Abstract
Objectives: Evidence from the US Truth® campaign suggests that interventions focusing on tobacco industry practices and ethics may be effective in preventing youth smoking uptake. We developed, piloted and evaluated a school-based intervention based on this premise.
Methods: Exploratory study Students in Years 7–8 (aged 11–13) in two UK schools received Operation Smoke Storm, comprising three 50-minute classroom-based sessions in Year 7, an accompanying family booklet and a 1-hour classroom-based booster session in Year 8. We compared the risk and odds of ever smoking and susceptibility to smoking in Year 8 students in study schools post-intervention compared with students in control schools. Focus groups and interviews with students, teachers and parents evaluated the acceptability of the intervention.
Results: In intervention schools the combined prevalence of ever smoking and susceptibility increased from 18.2% in Year 7 to 33.8% in Year 8. There was no significant difference in the odds of a Year 8 student in an intervention school being an ever smoker or susceptible never smoker compared with controls [adjusted OR 1.28, 95%CI 0.83-1.97, p=0.263] and no significant difference in the odds of ever smoking (aOR 0.82, 95%CI 0.42-1.58, p=0.549). Teachers highlighted differences by academic ability in how well the messages presented were understood. Use of the family component was low but was received positively by parents who engaged with it.
Conclusions: Operation Smoke Storm is an acceptable resource for delivering smoking-prevention education but it does not appear to have reduced smoking and susceptibility.
Strengths and limitations
• We used a mixed-methods design that enabled triangulation of quantitative and qualitative data to strengthen the internal and external validity of the findings.
• Conclusions are based on data from only two intervention schools, which served relatively more affluent and ethnically white populations than the national average.
• The comparison with external, non-randomised control data meant there were significant differences between the characteristics of students in intervention and control schools.
• Logistical difficulties meant we were unable to link students’ responses at baseline and follow-up, though smoking behaviours differed little between intervention and control schools at baseline and analyses were adjusted for confounders measured at follow-up.
Methods: Exploratory study Students in Years 7–8 (aged 11–13) in two UK schools received Operation Smoke Storm, comprising three 50-minute classroom-based sessions in Year 7, an accompanying family booklet and a 1-hour classroom-based booster session in Year 8. We compared the risk and odds of ever smoking and susceptibility to smoking in Year 8 students in study schools post-intervention compared with students in control schools. Focus groups and interviews with students, teachers and parents evaluated the acceptability of the intervention.
Results: In intervention schools the combined prevalence of ever smoking and susceptibility increased from 18.2% in Year 7 to 33.8% in Year 8. There was no significant difference in the odds of a Year 8 student in an intervention school being an ever smoker or susceptible never smoker compared with controls [adjusted OR 1.28, 95%CI 0.83-1.97, p=0.263] and no significant difference in the odds of ever smoking (aOR 0.82, 95%CI 0.42-1.58, p=0.549). Teachers highlighted differences by academic ability in how well the messages presented were understood. Use of the family component was low but was received positively by parents who engaged with it.
Conclusions: Operation Smoke Storm is an acceptable resource for delivering smoking-prevention education but it does not appear to have reduced smoking and susceptibility.
Strengths and limitations
• We used a mixed-methods design that enabled triangulation of quantitative and qualitative data to strengthen the internal and external validity of the findings.
• Conclusions are based on data from only two intervention schools, which served relatively more affluent and ethnically white populations than the national average.
• The comparison with external, non-randomised control data meant there were significant differences between the characteristics of students in intervention and control schools.
• Logistical difficulties meant we were unable to link students’ responses at baseline and follow-up, though smoking behaviours differed little between intervention and control schools at baseline and analyses were adjusted for confounders measured at follow-up.
| Original language | English |
|---|---|
| Journal | BMJ Open |
| Publication status | Accepted/In press - 5 Sept 2017 |