Abstract
Aims
To investigate whether effects of the ASSIST (A Stop Smoking In Schools Trial) school‐based smoking prevention intervention diffused from students to the people they lived with.
Design
Secondary analysis of a cluster randomized control trial (cRCT).
Setting
England and Wales.
Participants
10,730 students aged 12‐13 years in 59 schools assigned using stratified block randomisation to the control (29 schools, 5,372 students) or intervention (30 schools, 5,358 students) condition.
Intervention and comparator
The ASSIST intervention involves 2‐days of off‐site training of influential students to encourage their peers not to smoke over a 10‐week period. The control group continued with their usual education.
Measurements
The outcomes were the proportion of students who self‐reported living with a smoker and the smoking status of each resident family member/caregiver. Follow‐up assessments were immediately after the intervention and at 1 and 2 years post‐intervention.
Findings
The odds ratio for living with a smoker in the intervention compared with control group was 0.86 (95% confidence interval 0.72, 1.03) immediately after the intervention, 0.84 (0.72, 0.97) at a 1‐year follow‐up, and 0.86 (0.75, 0.99) at a 2‐year follow‐up. In a three‐tier multilevel model with data from all three follow‐ups, student‐reported smoking by fathers (OR = 0.90, 95% CI 0.80, 1.00), brothers (OR = 0.78, 95% CI 0.67, 0.92), and sisters (OR = 0.80, 95% CI 0.69, 0.92) was lower in the intervention compared with control group. Sub‐group analyses by baseline smoking status suggested these effects were more consistent with prevention of uptake than prompting cessation.
Conclusions
The ASSIST (A Stop Smoking In Schools Trial) school‐based smoking prevention intervention may have reduced the prevalence of smoking in people who lived with ASSIST‐trained students. This indirect transmission is consistent with the predictions of diffusion of innovations theory which underpins the design of ASSIST.
To investigate whether effects of the ASSIST (A Stop Smoking In Schools Trial) school‐based smoking prevention intervention diffused from students to the people they lived with.
Design
Secondary analysis of a cluster randomized control trial (cRCT).
Setting
England and Wales.
Participants
10,730 students aged 12‐13 years in 59 schools assigned using stratified block randomisation to the control (29 schools, 5,372 students) or intervention (30 schools, 5,358 students) condition.
Intervention and comparator
The ASSIST intervention involves 2‐days of off‐site training of influential students to encourage their peers not to smoke over a 10‐week period. The control group continued with their usual education.
Measurements
The outcomes were the proportion of students who self‐reported living with a smoker and the smoking status of each resident family member/caregiver. Follow‐up assessments were immediately after the intervention and at 1 and 2 years post‐intervention.
Findings
The odds ratio for living with a smoker in the intervention compared with control group was 0.86 (95% confidence interval 0.72, 1.03) immediately after the intervention, 0.84 (0.72, 0.97) at a 1‐year follow‐up, and 0.86 (0.75, 0.99) at a 2‐year follow‐up. In a three‐tier multilevel model with data from all three follow‐ups, student‐reported smoking by fathers (OR = 0.90, 95% CI 0.80, 1.00), brothers (OR = 0.78, 95% CI 0.67, 0.92), and sisters (OR = 0.80, 95% CI 0.69, 0.92) was lower in the intervention compared with control group. Sub‐group analyses by baseline smoking status suggested these effects were more consistent with prevention of uptake than prompting cessation.
Conclusions
The ASSIST (A Stop Smoking In Schools Trial) school‐based smoking prevention intervention may have reduced the prevalence of smoking in people who lived with ASSIST‐trained students. This indirect transmission is consistent with the predictions of diffusion of innovations theory which underpins the design of ASSIST.
| Original language | English |
|---|---|
| Journal | Addiction |
| Early online date | 26 Oct 2019 |
| DOIs | |
| Publication status | E-pub ahead of print - 26 Oct 2019 |
Structured keywords
- DECIPHer
Keywords
- smoking
- prevention
- peers
- family
- spill over
- diffusion