Cigarette smoking and drug use in schoolchildren: III--evaluation of a smoking prevention education programme.

A one year randomized controlled trial was used to evaluate the effectiveness of a smoking prevention programme designed by health educationalists for 10-12 year old primary schoolchildren. The study was carried out in the Hunter Region of New South Wales, Australia, using a sample of over 6000 children which would be large enough to detect, with high probability, differences of about 5% in smoking prevalence between the treatment and control groups. We report the results from the children surveyed in 1979 and 1980, before and after the programme was implemented. It was found that there were no significant differences in smoking behaviour between treatment and control groups. The changes that the programme did bring about were very small compared with the overall increases in smoking prevalence which occurred during the study period. The programme's effectiveness varied with both the age and sex of the children. It was most successful among older girls, aged 11-12 years, for whom smoking prevalence rates increased from 10.7% in 1979 to 22.6% in 1980 in the treatment group compared with 6.2% to 26.8% in the control group. It was least successful for younger boys, aged 10-11 years, for whom smoking increased from 9.4% to 14.5% in the treatment group compared with 10.3% to 11.8% in the control group. Attitudes changed in parallel with changes in smoking behaviour. Changes in knowledge differed only slightly between treatment and control groups. Inadequate implementation of the programme by some teachers may have been associated with adverse effects on the children's behaviour, attitudes and knowledge.