions are to be used at all, the reasons for their failure must be identified and addressed and they must form only a small part of a holistic national programme.