Operation Smoke Storm: qualitative evaluation of a novel intervention to prevent uptake of smoking in schoolchildren

Abstract

Background40% of smokers become addicted before age 16 years and those who start at an early age are less likely to quit and more likely to die from their habit than are those who start later. Evidence from the US truth campaign suggests that interventions focusing on the tactics of the tobacco industry can be effective in preventing smoking uptake by children. Operation Smoke Storm is the first UK intervention based on this premise and we report an evaluation of its acceptability and effectiveness. This resource comprises three classroom sessions in which students act as secret agents uncovering tobacco industry tactics through videos, quizzes, discussions, and presentations. MethodsEight focus groups were conducted with 80 students in year 7 (aged 11–12 years) who had participated in Operation Smoke Storm at two schools in the East Midlands, UK. 18 interviews were conducted with teachers who delivered the intervention. The focus groups and interviews were digitally audiorecorded, transcribed verbatim, and analysed with the Framework method. The study was approved by the University of Nottingham's medical school research ethics committee (reference C13122012 CHS EPH Smoking). FindingsStudents enjoyed the secret agent scenario and reported acquiring new knowledge about smoking and the tobacco industry, which seemed to strengthen their aversion to smoking. Most teachers felt confident about delivering the resource, but would have welcomed more background information about the topic and guidance on how to steer discussions. Teachers highlighted a need for the resource to be flexible and not dependent on lesson length, teacher confidence, or expertise. Students and teachers endorsed the idea of developing a booster component for year 8 students (12–13 years), though stressed practical considerations including computer access. Participants also supported the development of printed information complementing the resource to encourage parents to support their child to not experiment with tobacco. InterpretationAlthough data were only collected from two schools, this rigorously conducted study highlights that Operation Smoke Storm can be delivered by teachers to raise awareness about smoking-related issues. These promising findings are relevant for anyone looking to deliver a novel anti-smoking message to young people and for health policy makers aiming to reduce uptake of smoking. The ideas and issues raised by students and teachers are now being used to improve and extend the resource for further evaluation. FundingNational Institute for Health Research Public Health Research Programme (project number 11/3010/02). The funder had no role in the writing of this abstract or the decision to submit.