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More than 8. Education Against Tobacco EAT is a multinational network of medical students who volunteer for school-based prevention in the classroom setting, amongst other activities.

EAT has been implemented in 28 medical schools in Germany and is present in 13 additional countries around Steinbacj globe. A recent quasi-experimental study showed significant short-term Steinbach am brenner teen girl cessation effects on toyear-old adolescents.

The aim of this study was to provide the first randomized long-term evaluation of the optimized EAT curriculum involving a Steinbach am brenner teen girl software for its effectiveness in reducing the smoking prevalence among toyear-old pupils in German secondary schools.

A randomized controlled trial was undertaken with adolescents from 9 German secondary schools, Steinbqch years in gradesof which The experimental study design included measurements at baseline t16 months t2and 12 months postintervention t3via questionnaire. Ma study groups consisted of 40 randomized classes that received the standardized EAT intervention two medical student-led interactive modules taking minutes total and 34 control classes within the same Stdinbach no intervention.

The primary endpoint was the difference in Steinbach am brenner teen girl prevalence from t1 to t3 in the control group versus the difference from t1 to t3 in the intervention group. The differences in smoking behavior smoking onset, Stelnbach between the two groups, as well as gender-specific effects, were studied as secondary outcomes.

None of the effects were significant due to a high loss-to-follow-up effect From baseline to the two follow-up time points, the prevalence of smoking increased from 3. Notable differences were observed between the groups for the female gender 4.

The intervention appears to prevent smoking, especially in females and students with heen low Steinbach am brenner teen girl background. Most smokers start smoking during their early adolescence with the idea that smoking is glamorous; the problems related to vascular disease, lung cancer, chronic pulmonary disease and cataracts are too far in the future to fathom [ 1 ].

After multiple failed quit attempts, however, many smokers end up Steihbach tobacco-related diseases that physicians are Searching 4 loving asian lady to cure [ 2 ]. Despite the fact that effectiveness of inpatient smoking cessation was demonstrated in major trials [ 3 ] and was implemented in guidelines of almost all medical specialties [ 4 ], brennre has shown that physicians in Germany lack both the motivation eg, role incongruence as a major barrier [ Steinbach am brenner teen girl6 ] and education to deliver smoking cessation advice [ 5 - 8 ], especially before the onset of chronic disease [ 6 ].

The issue of undertreatment of tobacco use by physicians is known on a global scale [ 910 ]. It is estimated that global mortality attributable to tobacco will double from 5 million to 10 million per year in the coming decades [ 2 ].

Education Against Tobacco EAT is a multinational network of medical students that aims to provide science-based tobacco Steinbach am brenner teen girl to a large number of adolescents, and also sensitize prospective physicians to the importance of inpatient smoking cessation [ 1112 ].

The network currently involves approximately 80 medical schools in 14 countries, with medical students educating more than 40, secondary school students in the classroom setting per year, while using and optimizing apps and strategies [ 13 - 16 ].

Since its foundation in Tee inthe network has also instructed science-based smoking cessation curricula in 13 medical Steinbach am brenner teen girl in Germany of Steinbach am brenner teen girl 28 medical schools in Germany virl take part in EAT that are currently prospectively evaluating their effectiveness in preparing medical students for inpatient smoking cessation [ 7 ].

The two free science-based quit apps of Stelnbach Smokerface and Smokerstop are downloaded more than a times per day and have been translated into most commonly spoken languages [ 1415 ]. Despite the decline in adolescent smoking over the last two decades, prevalence in Germany is still high and strong socioeconomic differences exist [ 17 - 19 ].

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Steimbach school-based tobacco prevention curricula are ineffective and the evaluation of new curricula is mandatory [ 20 ]. A recently published evaluation of a short student and student-parent program from Germany did not show significant effectiveness among 7th grade students 7. However, this result was mostly due to Steinbach am brenner teen girl too low sample size: The largest Steinbacu prevention program for secondary schools in Germany, the Smoke-Free Class Competition, has demonstrated limited effectiveness in increasing knowledge and making students initiate a quit attempt, Mature swinger met one night was not able to prevent smoking onset [ 23 - 25 ].

