An evaluation of interventions to reduce the use of tobacco products

Article type
Authors
Honkins D, Briss P, Pechacek T, Glynn T, Fielding J
Abstract
Introduction/Objectives: A national, independent, non-federal organization, the Task Force on Community Preventive Services, is systematically reviewing published evidence on the effectiveness of population-based interventions to reduce the consumption of tobacco products. The Task Force will use this review to support evidence-based recommendations for population-based primary and secondary tobacco prevention programs and policies.

Methods: A consultation team, composed of recruited national and regional tobacco-prevention experts, developed a logic framework and a priority list of interventions. For each intervention selected for review, an analytic framework was developed that postulates a causal relationship between that intervention and one or more outcome measures. An initial literature search conducted in Medline employed search terms selected from the list of interventions, and was restricted to English language papers published between 1976 and 1998. Additional articles were identified through subsequent searches in electronic databases and bibliographies of extant review articles. Eligible are those studies that include (1) a population intervention with single or multiple components; (2) a comparison group; and (3) outcome measures of tobacco-use behaviors or attitudes at the individual or population level. Using a standard data abstraction form, evidence of effectiveness contained in each article was abstracted by two reviewers and disagreements resolved in discussion. Effect sizes, precision, and validity of findings from the body of studies within each intervention category were summarized according to predetermined criteria and translated into recommendations according to an explicit process developed by the Task Force.

Results: As of March 1998, two interventions, tobacco product taxation (44 studies) and mass media education (54 studies) are under evaluation. Estimates of effect sizes, precision, and validity of findings from these two bodies of evidence, with draft recommendations will be presented.

Discussion: Evidence of the effectiveness of population-based interventions to reduce the consumption of tobacco products is available in the published literature, can be assessed systematically, and used to support recommendations for action.