School-based smoking prevention by enhancement of life competence - An empirical evaluation

Aim of the Study: An intervention for the prevention of smoking in fifth grades of basic secondary schools is to be evaluated. Method: A non-randomised control group study was performed. The intervention-group consisted of 21 classes from 9 secondary schools of the County of Neuss, the control group of 34 classes from 12 schools of the counties of Neuss and Erft. The intervention consisted of up to 12 teaching units in one academic year with the goal of giving smoking-relevant information and of strengthening social competences. Before and after the intervention, pupils in both study groups answered questionnaires anonymously. The questions focussed on smoking behaviour in the previous four weeks (smoking frequency) and, limited to pupils who had never smoked before in the first interview (never-before-smokers), on the start of smoking. Results: A total of 1082 pupils participated in both interviews (intervention: 462; control: 620). Smoking frequency increased more within the intervention group than in the control group (p < 0.05). In the intervention group more never-before-smokers started smoking than in the control group (12.7% versus 7.8%; p < 0.05). After statistical control of age, sex, nationality, smoking status of relatives and the interaction of these variables with the intervention, both effects are no longer statistically significant. Instead another result is emerging: for pupils with a smoking father, smoking frequency in the intervention group increases significantly less than in the control group (p < 0.01). Conclusions: The intervention had no general effect for all pupils. However, it did have a positive effect specifically for pupils with a smoking father. The whole intervention does not seem to be cost-effective. Specific interventions with a focus on endangered groups could be more cost-effective.