Effectiveness of School-based Interventions for Preventing Tobacco Smoking Initiation Among Young People in Low-and-middle-income Countries: a Systematic Review Protocol.

Abstract Background: In-school young people in Low- and Middle-Income Countries (LMICs) are more likely to initiate tobacco use, sustain its use, and are at a higher risk of tobacco related-harms compared to their counterparts in High-Income Countries. Synthesized evidence however on the effectiveness of school-based tobacco prevention interventions for preventing tobacco initiation among young people in LMICs are not documented. We aim to evaluate the effectiveness of school-based interventions compared to non-intervention school programmes in preventing tobacco smoking initiation among young people in LMICs, including Ghana.Methods: The JBI methodology for systematic reviews of effectiveness will guide the conduct of this review. A comprehensive strategic search will be developed to retrieve both published and unpublished studies. Studies published in the English language from the year 2000 will be considered for the review. The processes of study selection, critical appraisal, data extraction, and data synthesis will be in accordance with the JBI approach for reviews of effectiveness. The primary outcome for the review will be the non-initiation of tobacco smoking by the youth. Discussion: We anticipate providing synthesized evidence on the effectiveness of school-based smoking initiation prevention among young people in LMICs. The findings could also support policymakers in regulating and implementing smoke-free laws.Systematic review registration: PROSPERO CRD42021246206