Efectiveness of school-based interventions for preventing tobacco smoking initiation among young people in low and middle-income countries: a systematic review protocol

Background: Despite the commendable progress made globally in tobacco control, the world is falling short of achieving a 30% relative reduction in current tobacco use by 2025. The African region remains the least in the eforts in fghting the tobacco epidemic and is most exploited by the tobacco industry. Schools have been continuously used for over three decades as a setting for delivering youth smoking prevention programmes; however, the evidence of the efectiveness of those school-based interventions provides varying outcomes. Also, interventions that proved to be efective, in high-income countries (HICs), may not necessarily be efective in the African region as a result of cultural diferences and other contrasting factors. An existing systematic review that explored school-based tobacco prevention programmes among the youth in Afri‑ can countries from 2000 to 2016 showed partial efectiveness. This review will address the gap by updating the 2016 review to examine studies in LMICs to generate fndings to help target resources which have the potential to save lives by preventing smoking initiation among young people. Methods: The JBI methodology for systematic reviews of efectiveness will guide the conduct of this review. A comprehensive strategic search will be developed to retrieve both published and unpublished studies that evaluate school-based interventions to prevent tobacco smoking initiation among in-school young people in LMICs compared to non-intervention programmes. Published studies would be from databases such as MEDLINE via Ovid, CINAHL via EBSCO, Embase, PsycINFO, PsycEXTRA, and the Cochrane Central Register of Controlled Trials. Sources of grey literature would be ProQuest Dissertations and Theses, MedNar, EBSCO Open Dissertations, Open Access Theses and Disserta‑ tions, and Trove. The databases will be searched for published studies in the English language. The processes of study selection, critical appraisal, data extraction, and data synthesis will be in accordance with the JBI approach for reviews of efectiveness with a minimum of two reviewers at each stage. The primary outcome of the review will be the non-initiation of tobacco smoking by the youth. Discussion: The review will provide synthesized evidence on the efectiveness of school-based smoking initiation prevention among young people in LMICs. The fndings of the review would support policymakers and programme implementers to develop targeted interventions for efective tobacco control initiatives. Systematic review registration: PROSPERO CRD42021246206
This article is published by BioMed Central and is also available at https://doi.org/10.1186/s13643-022-02127-8
Logo et al. Systematic Reviews (2022) 11:253 https://doi.org/10.1186/s13643-022-02127-8