Abstract
BackgroundIn France smoking initiation rates amongst 11 to 16 year-olds are worryingly high. Several studies show that early initiation to psycho-active substances is a strong predictor of tobacco addiction. Decreasing the age at which tobacco use starts represents a key challenge for reducing tobacco usage. Implementing an intervention trial using educational workshops based on the Theory of Planned Behavior (TPB) and covering the 4 years of secondary school could be effective.Methods“PEPITES” is an interventional research, using a cluster randomized design. It will allow assessing the effectiveness of interventions both in reducing the tobacco initiation rate and the regular smoking rate of secondary school pupils. We will also evaluate the process of the implementation of the study and thus will help to the transferability of the intervention.A partnership convention was signed between the JDB Foundation and the National Education authority which designated 6 secondary state schools for the PEPITES trial.The 6 schools were randomly allocated to 3 groups of 2 clusters each: 1 control group, 2 different intervention groups with 2 workshops per year during 4 years; In one of this group the 2 last workshops will be dedicated to measure the loss of taste due to tobacco smoking. In each school, all pupils in year 1 with a signed parental authorization (744 pupils) have been included in the trial. The interventions targets one of the variables of the TPB and the reinforcement of psycho-social competencies. We estimated that we could detect a reduction of increase ≥5.5 and 8% respectively in the 2 principal outcomes (risk α of 5%, and β of 80%).DiscussionCarrying out a randomized prevention trial in the school environment raises specific problems which it seems useful to detail for other educational actors who would like to perform a similar study.This discussion concerns the acceptation and cooperation of the National Education partners, the risks of contamination, the information given to parents and pupils and their consent, and the representativeness of the schools involved.Trial registrationISRCTN85812512. Registered 15 May 2018 by BioMed Central. (retrospectively registered).
Highlights
In France smoking initiation rates amongst 11 to 16 year-olds are worryingly high
This paper describe the protocol of the PEPITES trial (Program in Essonne for the Prevention of the Initiation to Tobacco through Education in the School environment), and its implementation in 6 secondary schools in the Essonne department
Population selection and randomization A partnership convention was signed between the Justin De Bouville (JDB) Foundation and the Essonne National education authority which designated 6 secondary mixed sex state schools for the PEPITES trial as part of their commitment to health education
Summary
In France smoking initiation rates amongst 11 to 16 year-olds are worryingly high. In France smoking initiation rates amongst 11 to 16 year-olds continue to be worryingly high, with some positive indicators in the Ile-de-France Paris region (IDF) compared to the rest of the French mainland [1]. In the early 2000s, tobacco usage was falling, the numbers have since leveled off, as demonstrated by the 2011 and 2014 Escapad surveys [4] In this context, the French Social Affairs Ministry launched a national policy to try to reduce the number of people smoking daily to below 20% by 2024 [5]. In France, until now, few actions have been effective in pushing back the age at which tobacco is first consumed and in reducing tobacco addiction amongst young people
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