摘要：Objectives. We synthesized evidence regarding effective strategies for smoking cessation among employed or unemployed young adults aged 18 to 24 years. Methods. For this knowledge synthesis, we used (1) a systematic review of the scientific literature, (2) a Delphi panel of experts, and (3) 6 focus groups of employed and unemployed young adult smokers. Results. Of 51 related studies, only 4 included employed and unemployed young adults in their samples (as opposed to students), and none focused solely on them. Using the Delphi process, 27 experts reached consensus on priorities for research, practice, and policy, emphasizing population engagement, recruitment, and innovative interventions. Key themes from focus groups were that interventions should be relevant to young adults, individual choice should be respected, and the positive aspects of quitting should be stressed. Despite having negative views on traditional smoking cessation methods, participants expressed optimism about being able to quit and proposed creative recommendations. Conclusions. Our findings set an agenda for targeting research, improving practice, and informing policy for smoking cessation among young adults. We also demonstrate the value of using 3 complementary approaches: literature review, expert opinion, and target population perspectives. When only community members have the experience, and only academics have the theories, both forms of knowledge are weakened. —Randy Stoecker 1 Although smoking rates for both adults and adolescents have decreased over the past 20 years in North America, rates for young adults aged 18 to 24 years have not changed substantially. 2 – 4 In Canada, as in other developing countries, young adults have the highest smoking rate of all age groups, and many make numerous unsuccessful attempts at quitting. 3 Yet this population has been largely overlooked in research, practice, and policy regarding effective programs for smoking cessation. Although an extensive scientific literature that can direct interventions in smoking prevention and cessation among adults has evolved, 5 , 6 such a body of knowledge does not exist for young adults. 7 The 2 groups of young adults at particular risk for tobacco use are the employed and the unemployed (as opposed to students). 8 – 11 Lantz noted that smoking rates were significantly higher among those not in school, making it conceivable that differential approaches and interventions are needed for specific subgroups of young adults. 9 Although there are numerous studies on college students, there is a dearth of research and programs aimed at the large proportion of working and nonworking young adults. What is known about smoking cessation with this population? We systematically reviewed and synthesized the evidence regarding effective smoking cessation strategies for adults aged 18 to 24 years who were employed or unemployed. Using a better-practices approach, 12 we explored the value of 3 distinct but complementary approaches to smoking cessation among young adults: (1) a systematic review of the relevant literature, both published and unpublished; (2) a Delphi process to synthesize expert opinion; and (3) focus groups composed of young adult (aged 18–24 years) Canadian employed and unemployed smokers. We present an overview of the main findings and key recommendations. A detailed description of the methods and findings is presented in the full background report. 13