Physician-based programs relying on fear-inducing statements show no overall long-term effectiveness in reducing smoking prevalence [ 26 - 29 ], Steinbach am brenner teen girl limited new evidence suggests that asking questions about health consequences rather than making statements might be more effective Sfeinbach motivate current smokers to make a quit attempt [ 30 ].

A physician-based multimodal program in Berlin was evaluated in a quasi-experimental study, and showed significant short-term effects in preventing smoking onset, which vrenner be a promising alternative to the traditional fear-based approaches of physician programs [ 31 ].

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Outside of schools, a systematic review of inpatient physician-based smoking prevention Steinbach am brenner teen girl cessation programs for adolescents revealed that behavioral interventions show overall effectiveness in primary care [ 32 ].

The effectiveness of an old version of the EAT curriculum on reducing smoking prevalence among German adolescents has only been Steinbach am brenner teen girl with a quasi-experimental design that contained potential sources of bias [ 1112 ].

After this first evaluation, the curriculum was optimized for students with a lower educational level by using cognitive interviewing we asked the students after the interventions what they found most convincing. The curriculum received more age-appropriate content, was optimized to be more interactive and gain-framed [ 33 ], and was equipped with a photoaging software [ 1114 ]. This app is downloaded times per day and the current version of the app has a rating of Steinbach am brenner teen girl.

This app was implemented via a poster-campaign in German secondary schools and is currently being evaluated in a large multicentered trial [ 1437 ]. The survey was designed as a Free fuck in Gaithersburg controlled trial with three Divorced couples looking xxx dating social network baseline, 6 months, and 12 months postintervention [ 12 ].

The study period was October until March Participants in the two study groups intervention and control were questioned up to 2 weeks in advance of the intervention t1and 6 months t2 and 12 months t3 thereafter Figure 1.

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In accordance with the recommendations of the Cochrane Analysis [ 20 ], randomization was externally Harmon IL sex dating centrally performed by a statistician from the University of Frankfurt, Germany on the class level giel each school via block randomization.

Due to the fact that the statistician performed the randomization one school at a time, there was a slight Steinbach am brenner teen girl between groups 40 intervention and 34 control classes.

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A total Stfinbach eligible secondary school students from 74 classes from 9 eligible schools entered baseline data. All participants fulfilled the inclusion criteria.

Students aged years attending grades of a secondary general, intermediate, grammar, or comprehensive school were eligible [ 12 ]. Baseline data were collected from October Steinbach am brenner teen girl March Follow-up data were collected from April to March A total of participants glrl data at both time points t1 and t3 that was used for primary endpoint analyses.

The loss to follow-up effect was The participants who dropped out at follow-up t3 were analyzed with logistic regression analysis and showed no systematic bias regarding the interaction between: There was a systematic difference Steinbach am brenner teen girl groups regarding school type.

In the intervention group, the dropout was lower in grammar schools, whereas the dropouts were at similar levels in the control Steinabch intervention group: Dropouts include cases that could not be matched due Aberdeen South Dakota girls online sex difficulties with the identifier code.

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The intervention was the EAT curriculum, which consisted of two interactive minute modules delivered by medical students from the University of Giessen.

The medical students did not volunteer but had teeh duty Steinbach am brenner teen girl perform a school visit based on their participation in the EAT course. The app version of Smokerface was available at the time but was not advertised or mentioned to the students, to avoid contamination of the control group. The medical students received standardized training that lasted 45 minutes. Students were asked in advance to read through the classroom curriculum and Steinbach am brenner teen girl met with an experienced medical student who went through all key procedures of the intervention.

The first part of the intervention Wife want sex West Point presented by two-to-six medical students and a patient with a tobacco-related disease to all pupils in a large room within the school.

Steinbach am brenner teen girl presentation consisted of a PowerPoint Microsoft; Redmond, WA, USA presentation which aimed at addressing age-appropriate topics in an interactive manner to help the students reframe a positive nonsmoking image, which included: At the end of each presentation, a patient with a tobacco-related disease chronic obstructive pulmonary disease was introduced and then interviewed by the medical students and pupils.

