ASSIST: A stop smoking in schools trial
Our DECIPHer-ASSIST programme is effectively tackling smoking uptake in UK schools.
Smoking is the largest single cause of preventable illness in the UK. Over the last decade the number of adult smokers has fallen - whilst the number of teenage smokers has risen.
There has been no strong evidence to show the effectiveness of anti-smoking programmes in UK schools. Schools in many countries undertake smoking prevention programmes but there has been mixed evidence of their effectiveness. In the past most peer-led approaches have been classroom-based and rigorous assessments are scarce.
It was in response to this challenge that Professor Laurence Moore (formerly School of Social Sciences and DECIPHer, now Glasgow University) and Professor Rona Campbell (University of Bristol) developed and evaluated the ASSIST programme, funded by the Medical Research Council.
The peer supporters approach
The DECIPHer-ASSIST trial recruited peer-nominated students aged 12-13 as 'peer supporters'. They were taught how to intervene with their Year 8 peers in everyday situations to discourage them from smoking. Training was given outside of the school environment.
Fifty-nine schools in South Wales and Bristol were randomly allocated either to continue with their normal smoking education programme, or to do so with additional peer supporter training.
The trial followed the students for two years to see whether smoking prevalence in the intervention schools was lower than in the schools which did not receive the training. It demonstrated that the programme reduced the prevalence of smoking by 10% - and that it is cost-effective.
- Around 10 million adults smoke in the UK.
- Cigarettes are responsible for more than 11,000 deaths worldwide every day.
- Children who start smoking before the age of 16 are twice as likely to continue as adults (compared those who take up the habit later).
Due to the success of the trial a new not-for-profit company, DECIPHer IMPACT was set up in March 2010 to licence the ASSIST programme. The company gives training, materials, support and ongoing quality assurance to Primary Health Care Trusts in England and Public Health Wales.
Since 2010, over 60,000 Year 8 students have taken part in ASSIST. The evidence-based research suggests that approximately 1,650 young people will not go on to take up smoking as a result.
The treatment of lung cancer in England cost the NHS £260.8million during 2009/10. If implemented throughout the UK, it is estimated that the ASSIST programme would prevent 20,000 young people taking up smoking each year.
The company set up to licence the programme, DECIPHer IMPACT, was the overall winner of the Bristol Research and Innovation Group for Health (BRIG-H) 2011 Health Innovation Award. The award recognises outstanding health innovation achievements.
- Hollingworth, W. et al., 2012. Reducing smoking in adolescents: cost-effectiveness results from the cluster randomized ASSIST (a stop smoking in schools trial). Nicotine & Tobacco Research 14 (2), pp.161-168. (10.1093/ntr/ntr155)
- Starkey, F. et al., 2009. Identifying influential young people to undertake effective peer-led health promotion: the example of A Stop Smoking In Schools Trial (ASSIST). Health Education Research 24 (6), pp.977-988. (10.1093/her/cyp045)
- Campbell, R. et al., 2008. An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): a cluster randomised trial. The Lancet 371 (9624), pp.1595-1602. (10.1016/S0140-6736(08)60692-3)