An effective school-based prevention programme for tobacco, alcohol and drugs: the EU-Dap cluster randomized trial

Background The EU-DAP study is a cluster randomized controlled trial investigating the effectiveness of a school-based curriculum in preventing drug use among adolescents, conducted in 7 European countries. The curriculum, based on a comprehensive social life skills approach, was administered during 2004-05 school year in 78 schools (7th, 8th and 9 grades), while 64 schools served as reference group. Methods Schools were randomised into 3 intervention (basic curriculum, basic plus peer involvement and basic plus parent involvement), and a usual curriculum control arm. A pre-test survey was conducted before the implementation, and the post-test survey immediately after the end of the program. Multilevel Analysis was used to investigate the effectiveness of the program in preventing and reducing drug use between pre and post test. Prevalence of use at the country level and individual baseline use were included in the model to take into account of the differences observed at baseline among the centres and the arms. Results The program appear to be effective in reducing the prevalence of use in the last 30 days for all the analysed variables. The results are statistically significant for daily cigarettes smoking, sporadic and regular drunkenness and slightly significant for sporadic use of cannabis. The estimated reduction of use is around 12% for sporadic smoking (at least once in the last 30 days), 28% for sporadic drunkenness, 23% for sporadic use of cannabis, 11% for sporadic use of any drug. The reduction is around 14% for regular smoking (>6 times), 30% for daily smoking (>20 cigarettes), 31% for regular drunkenness (> 3 times) and 24% for regular use of cannabis (> 3 times). Conclusions The EU-Dap project is the first European evaluation of a comprehensive drug prevention program among adolescents. It reduces of 25-30% the daily use of cigarettes, sporadic and regular drunkenness and sporadic use of cannabis.