Table 5 Effectiveness of policies on substance misuse (tobacco and alcohol 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

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)