The 13th World Conference on Tobacco OR Health

Objective: This study evaluates the effects of the European Smoking Prevention Framework Approach study in six countries at 12 (T2) 24 (T4) and 30 months (T5) after the pre-test.

Methods: Randomized control trials were conducted in Finland, Denmark, the United Kingdom and Portugal. Quasi-experimental designs were used in the Netherlands and Spain. The program targeted four levels: adolescents in schools, school policies, parents and the community. The results were analyzed using Multi Level Analyses and Structural Equation Methods.

Results: The programs were similar in overall goals and theoretical methods. The integral prevention strategy chosen did result in different programs in each country. Most attention was given to the individual level, and countries encountered difficulties in setting up community activities. The practical strategies chosen, however, differed in each country, resulting in 6 different approaches. Significant preventive effects were found on cognitions, such as attitudes and self-efficacy expectations, although the results differed per country. Significant effects on regular weekly smoking were found at all post-tests in Finland. Significant effects at T2 and T4 were found in Spain. Significant effects at T4 were identified in Portugal. At the last post-test (T4) the ESFA program was effective for non-native adolescents in the Netherlands. Further in-depth analysis showed that the assumption that smoking onset is caused mainly by peers may need some revision, and future programs should not solely rely on the social influence paradigm.