Diffusion of effects of the ASSIST school-based smoking prevention intervention to non-participating family members: a secondary analysis of a randomised controlled trial

White, J., Holliday, J., Daniel, R., Campbell, R. and Moore, L. (2019) Diffusion of effects of the ASSIST school-based smoking prevention intervention to non-participating family members: a secondary analysis of a randomised controlled trial. Addiction, (doi:10.1111/add.14862) (PMID:31656057) (Early Online Publication)

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Abstract

Aims: To investigate whether effects of the ASSIST (A Stop Smoking In Schools Trial) school‐based smoking prevention intervention diffused from students to the people they lived with. Design: Secondary analysis of a cluster randomized control trial (cRCT). Setting: England and Wales. Participants: 10,730 students aged 12‐13 years in 59 schools assigned using stratified block randomisation to the control (29 schools, 5,372 students) or intervention (30 schools, 5,358 students) condition. Intervention and comparator: The ASSIST intervention involves 2‐days of off‐site training of influential students to encourage their peers not to smoke over a 10‐week period. The control group continued with their usual education. Measurements: The outcomes were the proportion of students who self‐reported living with a smoker and the smoking status of each resident family member/caregiver. Follow‐up assessments were immediately after the intervention and at 1 and 2 years post‐intervention. Findings: The odds ratio for living with a smoker in the intervention compared with control group was 0.86 (95% confidence interval 0.72, 1.03) immediately after the intervention, 0.84 (0.72, 0.97) at a 1‐year follow‐up, and 0.86 (0.75, 0.99) at a 2‐year follow‐up. In a three‐tier multilevel model with data from all three follow‐ups, student‐reported smoking by fathers (OR = 0.90, 95% CI 0.80, 1.00), brothers (OR = 0.78, 95% CI 0.67, 0.92), and sisters (OR = 0.80, 95% CI 0.69, 0.92) was lower in the intervention compared with control group. Sub‐group analyses by baseline smoking status suggested these effects were more consistent with prevention of uptake than prompting cessation. Conclusions: The ASSIST (A Stop Smoking In Schools Trial) school‐based smoking prevention intervention may have reduced the prevalence of smoking in people who lived with ASSIST‐trained students. This indirect transmission is consistent with the predictions of diffusion of innovations theory which underpins the design of ASSIST.

Item Type:Articles
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Moore, Professor Laurence
Authors: White, J., Holliday, J., Daniel, R., Campbell, R., and Moore, L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Addiction
Publisher:Wiley
ISSN:0965-2140
ISSN (Online):1360-0443
Published Online:26 October 2019
Copyright Holders:Copyright © 2019 Society for the Study of Addiction
First Published:First published in Addiction 2019
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
190877Quinquennial Core FundsLaurence MooreMedical Research Council (MRC)MC_UU_12017/14HW - MRC/CSO SPHSU Support Services
SPHSU14

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