ASSIST
ASSIST (named for its trial: A Stop Smoking in Schools Trial), is a schools-based smoking prevention programme. It is a universal programme for children between the ages of 12 and 13. It is delivered in secondary schools, and aims to improve resilience and reduce the take-up of smoking.
The programme involves using a questionnaire to identify influential students within schools, and then recruiting them into the programme and delivering interactive skills and information training. These influential peer supporters then disseminate information positively and effectively to empower their friendship groups not to take up smoking.
EIF Programme Assessment
Child outcomes
This programme can affect outcomes for children in Active and healthy, physical and mental wellbeing.
According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:
Preventing substance abuse
Reduced prevalence of smoking in the past week
based on study 1
- Statement: 2.64-percentage point reduction in proportion of participants smoking in the last week (self-report)
- Score: 6
- Timeframe: A year later
- Long term: 1
This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.
Who is it for?
The best available evidence for this programme relates to the following age-groups:
Preadolescents
How is it delivered?
The best available evidence for this programme relates to implementation through these delivery models:
- Group
Where is it delivered?
The best available evidence for this programme relates to its implementation in these settings:
- Secondary school
How is it targeted?
The best available evidence for this programme relates to its implementation as:
- Universal
Where has it been implemented?
- England
- France
- Scotland
- Wales
- Ireland
Ireland provision
Ireland evaluation
About the programme
What happens during the delivery?
How is it delivered?
- ASSIST is delivered in six sessions of varying length – one 20-minute session, three hour-long sessions, and two full-school-day sessions. These are delivered to groups of peer supporters by external trainers.
What happens during the intervention?
- The programme involves four distinct phases:
- Students are nominated by their peers using a questionnaire completed by the whole year group.
- The most nominated 18%, balanced by gender, are then recruited to join the programme as peer supporters.
- These peer supporters will then participate in two days of training away from school where they will be given the skills and information that they need to perform their role. The training is very interactive and student-led. There is much emphasis on influence and persuasion – being empathetic, non-judgmental and understanding about the reasons why people smoke, as well as the benefits of making healthier choices. Students are encouraged to record their conversations in a diary which they bring to each of the follow-ups. These school-based sessions give students and trainers an opportunity to share progress and support each other while also refreshing skills and information.
- At the end of the programme the students are presented with a certificate, as is the school, which is left with a high-quality group of young health ambassadors.
What are the implementation requirements?
Who can deliver it?
- This programme is delivered by a lead trainer with NFQ-6 level qualifications, and two trainers also with NFQ-6 level qualifications.
What are the training requirements?
- Practitioners have 21 hours of programme training each. Booster training of practitioners is not required.
How are the practitioners supervised?
Practitioner supervision is provided through the following processes:
- It is recommended that practitioners are supervised by one host agency supervisor (qualified to NFQ-7/8 level).
- It is recommended that practitioners are also supervised by one programme developer supervisor (qualified to NFQ-7/8 level).
What are the systems for maintaining fidelity?
Programme fidelity is maintained through the following processes:
- Training manual
- Other printed material
- Other online material
- Face-to-face training
- Fidelity monitoring.
Is there a licensing requirement?
There is a licence required to run this programme.
How does it work? (Theory of Change)
How does it work?
- Smoking-related behavioural change in adolescents is propagated by trained peer supporters who promote the benefits of remaining smoke-free and the risks of smoking.
- The programme teaches influential peer supporters’ ways of disseminating information positively and effectively, alongside conflict resolution methods, to empower their friendship groups not to take up smoking.
- In the short term, peer supporters learn about the risks of smoking and the benefits of being smoke-free, and are trained to disseminate these messages in an ad-hoc way by looking for opportunities to include smoking facts in their everyday conversations with their friends.
- In the long term, peer supporters develop leadership and communication skills and build personal resilience, and are more confident and less likely to take up smoking.
Intended outcomes
- Active and healthy, physical and mental wellbeing
Contact details
Sally Good
sally.good@evidencetoimpact.com
About the evidence
ASSIST’s most rigorous evidence comes from a cluster RCT which was conducted in the UK.
This study identified statistically significant positive impact on a number of child outcomes.
This programme is underpinned by one study with a level 3 rating, hence the programme receives a level 3 rating overall.
Study 1
| Citation: | Campbell et al., 2008 |
| Design: | Cluster RCT |
| Country: | United Kingdom |
| Sample: | 10,730 children recruited from 59 schools, with low number of smokers at baseline. |
| Timing: | Post-test; 1-year follow-up; 2-year follow-up |
| Child outcomes: |
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| Other outcomes: | |
| Study rating: | 3 |
Campbell, R., Starkey, F., Holliday, J., Audrey, S., Bloor, M., Parry-Langdon, N., ... & Moore, L. (2008). An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): a cluster randomised trial. The Lancet, 371(9624), 1595-1602.
Available at
https://www.sciencedirect.com/science/article/pii/S0140673608606923
Study design and sample
The first study is a rigorously conducted RCT.
This study involved random stratified-blocked assignment (stratified by country; type of school; size of school; level of entitlement to free school meals) of schools to an ASSIST group or to a control group which continued their usual smoking education.
This study was conducted in the UK, with a sample of 10,730 children recruited from 59 schools in the west of England and southeast of Wales. The sample was relatively diverse in terms of family affluence. Only a small proportion (6%) of children were smokers at baseline.
Measures
Smoking prevalence was measured using a questionnaire asking children to report on whether they had smoked in the past week (self-report).
Findings
This study identified statistically significant positive impact on a child outcome, which was reduced prevalence of smoking in the past week (at 1-year follow-up).