Schools can help to prevent kids starting smoking

“See you round the back of the bike shed at lunchtime?”  That was a familiar whisper from a rebellious bunch of elf maidens when I was at school.  To be followed by a lot of giggling and a smoke cloud rising up from the aforementioned bike shed just after the bell rang.  In those days smoking was more socially acceptable.  There are many more policies in place now to try and prevent the uptake of smoking particularly amongst the young.

The National Institute for Health and Care Excellence (NICE) published one such intervention in 2010, a reference guide on ‘School-based interventions to prevent the uptake of smoking among children and young people’ (NICE PH23).  This has been followed up by a recent report from the Evidence Update Advisory Group (EUAG).  This summarises selected new evidence published since the original literature search was carried out and details any impact it might have on current guidelines. 19 items of evidence were selected from 1 November 2008 to 31 October 2012.

Here are some of the key points from the EUAG Evidence Update:

  • Effective school tobacco policies are enforced, strongly prohibitive with explicit purposes and goals
  • A lesson-based smoking prevention programme prior to secondary school may have long term preventative effects on smoking that continue into secondary school
  • Helping children to develop cigarette refusal behaviour may reduce smoking in the long term
  • ‘Project Toward No Drug Abuse’ (a general substance abuse prevention programme) may prevent smoking among older teenagers from schools with a high drug use risk.  Further research is needed to pilot this intervention in the UK
  • The ‘Smokefree Class Competition’ (an incentive-driven smoking prevention intervention) may not prevent smoking initiation among non-smoking children and adolescents in the long term
  • Limited evidence suggests that a web based programme may help to prevent smoking among some groups of students and could be used in conjunction with other forms of adult-led interventions
  • The ASSIST (A Stop Smoking in School Trial) programme is cost effective and may be more effective among girls of lower socioeconomic status
  • Implementing school-based sessions on resisting substance use, as part of a wider community and university partnership, appears to reduce smoking in the long term

The majority of the findings from the EUAG report are in broad agreement with the recommendations in NICE PH23 and have no impact on the current guidelines.  For a more detailed look at the individual studies involved in the report see the link below.


National Institute for Clinical Health and Excellence School-based interventions to prevent the uptake of smoking among children and young people NICE Public Health Guidance 23.London: NICE, February 2010

Evidence Update 38 – School-based interventions to prevent the uptake of smoking among children and young people (April 2013) [PDF]