Longitudinal effects of the European smoking prevention framework approach (ESFA) project in Spanish adolescents

Background: To describe the effects of a Spanish smoking prevention programme in the context of an European project on regular smoking, in a sample of Barcelona adolescents. Method: A quasi-experimental design was conducted. An experimental group (EG) (1080 pupils) was exposed to programme and compared with a control group (CG) (872 students). The intervention included a school-based programme (16 sessions in 3 years), reinforcement of a smoke-free school policy, smoking cessation for teachers, brochures for parents and other community-based activities involving youth clubs and tobacco sales. Results: At 12 months, 4.5 of boys and 5.6 of girls were new smokers in the EG versus 6.7 and 11.7 in the CG (P < 0.001). At 36 months, 18.6 of boys and 31.2 of girls in the EG were regular smokers versus 21.6 of boys and 38.3 of girls in the CG (P < 0.001). The main factors associated with progression to regular smoking at 36 months were to be girl, to attend to a public school and to belong to the CG. Conclusion: These results endorse the effectiveness of multi-modal smoking prevention programmes, which include strategies with adults who influence adolescents.