Little empirical support currently exists for the effectiveness of these approaches. One possible explanation for the mixed results of programs for youth is inadequate program evaluation. One of the most significant barriers to implementing effective prevention programs is translating a successful, but small scale and tightly controlled, intervention to the community. Once the intervention has reached the community it is often assumed to be effective without further evaluation. The failure to evaluate youth prevention programs is a serious deficiency in being able to defend additional investments in youth tobacco control efforts.
Many new innovations appear promising.
However, they need rigorous program evaluation in order for us to understand better the magnitude of the effects, whether or not different groups of youth respond differently to the intervention, the costs involved, and the barriers and facilitators to program implementation. The most obvious conclusion is that adolescent smoking prevention efforts have had mixed results. No one approach is likely to reverse that finding. Despite recent research and innovative prevention strategies, we cannot say that there are any new revelations about the effectiveness of these programs beyond the conclusions reached by the Surgeon General and the Institute of Medicine in 1994. As a result, advocating for a focus on youth smoking prevention and control is somewhat controversial.