title: Smoking Prevention for Students: Findings From a Three-Year Program of Integrated Harm Minimization School Drug Education.
abstract: BACKGROUND
  This study investigated the impact of the Drug Education in Victorian Schools (DEVS) program on tobacco smoking. The program taught about licit and illicit drugs in an integrated manner over 2 years, with follow up in the third year. It focused on minimizing harm, rather than achieving abstinence, and employed participatory, critical-thinking and skill-based teaching methods.
  
  
  METHODS
  A cluster-randomized, controlled trial of the program was conducted with a student cohort during years 8 (13 years), 9 (14 years), and 10 (15 years). Twenty-one schools were randomly allocated to the DEVS program (14 schools, n = 1163), or their usual drug education program (7 schools, n = 589). One intervention school withdrew in year two.
  
  
  RESULTS
  There was a greater increase in the intervention students' knowledge about drugs, including tobacco, in all 3 years. Intervention students talked more with their parents about smoking at the end of the 3-year program. They recalled receiving more education on smoking in all 3 years. Their consumption of cigarettes had not increased to the same extent as controls at the end of the program. Their change in smoking harms, relative to controls, was positive in all 3 years. There was no difference between groups in the proportionate increase of smokers, or in attitudes towards smoking, at any time.
  
  
  CONCLUSIONS
  These findings indicate that a school program that teaches about all drugs in an integrated fashion, and focuses on minimizing harm, does not increase initiation into smoking, while providing strategies for reducing consumption and harm to those who choose to smoke.
authors.affiliation: a School of Education, Charles Darwin University , Darwin , Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Midford
authors.affiliation: b Youth Research Centre, University of Melbourne , Carlton , Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Cahill
authors.affiliation: c Health Promotion Evaluation Unit (School of Sport Science, Exercise and Health), University of Western Australia , Crawley , Australia.
authors.forename: Leanne
authors.initials: L
authors.lastname: Lester
authors.affiliation: d Department of Social Work and Public Health, Oxford Brookes University , Oxford , United Kingdom.
authors.forename: David R
authors.initials: DR
authors.lastname: Foxcroft
authors.affiliation: e Department of Research and Evaluation, Royal Far West , Manly , Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Ramsden
authors.affiliation: f Victorian Department of Education and Early Childhood Development , Dandenong , Australia.
authors.forename: Lynne
authors.initials: L
authors.lastname: Venning
mesh_terms: D000293:Adolescent; D005260:Female; D040261:Harm Reduction; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015397:Program Evaluation; D012572:School Health Services; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D013334:Students / Q000523:psychology*
keywords: Australia; Tobacco; education; harm minimization; prevention; school; smoking; students