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ASSIST: A Stop Smoking in Schools Trial

An Evidence-Based Practice

Description

ASSIST is a program that targets adolescents in communities in secondary schools in the west of England and southeast Wales. The goal is to develop an influential group consisting of young people trained to encourage other peers to follow a healthy lifestyle. In order to have an effective intervention, programs have to target groups, such as young people, to reduce tobacco abuse. More than 80% of smokers start smoking before the age of eighteen and each day about 3,450 adolescents between the ages of 12-17 smoke their first cigarette with an estimated that 5.2% of middle school students are already actively smoking. ASSIST targets adolescents through trained peer leaders who encourage other students to resist tobacco use. Early prevention can draw young adolescents away from substance abuse and into a mind set to live a healthier lifestyle. The essential component of this program is first identifying "natural" and "influential" leaders who are "well liked" and "trusted by others". ASSIST will train these young peer leaders to spread the word about resisting the use of tobacco. With the help of Cardiff Institute of Society, Health and Ethics, ASSIST can implement their program to reduce the number of adolescent smokers and its health effects.

Goal / Mission

ASSIST aims to develop a diverse group consisting of young people that will then influence their peers to defy the idea of smoking thus reducing the number of adolescent smokers and reducing its health effects.

Impact

A peer-led intervention reduced smoking among adolescents at a modest cost: the ASSIST program cost of £32 ($42 USD) (95% CI = £29.70–£33.80) per student. The incremental cost per student not smoking at 2 years was £1,500 ($1984 USD) (95% CI = £669–£9,947).

Results / Accomplishments

Data was gathered through questionnaires and saliva samples on four separate instances--at baseline, immediately after the intervention, at 1-year follow-up, and at 2-year follow-up. Even after adjusting for baseline differences, smoking prevalence was lower in the intervention schools than in the control schools at the three follow-up points. Multilevel modeling with data from all three follow-ups shows a 22% decrease in the odds of being a regular smoker in an intervention school versus a control school (OR = 0.78 with 95% CI 0.64-0.96). ASSIST was found to be most successful at the 1-year follow up. The odds ratio of being a smoker among all students at the 1-year follow-up was 0.77 (95% CI 0.59-.099), which was significant (p = 0.043). Among the high-risk group, the odds ratio at the 1-year follow-up was 0.75 (95% CI 0.56-0.99), also found to be significant (p = 0.046).

About this Promising Practice

Organization(s)
Cardiff Institute of Society, Health and Ethics; Department of Social Medicine at the University of Bristol
Primary Contact
Professor Laurence Moore
Cardiff University, Cardiff Inst Soc Hlth & Eth, Sch Social Sci, Cardiff CF10 3BD, S Glam Wales
+44 0141 353 7550
Laurence.Moore@glasgow.ac.uk
https://www.gla.ac.uk/researchinstitutes/healthwel...
Topics
Health / Alcohol & Drug Use
Organization(s)
Cardiff Institute of Society, Health and Ethics; Department of Social Medicine at the University of Bristol
Source
Medical Research Council
Date of publication
2008
Date of implementation
2001
Geographic Type
Urban
Location
United Kingdon
For more details
http://orca.cf.ac.uk/19211/
http://orca.cf.ac.uk/27366/
Target Audience
Children, Teens
Submitted By
Amalia Garcia, Alannah Tomich, Andrea Oliva - UC Berkeley School of Public Health

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  3. Lancaster County School-Community Tobacco Prevention Program

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.