4.7 Article

The effectiveness of a school-based substance abuse prevention program: EU-Dap cluster randomised controlled trial

Journal

PREVENTIVE MEDICINE
Volume 47, Issue 5, Pages 537-543

Publisher

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ypmed.2008.06.018

Keywords

School-based prevention; Substance use; Cannabis; Alcohol drinking; Tobacco; Cluster randomised controlled trial; Comprehensive social-influence model

Funding

  1. European Commission [SPC 2002376]
  2. Compagnia di San Paolo [2002-0703]
  3. Lega Italiana per la Lotta contro i Tumori [2003 43/4]
  4. Swedish Council for Working Life and Social Research [2002-0979]
  5. Stockholm County Council [LS 0401-0117]

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Objective. To evaluate the effectiveness of the school-based drug abuse prevention program developed in the EU-Dap study (EUropean Drug Abuse Prevention trial) in preventing the use of tobacco, alcohol and drugs at the post-test. Methods. Cluster Randomised Controlled Trial. Seven European countries participated in the study: 170 schools (7079 pupils 12-14 years of age) were randomly assigned to one of three experimental conditions or to a control condition during the school year 2004/2005. A pre-test survey assessing past and current substance use was conducted before the implementation of the program. The program consisted in 12-hour class-based curriculum based on a comprehensive social-influence approach. A post-test survey was carried out in all participating schools. 3 months after the end of the program. The association between program condition and change in substance use at post-test was expressed as adjusted Prevalence Odds Ratio (POR), estimated by multilevel regression model. Results. Program effects were found for daily cigarette smoking (POR=0.70; 0.52-0.94) and episodes of drunkenness in the past 30 days (POR=0.72: 0.58-0.90 for at least one episode, POR=0.69: 0.48-0.99 for three or more episodes), while effects on Cannabis use in the past 30 days were of marginal statistical significance (POR=0.77; 0.60-1.00). The curriculum was successful in preventing baseline non-smokers or sporadic smokers from moving onto daily smoking, but it was not effective in helping baseline daily smokers to reduce or stop smoking. Conclusion. School curricula based on a comprehensive social-influence model may delay progression to daily smoking and episodes of drunkenness. (C) 2008 Elsevier Inc. All rights reserved.

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