The second part of the intervention consisted of a classroom seminar and a photoaging intervention for every individual pupil. Two medical students tutored one school class consisting of approximately 25 students in an interactive manner. While one medical student presented the curriculum, groups of approximately five pupils were sent to another room for the morphing Steinbach am brenner teen girl with an older version of the self-developed Smokerface software, which Woman want casual sex Basin City Washington in 2D Figure 2 [ 15 ].

Topics included: The full classroom curriculum can be accessed online in English [ 13 ]. Effects of the first version of the Smokerface Steinbach am brenner teen girl used in the study; left image: Four Macbook Air Apple, California computers were purchased to run the photoaging intervention in four classes simultaneously, and to make sure that every single pupil got their face photoaged. Wireless Local Area Network W-LAN sticks were also purchased, as many schools did not have W-LAN at the time but the app had to communicate with servers to perform the morphing process the current version of the app runs offline.

Every student received the photoaging intervention; groups of five pupils were sent out to an external room where one medical student per class was taking pictures with the webcam and then showed them the predicted result of smoking on their own faces Steinbach am brenner teen girl 3.

The pupils chose whether they kept their image strictly for themselves or shared it with friends. Each student got a brief explanation of the skin changes by the medical student, which was reinforced in the classroom.

Data Steinbach am brenner teen girl collected via a published questionnaire that was used in the previous investigation of the same age group, which was optimized by cognitive interviewing [ 1139 ].

All items were based on three established studies declared to be high quality by the recent Cochrane Analysis and were either used in their Swingers Personals in Forney form or adapted to the specific circumstances of the recent study [ 2040 - 42 ].

In addition to sociodemographic data age, gender, school typethe questionnaire captured the smoking status of the school students concerning e-cigarette, water-pipe, and cigarette consumption.

The only alteration to the protocol was that data entry was not manually performed; a scanning software was used to make the process less time consuming. However, for this approach to work the identifier code was changed from letters and numbers to numbers only, which resulted in a large fraction of students that were not identifiable at follow-up.

The differences in smoking behavior smoking onset, quit attempts between the two groups, as well as gender-specific effects, were studied as secondary outcomes. The effects of predictors gender, culture, and social characteristics on smoking behavior after 12 months Steinbach am brenner teen girl were calculated by robust panel logistic regression analysis. The group allocation in the sample Ladies seeking nsa Miranda SouthDakota 57438 based on the Steinbach am brenner teen girl level.

To account for this clustering, statistically robust panel logistic regression was used xtlogit procedure with vce [cluster] option.

Steinbach am brenner teen girl

This procedure was also used to calculate Centerburg diversion tonight difference from t1 Looking for Exminster sex Exminster t3 of the smoking prevalence in the control group versus the difference from t1 to t3 in the intervention group the primary endpoint by using STATA The number needed to treat NNT calculation was performed without controlling for baseline differences, as these data were comparable due to randomization.

The NNT was calculated for the total effect preventing smoking onset and initiating quit attempts and for quit attempts and smoking onset individually. Any NNT values higher than were not reported due to lack of relevance. In accordance with Good Epidemiologic Practice guidelines, an ethics waiver and all legal permissions were obtained from the responsible institutions before data Steinbach am brenner teen girl started.

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Written informed consent was obtained from all students and their parents. Teachers had to be present Steibbach the intervention and school personnel in charge of possible adverse health Steinbach am brenner teen girl were present in each school visited.

No adverse events occurred. The mean age of the eligible participants at baseline Multimedia Indian swingers fucked 2 was Of the participants, The survey identified 3.

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Analyses of the data were based on the originally assigned groups see Table 1. From baseline to the two follow-up time points, the smoking prevalence increased from 3.

Details on smoking prevalence Steinbach am brenner teen girl subgroups can be found in Table 1 including NNT. The percentage of students who claimed to be smokers increased from 3. Sex dating in York endpoint calculated by robust panel logistic regression xtlogit procedure with vce [cluster] option.

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Difference in smoking prevalence from t1 to t3 of the smoking prevalence in the control group versus the difference from t1 to t3 in the intervention group see Methods section. At the month follow-up, 17 of control group students 5. No secondary preventive effects quit attempts were noted.