title: Effectiveness of a school-based multi-component smoking prevention intervention: the LdP cluster randomized controlled trial.
abstract: OBJECTIVE
  We assessed the effectiveness of the Luoghi di Prevenzione-Prevention Grounds school-based smoking prevention programme.
  
  
  METHODS
  We undertook a cluster randomized controlled trial of 989 students aged 14-15 years in 13 secondary schools located in Reggio Emilia, Italy. The intervention consisted of the "Smoking Prevention Tour" (SPT) out-of-school workshop, one in-depth lesson on one Smoking Prevention Tour topic, a life-skills peer-led intervention, and enforcement surveillance of school antismoking policy. Self-reported past 30-day smoking of ≥ 20 or 1-19 days of cigarette smoking (daily or frequent smoking, respectively) was recorded in 2 surveys administered immediately before and 18 months after the beginning of the programme. Analysis was by intention to treat. The effect of the intervention was evaluated using random effects logistic regression and propensity score-matching analyses.
  
  
  RESULTS
  Past 30-day smoking and daily cigarette use at eighteen months follow-up were 31% and 46% lower, respectively, for intervention students compared to control students. Taking into account non-smokers at baseline only, daily smoking at eighteen months follow-up was 59% lower in intervention students than in controls. Past 30-day smoking in school areas was 62% lower in intervention students compared to controls.
  
  
  CONCLUSIONS
  The Luoghi di Prevenzione-Prevention Grounds programme was effective in reducing daily smokers and in reducing smoking in school areas.
authors.affiliation: Cancer Prevention and Research Institute (ISPO), Florence, Italy. Electronic address: g.gorini@ispo.toscana.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gorini
authors.affiliation: Cancer Prevention and Research Institute (ISPO), Florence, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Carreras
authors.affiliation: Lega contro i Tumori (LILT) di Reggio Emilia, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Bosi
authors.affiliation: Lega contro i Tumori (LILT) di Reggio Emilia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Tamelli
authors.affiliation: Istituto Oncologico Romagnolo (IOR), Forlì, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Monti
authors.affiliation: Lega contro i Tumori (LILT) di Reggio Emilia, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Storani
authors.affiliation: Cancer Prevention and Research Institute (ISPO), Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Martini
authors.affiliation: Department of Translational Medicine, Avogadro University, Novara, Italy.
authors.forename: Elias
authors.initials: E
authors.lastname: Allara
authors.affiliation: Public Health Service, Emilia-Romagna Region, Bologna, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Angelini
authors.affiliation: Department of Translational Medicine, Avogadro University, Novara, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Faggiano
mesh_terms: D016009:Chi-Square Distribution; D016000:Cluster Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D010379:Peer Group; D011322:Primary Prevention / Q000193:education / Q000379:methods; D015397:Program Evaluation; D012572:School Health Services / Q000331:legislation & jurisprudence / Q000592:standards*; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000331:legislation & jurisprudence / Q000379:methods*; D000074606:Smoking Prevention; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013534:Survival; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cluster randomized control trial; School-based prevention; Smoking prevention; Tobacco; Youth