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A Stop Smoking in Schools Trial (ASSIST)

The following people are involved with this project:

More about this project

A randomised controlled trial of the effectiveness of a school-based, peer-led smoking intervention.

Smoking is the largest single cause of preventable illness in the UK, but whilst adult smoking prevalence has been falling, smoking amongst teenagers has risen over the last decade. Much money, time and effort is spent on anti-smoking programmes in UK schools, yet there is no rigorous evidence to support the effectiveness of any of these programmes.

This project evaluated a different approach, which was not classroom-based or teacher-delivered. Instead, peer-nominated students in Year 8 (aged 12-13) were recruited as 'peer supporters' and given intensive training off the school premises by professional health promotion staff. The peer supporters were trained to intervene informally with their Year 8 peers in everyday situations to discourage them from smoking (Audrey et al., 2004). This approach was based on that used in a successful intervention to reduce unsafe sexual practices among gay men ( Prior to the full-scale trial, the approach had been tested in a feasibility study conducted in four South Wales schools in the mid 1990's (Bloor et al, 1999).

The large-scale effectiveness trial, known as ASSIST, is funded by a grant of £1.5m from the Medical Research Council, and is led by Dr Rona Campbell from the Department of Social Medicine at the University of Bristol, and Professor Laurence Moore from the Cardiff Institute of Society, Health and Ethics. The project aims to test the effectiveness of the intervention using a pragmatic cluster randomised trial design. Fifty-nine schools in South East Wales and the West of England were randomly allocated either to continue with their normal smoking education programme, or to do so with the additional peer supporter programme.

Students were followed up for two years to assess whether smoking prevalence in the intervention schools was lower than that in the schools which did not receive the programme. In addition, the study involved a substantial component of process evaluation, and an economic evaluation to assess the gains of the intervention against the costs of achieving them.

Analysis of the trial data is currently underway, and papers reporting the results of the process, outcome and economic evaluations are under preparation. Results from the one-year follow-up data were presented at the Society for Social Medicine’s Annual Meeting in September 2004 (Moore at al, 2004). Two dissemination conferences were held in November 2004, at which the results of the trial were fed back to participating schools. These dissemination events also attracted representatives of local, regional and national health authorities, and included discussion of how the ASSIST intervention could be implemented and funded in the future (See Issue 4 of the CISHE Newsletter for more information).

Project dates
01 Feb 2001 - 01 Apr 2005
Project director(s):
Rona Campbell
Prof Laurence Moore - CISHE Cardiff University
Dr Nina Parry-Langdon - Welsh Assembly Government
Prof Michael Bloor - Centre for Drug Misuse Research Glasgow University
Project funder:
Medical Research Council (£1.5 million), with contributions from Bro Taf, Morgannwg and Gwent Health Authorities
Project collaborator(s):
Cardiff Institute of Society - Health and Ethics
Centre for Drug Misuse Research - Glasgow University
Rona Campbell