The effectiveness of a school-based substance abuse prevention program: 18-month follow-up of the EU-Dap cluster randomized controlled trial.

AIM: To evaluate the effectiveness of a school-based substance abuse prevention program developed in the EU-Dap study (EUropean Drug Addiction Prevention trial). MATERIALS AND METHODS: Cluster Randomized Controlled Trial. Seven European countries participated in the study; 170 schools (7079 pupils 12-14 years of age) were randomly assigned to one of three experimental conditions or to a control condition during the school year 2004/2005. The program consisted of a 12-h curriculum based on a comprehensive social influence approach. A pre-test survey assessing past and current substance use was conducted before the implementation of the program, while a post-test survey was carried out about 18 months after the pre-test. The association between program condition and change in substance use at post-test was expressed as adjusted prevalence odds ratio (POR), estimated by multilevel regression models. RESULTS: Persisting beneficial program effects were found for episodes of drunkenness (any, POR=0.80; 0.67-0.97; frequent, POR=0.62; 0.47-0.81) and for frequent cannabis use in the past 30 days (POR=0.74; 0.53-1.00), whereas daily cigarette smoking was not affected by the program as it was at the short-term follow-up. Baseline non-smokers that participated in the program progressed in tobacco consumption to a lower extent than those in the control condition, but no difference was detected in the proportion of quitters or reducers among baseline daily smokers. CONCLUSION: The experimental evaluation of an innovative school curriculum based on a comprehensive social influence approach, indicated persistent positive effects over 18 months for alcohol abuse and for cannabis use, but not for cigarette smoking.

School-based alcohol education: results of a cluster-randomized controlled trial.

OBJECTIVE: This study aimed to examine the effects of a school-based alcohol education intervention. DESIGN: Two-arm three-wave cluster-randomized controlled trial, with schools as the unit for randomization. Surveys were conducted prior to intervention implementation, then 4 and 12 months after baseline. SETTING: A total of 30 public schools in Schleswig-Holstein, Germany. Participants Baseline data were obtained from 1686 7th graders. The retention rate was 85% over 12 months. Intervention The intervention consisted of four interactive lessons conducted by teachers, booklets for students and booklets for parents. MEASURES: Knowledge, attitudes, life-time alcohol consumption (ever use alcohol without parental knowledge, ever been drunk and ever binge drinking) and past-month alcohol use. RESULTS: Intention-to-treat analyses revealed that intervention status was associated with more general knowledge about alcohol and lower levels of life-time binge drinking. No effects were found with respect to students' self-reported attitudes, intentions to drink, life-time alcohol use and past-month alcohol use. CONCLUSIONS: The results indicate that this brief school-based intervention had a small short-term preventive effect on alcohol misuse.

The effectiveness of a school-based substance abuse prevention program: EU-Dap cluster randomised controlled trial.

OBJECTIVE: To evaluate the effectiveness of the school-based drug abuse prevention program developed in the EU-Dap study (EUropean Drug Abuse Prevention trial) in preventing the use of tobacco, alcohol and drugs at the post-test. METHODS: Cluster Randomised Controlled Trial. Seven European countries participated in the study; 170 schools (7079 pupils 12-14 years of age) were randomly assigned to one of three experimental conditions or to a control condition during the school year 2004/2005. A pre-test survey assessing past and current substance use was conducted before the implementation of the program. The program consisted in 12-hour class-based curriculum based on a comprehensive social-influence approach. A post-test survey was carried out in all participating schools, 3 months after the end of the program. The association between program condition and change in substance use at post-test was expressed as adjusted Prevalence Odds Ratio (POR), estimated by multilevel regression model. RESULTS: Program effects were found for daily cigarette smoking (POR=0.70; 0.52-0.94) and episodes of drunkenness in the past 30 days (POR=0.72; 0.58-0.90 for at least one episode, POR=0.69; 0.48-0.99 for three or more episodes), while effects on Cannabis use in the past 30 days were of marginal statistical significance (POR=0.77; 0.60-1.00). The curriculum was successful in preventing baseline non-smokers or sporadic smokers from moving onto daily smoking, but it was not effective in helping baseline daily smokers to reduce or stop smoking. CONCLUSION: School curricula based on a comprehensive social-influence model may delay progression to daily smoking and episodes of drunkenness.

