Targeting early antecedents to prevent tobacco smoking: Findings from an epidemiologically based randomized field trial

Objectives. This study examined whether interventions aimed at aggressive/disruptive classroom behavior and poor academic achievement would reduce the incidence of initiation of smoking. Methods. An epidemiologically based, universal randomized preventive trial involved 2311 children in 2 classroom-based preventive interventions or controls. Each intervention was directed at 1 of the aforementioned 2 antecedents over first and second grades in 19 urban schools. Results. Smoking initiation was reduced in both cohorts for boys assigned to the behavioral intervention. Conclusions. Targeting early risk antecedents such as aggressive behavior appears to be an important smoking prevention strategy.