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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 12:00 PM

Can we successfully harness peer influence to prevent smoking in adolescence? Lessons from A Stop Smoking in Schools Trial, England and Wales, 2001-2005

Laurence A.R. Moore, PhD, MSc1, Rona M. Campbell, PhD2, Fenella A. Starkey, PhD2, Joanne C. Holliday, MA1, Suzanne Audrey, PhD2, Nina Parry-Langdon, PhD3, and Mick Bloor, PhD4. (1) Cardiff Institute of Society, Health and Ethics, Cardiff University, 53, Park Place, Cardiff, CF10 3AT, United Kingdom, (2) Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol, BS8 2PR, United Kingdom, (3) Public Health Improvement Division, Welsh Assembly Government, Cathays Park, Cardiff, CF10 3NQ, United Kingdom, (4) Faculty of Law, Business and Social Sciences, University of Glasgow, 89 Dumbarton Road, Glasgow, G11 6PW, United Kingdom

Objective: ASSIST evaluated a novel ‘diffusion of innovation' approach which identified influential students in Year 8 (aged 12-13) using peer nomination techniques. These ‘peer supporters' were trained to informally intervene in everyday situations to encourage their fellow students not to smoke. ASSIST was based on CDC's Popular Opinion Leader intervention to change risky sexual norms and behaviors in the gay community (Kelly 1997).

Methods: Cluster randomised trial among 10730 students in 59 schools in the West of England and South-East Wales. Self-report questionnaires, social network data and saliva cotinine samples were obtained at one and two year follow-up. The trial included a nested process evaluation.

Results: Response rates were over 92% throughout. At one-year follow-up, regular (weekly) smoking prevalence by treatment group was 23.1% (control: 95% CI=19.9-26.6) and 18.8% (intervention: 95% CI=15.7-22.4) among students who were experimental or occasional smokers at baseline, and 14.5% (C: 95% CI=12.4-16.9) and 11.7% (I: 95% CI=9.7-13.9) among all students. Cotinine validated results support these findings, suggesting an effect size of a magnitude of public health importance. Two-year follow-up data are currently being analysed and will be included in this presentation.

The session will comprise 4 presentations by ASSIST team-members, chaired by Professor Moore. The first will describe the trial methods and results. The wider implications of the study will be discussed with the aid of presentations on the peer nomination process to identify influential students; analysis of the peer supporters' social networks; and qualitative analysis of the perceptions and experiences of the peer supporters.

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