Table 5.
Effectiveness of policies on substance misuse (tobacco and alcohol use)
| Study | Design | Policy | Outcomes | Specific outcome | Impact (+) Favorable and significant change (=) No change |
Strength of Association |
|---|---|---|---|---|---|---|
| Tobacco use | ||||||
| Evans-Whipp et al., 2010 [37] | Cross-sectional | Comprehensive smoking bans, policy orientation towards abstinence and harm minimization principles, possession of tobacco products among students | Current tobacco use, Daily smoking, Perception of smoking in school campus | Smoking ban – current smoking | = | OR (95% CI): 0.86 (0.59, 1.25) |
| Harm minimization – current smoking | = | OR (95% CI): 1.09 (0.99, 1.21) | ||||
| Strict enforcement – current smoking | = | OR (95% CI): 0.78 (0.57, 1.05) | ||||
| Smoking ban – daily smoking | = | OR (95% CI): 0.95 (0.53, 1.69) | ||||
| Harm minimization – daily smoking | = | OR (95% CI): 1.01 (0.85, 1.20) | ||||
| Strict enforcement – daily smoking | = | OR (95% CI): 0.70 (0.44, 1.12) | ||||
| Smoking ban – perception | = | OR (95% CI): 1.39 (0.67, 2.89) | ||||
| Harm minimization – perception | = | OR (95% CI): 1.18 (0.97, 1.43) | ||||
| Strict enforcement – perception | + | OR (95% CI): 0.45 (0.25, 0.82) | ||||
| Hamilton et al., 2005 [38] | RCT | School-based harm minimization smoking intervention | Regular smoking, smoking within previous month | Regular smoking | + | Intervention vs comparison OR (95% CI): Baseline 0.74 (0.45, 1.22) Post-intervention: 0.50 (0.33, 0.74) |
| Smoking within previous month | + | Intervention vs comparison OR (95% CI): Baseline 0 0.95 (0.71, 1.28) Post-intervention: 0.69 (0.53, 0.91) | ||||
| Lovato et al., 2007 [39] | Cross sectional | School/ District tobacco control policies – policy intention (written policy), policy implementation, perception of policy enforcement | Prevalence of smoking | Policy intention – smoking prevalence | + | β = −0.11 (R2 = 0.27) (P < 0.05) |
| Policy implementation – smoking prevalence | + | β = −0.04 (R2 = 0.21) (P < 0.05) | ||||
| Policy perception – smoking prevalence | + | β = −0.55 (R2 = 0.62) (P < 0.05) | ||||
| Murnaghan et al., 2008 [40] | Cross-sectional | Policy banning smoking in school property participated in provincially directed school-based smoking prevention program | Current smoking, Occasional smoking and Regular smoking | Occasional vs nonsmoker | = | OR (95% CI): 1.54 (0.79, 3.01) |
| Regular vs occasional smoker | = | OR (95% CI): 0.92 (0.69, 1.23) | ||||
| O’Brien et al., 2010 [35] | Cross-Sectional | Tobacco control school-based policy – Teacher shared information of consequences of smoking | Frequency of smoking in past month | Average cigarettes smoked/day | = | Not reported |
| Paek et al., 2013 [41] | Cross-sectional | Tobacco-free school policy | Frequency of smoking | Frequency of smoking | + | β = −0.56 (P < 0.05) |
| Patel et al., 2012 [20] | Cross-sectional | Avoiding tobacco promotion | Tobacco use | Tobacco use | + | P < 0.05 |
| Alcohol use | ||||||
| Evans-Whipp et al., 2013 [42] | Cross-sectional | Low policy enforcement, Abstinence alcohol message, Harm minimization alcohol message | Alcohol use: alcohol use on school grounds, current alcohol use. Binge drinking, student alcohol harm | Low policy enforcement - Use on school grounds | + | OR (95% CI): 1.48 (1.07, 2.05) |
| Low policy enforcement - Current alcohol use | = | OR (95% CI): 1.12 (0.95, 1.32) | ||||
| Low policy enforcement - Binge drinking | = | OR (95% CI): 1.14 (0.94, 1.38) | ||||
| Low policy enforcement - Student alcohol harm | = | OR (95% CI): 1.02 (0.84, 1.25) | ||||
| Abstinence alcohol message - Use on school grounds | = | OR (95% CI): 0.85 (0.66, 1.10) | ||||
| Abstinence alcohol message - Current alcohol use | = | OR (95% CI): 0.90 (0.78, 1.04) | ||||
| Abstinence alcohol message - Binge drinking | = | OR (95% CI): 0.84 (0.59, 1.25) | ||||
| Abstinence alcohol message - Student alcohol harm | = | OR (95% CI): 0.86 (0.71, 1.04) | ||||
| Harm minimization alcohol message - Use on school grounds | = | OR (95% CI): 0.90 (0.73, 1.10) | ||||
| Harm minimization alcohol message - Current alcohol use | = | OR (95% CI): 0.92 (0.83, 1.02) | ||||
| Harm minimization alcohol message - Binge drinking | = | OR (95% CI): 0.82 (0.72, 1.92) | ||||
| Harm minimization alcohol message - Student alcohol harm | + | OR (95% CI): 0.83 (0.71, 0.96) | ||||