Topic 1 Introduction

  • Placing the high-risk students all together has been shown that increases risky behaviour (Poulin and Dishion, 2001, in European Prevention Curriculum (EUPC), 2019); however, delivering an intervention at the general population of the school does not stigmatize any student while at the same time, the intervention is delivered to all students.
  • The three more common models on which education programmes are based for a preventive intervention are:

a)Information deficit/rational model: Programmes following this model provide information about the health risks and negative social consequences of tobacco use so to address “knowledge deficits” mainly to provoke negative feelings such as fear, concern, or disgust. 

b)Affective education model: The programmes try to influence beliefs, attitudes, intentions, and norms related to tobacco use with a focus on enhancing self-esteem and values.

c)Social influence resistance model (Bruvold, 1993; Lantz et al., 2000): This model emphasises that, in addition to individual factors like knowledge and attitudes, the social environment is a critical factor in tobacco use. From that, it places focus on social environment factors that can influence tobacco use, including peer behaviour and attitudes, and certain aspects of environmental, familial, and cultural contexts. The programmes focus on building skills to resist negative influences, for example, communication and decision-making skills, assertiveness training, and recognition of industry advertising tactics and peer influences.

  • The scientific results from many school-based tobacco use prevention programs implemented primarily at the elementary school and/or middle school level, showed that educational programs based on the social influence resistance model are the most effective ones, in terms of smoking initiation and level of use. 
  • In this portal of the European Monitoring Center for Drugs and Drugs Addiction, there is information of programmes implemented in the prevention of tobacco use, evaluated from beneficial, to programmes with evidence of ineffectiveness.
  • For instance, multi-component programmes, with both family and schools interventions, for preventing smoking among children and adolescents were found in a systematic review (Thomas, 2015, 27 RCTs), to be more effective (Rating: Beneficial) than school-only intervention in:

a)reducing smoking in adolescents who never smoked at baseline 

b)reducing smoking in adolescents who were smokers at baseline


Increased knowledge, experience-sharing, political will, appropriate resources and sound strategies are required to scale-up efforts against tobacco use (WHO, European Tobacco Use – Trends Report, 2019).

We recommend that you take some time to navigate on the portal and find out other beneficial but also ineffective programmes in the field.

Older participants ages 16 to more than 20 years

Project Toward No Drug Abuse (TNT)

Description of methodology: 

  • The programme is for 7th-grade students and is composed of ten core lessons (normative social influence, informational social influence, and physical consequences) and two booster lessons of 40-50 minutes.
  • The ten core lessons are designed to occur during two weeks, with the possibility to be spread out over as long as four weeks with the only condition that all lessons are taught.
  • The curriculum uses a wide variety of activities to encourage student involvement and participation.
  • These activities include games, videos, role-plays, large and small group discussions, use of student worksheets, homework assignments, activism letter writing, and a videotaping project.
  • The booster lessons are designed to be taught one year after the core lessons. It is recommended that the booster lessons be delivered in a two-day sequence, although they could be taught one lesson per week. They summarise the learned material and discuss how this material might be used in daily living.
  • For the implementation of the training, there is a manual that provides step-by-step instructions for completing the lessons, along with introductory material. Other components of the curriculum include two videos (one on assertive refusal and the other on combating tobacco use-specific social images), a student workbook, and an optional kit that includes posters and other instructional materials. A teacher training before program implementation, conducted by a certified trainer, is recommended.

To ensure program effectiveness, the program needs to be taught, following the below:

  • Completion of all 10 core lessons and 2 booster sessions, in the recommended time frames.
  • Implementation of the lessons during 40–50-minute periods.
  • Use of the program materials.
  • Dedicated, enthusiastic, trained teachers.

Outcomes of evaluation of the programme:

It was shown that this program succeeded in: 

  • Obtaining significant effects on initiation and weekly use of smokeless tobacco and cigarettes. 
  • Reducing the initiation of cigarettes by approximately 26% over the control group, when one-year and two-year follow-up outcomes were averaged together. 
  • Reducing the initiation of smokeless tobacco use by approximately 30%.
  • Reducing weekly or more frequent cigarette smoking by approximately 60%.
  • Eliminating weekly or more frequent smokeless tobacco use.

For more details on evaluation, click here.