Smoking in a popular German television crime series 1985-2004.

OBJECTIVE: We aimed to study the prevalence of smoking in a popular German television crime series ("A case for two"), which has been internationally distributed in 59 countries, over a 20 year period. METHOD: A content analysis of five randomly selected episodes per year of one crime series for the period 1985 to 2004 (100 episodes in total) was conducted. Smoking status of all major and minor series characters was assessed. Each episode was coded regarding one or more smoking occurrences, defined as active smoking or handling with tobacco products by a character. RESULTS: 97% of the episodes portrayed tobacco use with a median of 5 occurrences per episode. The series contained 1013 major and minor characters; the overall smoking prevalence was 17.1%. A downward trend in smoking occurrences and prevalence of major and minor characters who smoke from 1985 was followed by an increase in the last decade. CONCLUSION: Tobacco use is frequently portrayed in a popular prime-time German crime series, following a U curve over a 20 year period.

Smoking in contemporary German television programming.

OBJECTIVE: To study the prevalence of smoking in German television in 2005. METHODS: Content analysis of all programmes of the four main national channels Das Erste, ZDF RTL and Pro7 over one week between 3 pm and 12 pm. A total of 395 programmes were analysed (252 h of programming). Each programme was coded regarding whether there was one or more smoking occurrence, defined as active smoking or handling with tobacco products by a character. RESULTS: Smoking was portrayed in 176 (45%) of the programmes. Smoking occurrences were frequent in movies (77%), and in TV magazines (69%). Movies, films, and serials produced in Germany showed more often smoking (65%) compared with productions from abroad (48%; p = 0.051). CONCLUSIONS: Smoking is frequently portrayed in German TV.

Initial evaluation of a real-world self-help smoking cessation programme for adolescents and young adults.

There is a lack of effective smoking cessation programmes for young people, despite the urgent need for them. The present study reports the initial results of a real-world self-help cessation programme which also contained a "quit and win"-contest component designed for adolescents and young adults. Consecutive registrants (N=1265) were surveyed 11 to 23 months after they registered to the programme to assess continuous abstinence. Results must be interpreted cautiously because this is an uncontrolled study with a 20.7% response rate (N=262). The programme was assessed positively by the participants. Results showed an 8.5% intention-to-treat quit rate with an average duration of 51.30 weeks continuous abstinence. Predictors for successful smoking were occasional smoking (not daily smoking) and older age.

Effectiveness of the "Smoke-Free Class Competition" in delaying the onset of smoking in adolescence.

BACKGROUND: This paper examines the effectiveness of the "Smoke-Free Class Competition" in delaying the onset of smoking in adolescence. Each participating class must decide if they want to be a "smoke-free class" for the 6-month period from fall to spring. Classes monitor their (non-)smoking behavior and report it to the teacher regularly. Classes in which pupils refrain from smoking for this period of time participate in a prize draw, in which they can win a number of attractive prizes. METHODS: To evaluate the effectiveness of the competition, a sample of 131 participating and nonparticipating classes (number of pupils 2,142; mean age 12.9 years, SD = 0.98) was compared with regard to their smoking behavior. Smoking status was determined by self-assessment on three occasions: (a) prior to the beginning of the competition, (b) 1 month after the competition, and (c) 1 year after the start of the competition. RESULTS: From pretest to posttest smoking increased by 7.5% in the comparison group, while it decreased by 0.2% in the intervention group (OR = 2.19; P < 0.001). In the follow-up measurement, a clear increase in smoking prevalence occurs in all groups; however, the pupils in the intervention condition still have a significant lower increase of smoking (OR = 1.45; P < 0.01). Moreover, with regard to the nonsmokers at baseline, pupils in the comparison group showed significantly higher prevalences in smoking than the intervention group in the postmeasurement, 7.8 versus 13.9% (OR = 1.98; P < 0.001), as well as in the in the follow-up-measurement, 17 versus 21.3% (OR = 1.36; P < 0.05). CONCLUSIONS: The results suggest that the participation in the competition could delay the onset of smoking in adolescence.