Four Year Results of a School-Based Anti-Smoking Intervention : The "PEPITES" Cluster Randomized Trial
Stéphanie VIEIRA, Céline LAMBERT, Fabrice CHERUEL, Bruno PEREIRA, Hélène SANCHO-GARNIER
Background PEPITES is an interventional research study, using a cluster-randomized design to assess the effectiveness of interventions both in reducing the tobacco initiation rate and the regular smoking rate of secondary school pupils.Methods The regional National Education authority designated 6 state secondary schools for the PEPITES trial. The 6 schools were randomly allocated to 2 groups: 1 control group (2 clusters), 1 intervention group (4 clusters) with 2 workshops per year during a 4
... ar period. The interventions targeted the variables of the Theory of Planned Behaviors and the reinforcement of psycho-social competencies. The 2 principal outcomes for the PEPITES trial were: the prevalence of pupils having experimented tobacco smoking at the end of years 2, 3 and 4, and the prevalence of regular cigarette smokers at the end of years 2, 3 and 4. The process was also evaluated. To compare the evolution of smoking experimentation over time in the two randomization groups, generalized linear mixed models with logit link function were used, considering the school and student as random effects.Results Globally, over time and regardless of the method of experimentation, the increase in the rate of pupils experimenting is slower in the intervention group than in the control group. The difference between the two groups during this period becomes significant (p=0.03) at the end of 9th grade. Concerning confirmed smokers, we note a slower but not significant increase in the percentage of cigarette smokers in the intervention group. For those who are smoking every day, no increase was noted in the intervention group, whereas a 2.8% increase was noted in the control group at the end of 9th grade.Conclusions The implementation of effective tobacco prevention actions in schools is important, as part of a programmed pathway from nursery school right through to high school. The implementation of the addictions plan for 2018-2020 should contribute to this policy but should rely on programs which have already proven to be effective in the medium and long term like this study.Trial Registration ISRCTN85812512. Retrospectively registered 15 May 2018.