Building teenagers’ resilience to say ‘No’ to smoking

A training programme to help teenagers say “No” if they are offered a cigarette or asked to vape is being offered to schools under a licensing deal signed by the University.

Called INTENT and developed by a team of psychologiststs, the training involves young people creating a series of “if this happens … then I will do this” scenarios, to develop the resilience to deal with pressure from friends or associates to smoke.

As part of the testing of INTENT, 6,115 students were tracked over four years. They were split into a group that received the intervention and a control group that didn’t. Children who at baseline had reported trying a cigarette were excluded from the analysis of the programme’s effectiveness.

In the group that received INTENT training, 29.3% of pupils reported smoking at least once (975 pupils out of 3326). In the control group, 35.8% reported smoking at least once (948 pupils out of 2,648). Overall, the group that received INTENT training saw a 20.4% reduction in pupils who tried a cigarette when compared with the control group.

Students who participated in INTENT were also significantly less likely to transition from e-cigarettes to tobacco cigarettes compared to those that did not receive the intervention.

INTENT, which was developed under the leadership of Professor Mark Conner from the School of Psychology at Leeds, is now being distributed to schools through a licensing arrangement with a not-for-profit organisation called Evidence to Impact, which works through local authority public health teams.

The training programme is targeted at young people aged 11 to 15 and involves eight sessions over four years, with students developing more sophisticated “if … then” plans as they get older and face greater peer pressures.

Anti-smoking campaigns still needed

Paul Harrod, CEO of Evidence to Impact, said: “Although the number of teenage smokers has declined, 16% of 11-year-olds have smoked at least once, and it is important that we continue to invest in prevention. It is better to prevent someone from taking up the habit in the first place than having to invest in expensive cessation programmes later in life.”

Figures from the anti-smoking campaign group ASH (Action on Smoking and Health) reveal that in 2018, 16% of 11 to 15-year-olds (23% in 2012) had smoked at least once – the lowest proportion since the survey began in 1982, when 53% had tried smoking. Although cigarette use has fallen among this age group, smoking is still responsible for early death and chronic illness in later life.

Many people who have become long-term smokers started as 15 or 16-year-olds, so there is a need to equip teenagers with the resilience to reject smoking.

INTENT works by helping pupils develop their own, bespoke plans, by using simple “if this happens, then I will do this” – a process psychologists call an implementation intention plan.

Professor Mark Conner welcomed the launch of the new anti-smoking programme in schools.

He said: “For example, a student might plan that if his friend Callum offers him a cigarette on the way home, then he will say, ‘No thanks, it messes with my asthma’.”

The “If … then” planning is supported by health education messages about the dangers of smoking.

The findings of the evaluation of INTENT are available on the American Psychological Association website.

INTENT offers value for money

Professor Conner added: “I am delighted that INTENT is now being delivered in schools. It is free to schools because it is funded by the local authority or health board. The annual cost could be as low as £1 per pupil per year.”

Evidence to Impact is working with public health teams in seven local authorities. One is Stoke on Trent.

Liz Beacon, Children and Young People Public Health Specialist at Stoke on Trent City Council, said: “We chose INTENT because it is an evidence-based smoking prevention programme which equips young people with useful and practical tools to respond to potentially challenging situations.

“INTENT offers a value for money approach that is less labour intensive to manage and deliver within the school setting and encourages schools to take ownership, making it very sustainable.”

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