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Cutting teenage smoking

09 May 2008

Girl breaking cigarette

Smoking rates among teenagers can be reduced by training popular secondary school pupils to promote anti-smoking messages in conversations with friends, a new study has found.

Peer pressure and peer selection play a large part in whether or not a young person smokes. However, peer influence can be also protective, leading to attempts to harness it to positive effect.

Researchers at the University’s Cardiff Institute of Society Health and Ethics (CISHE) and colleagues at Bristol University studied the effectiveness of ‘A Stop Smoking in Schools Trial’ (ASSIST) in 59 schools across western England and Wales, involving 11,000 students aged 12-13 years.

Young people were asked to nominate influential students in their year group. The most popular nominees were invited to train as peer supporters, encouraging others not to start smoking. At a two-day training event, held outside of school and using external trainers, peer supporters learned about the risks of smoking, economic benefits of stopping, communication skills, group work, negotiation, conflict resolution, sensitivity to others, personal values, and building confidence and self-esteem. Over a ten-week period following the training, the peer supporters were asked to have conversations with other students in their year group about the benefits of not smoking.

The researchers found that students in schools running ASSIST were 25 per cent less likely to take up regular smoking than control group pupils immediately after the programme had been run. Pupils were 23 per cent less likely to start regular smoking after one year and 15 per cent less likely after two years. Among pupils most likely to start smoking, there were reductions of 21 per cent (immediately after), 25 per cent (after one year) and 15 per cent (after two years). If implemented on a UK-wide basis, it is estimated that ASSIST could reduce the number of 14-15-year-old school students taking up regular smoking by around 43,000 each year.

CISHE director Professor Laurence Moore said: "Our study has shown that the ASSIST training programme was effective in achievement of a sustained reduction in uptake of regular smoking in adolescents for two years after its delivery. Furthermore, it was well received by both students and staff.

"The study also suggests that increasing resources for smokinge prevention in adolescence rather than entirely focusing on cessation could help to avoid further widening health inequalities."

The ASSIST intervention is now being rolled out across Wales by the National Public Health Service, and by some Primary Care Trusts in England. There is substantial international interest in the programme, notably in Canada and Australia.

The research is published in The Lancet this week.