Complex approaches show promise, with some persistence of abstinence (30 days point prevalence abstinence or continuous abstinence at six months), especially those incorporating elements sensitive to stage of change and using motivational enhancement and CBT.  We await results of recent trials of Not on Tobacco trials and more data is needed on sustained quitting that allows for the episodic nature of much adolescent smoking. There were few trials with evidence about pharmacological interventions (nicotine replacement and bupropion), and none demonstrated effectiveness for adolescent smokers. There is not yet sufficient evidence to recommend widespread implementation of any one model.
There continues to be a need for well-designed adequately powered randomized controlled trials of interventions for this population of smokers.
Health risk appraisal modifies cigarette smoking behavior among college students.
To assess whether Health Risk Appraisal (HRA), a computer-scored lifestyle analysis questionnaire, can result in significant changes in health behavior, a controlled clinical trial with one-year follow-up was conducted among entering freshmen at an urban state university. Three hundred fifty entering freshmen were each assigned to one of four groups: HRA with feedback, HRA without feedback, initial control, and final control. Twenty-two per cent of the nonsmokers in the no-feedback group, as compared with 5% in the feedback group, acquired the habit of cigarette smoking (p less than 0.001). Furthermore, 26% of the smokers in the feedback group, as compared with 6% in the no-feedback group, were able to quit smoking (p less than 0.05). Among those unable to quit smoking, 59% in the feedback group, as compared with 19% in the no-feedback group, were able to reduce their cigarette consumption by more than six cigarettes per day (p less than 0.01). Health Risk Appraisal, when accompanied by feedback counseling, was an effective health promotion tool to help prevent nonsmokers from acquiring the habit and to modify cigarette smoking behavior among college freshmen.