Smoking Prevention for Students: Findings From a Three-Year Program of Integrated Harm Minimization School Drug Education

ABSTRACT

Background: This study investigated the impact of the Drug Education in Victorian Schools (DEVS) program on tobacco smoking. The program taught about licit and illicit drugs in an integrated manner over 2 years, with follow up in the third year. It focused on minimizing harm, rather than achieving abstinence, and employed participatory, critical-thinking and skill-based teaching methods. Methods: A cluster-randomized, controlled trial of the program was conducted with a student cohort during years 8 (13 years), 9 (14 years), and 10 (15 years). Twenty-one schools were randomly allocated to the DEVS program (14 schools, n = 1163), or their usual drug education program (7 schools, n = 589). One intervention school withdrew in year two. Results: There was a greater increase in the intervention students' knowledge about drugs, including tobacco, in all 3 years. Intervention students talked more with their parents about smoking at the end of the 3-year program. They recalled receiving more education on smoking in all 3 years. Their consumption of cigarettes had not increased to the same extent as controls at the end of the program. Their change in smoking harms, relative to controls, was positive in all 3 years. There was no difference between groups in the proportionate increase of smokers, or in attitudes towards smoking, at any time. Conclusions: These findings indicate that a school program that teaches about all drugs in an integrated fashion, and focuses on minimizing harm, does not increase initiation into smoking, while providing strategies for reducing consumption and harm to those who choose to smoke.

KEYWORDS:

• Tobacco
• smoking
• school
• students
• education
• prevention
• harm minimization
• Australia

Additional information

Funding

This work was supported by the Australian Research Council—Linkage Project and the Victorian Department of Education and Early Childhood Development.

Notes on contributors

Richard Midford

Richard Midford is Professor of Health in Education, in a joint appointment between Charles Darwin University and the Menzies School of Health Research. He also holds an adjunct appointment at the Australian National Drug Research Institute. His research focuses on social and emotional wellbeing, how alcohol and drug harm prevention programs can be developed in partnership with local communities, prevention in workplace settings and development of effective school drug education.

Helen Cahill

Helen Cahill is Associate Professor and Deputy Director of the Youth Research Centre in the Graduate School of Education at the University of Melbourne. She is the author of a range of school and community education programs used in Australia and the Asia-Pacific region addressing issues relating to social and emotional learning, alcohol and other drug use, HIV prevention, mental health promotion, and reduction of gender-based violence. She specializes in the involvement of young people in participatory research.

Leanne Lester

Leanne Lester is an Associate Professor in the Health Promotion Evaluation Unit of The School of Sports Science, Exercise and Health at the University of Western Australia. She is an epidemiologist and biostatistician with experience in school based research focusing on child and adolescent health.

David R. Foxcroft

David R. Foxcroft is Professor of Community Psychology and Public Health at Oxford Brookes University. His research is oriented to understanding (and improving) behavior in context, especially how social structures (e.g. families, schools, communities, employers, regulation, government) can support improved health and wellbeing in communities and populations. A focus is the prevention of risk behaviors in children and young people.

Robyn Ramsden

Robyn Ramsden is the Research and Evaluation Manager at Royal Far West, an organization providing allied health services to children living in rural and remote parts of Australia. She holds an honorary fellowship at Deakin University in the School of Health and Social Sciences. Her most recent research and evaluation work has focused on addressing the gaps in health services in rural and remote Australia using telehealth.

Lynne Venning

Lynne Venning is Senior Wellbeing and Engagement Officer with the Victorian Department of Education and Training. Her role is to support schools across the South-Eastern region with the implementation of wellbeing and engagement policies and to support schools with their implementation of drug education programs.