Unplugged”: a school-based prevention program for tobacco, alcohol and drugs: effectiveness on alcohol use at 1 year follow-up

Introduction The empirical evidence of effectiveness of school-based programs against substance abuse is rather weak, and most high quality evaluation studies have been conducted in North America. The EU-Dap study is a multicenter cluster randomized trial funded by the European Commission in 2002 and designed to conduct a rigorous evaluation of an innovative school-based curriculum for the prevention of substance use in European junior high schools. Methods The “Unplugged” program, based on a comprehensive social influence approach and consisting of 12 one-hour sessions delivered by class teachers, was implemented in seven European countries during the 2004-2005 school year. One hundred and forty-three schools (7th, 8th and 9th grade) were randomised into three intervention arms (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 of the program (n=7079), while two post-test surveys were conducted afterwards, the first 3 months after the end of the program (n=6370), and the second at 1 year follow-up (n=5541). Multilevel Analysis was used to investigate the effectiveness of the program in preventing and reducing drug use at the post test and at one year follow-up. Results At the post-test, the program was effective in reducing the prevalence of use in the last 30 days for all the analysed variables. For sporadic drunkenness episodes the reduction was 28% and 31% for regular ones (>3 times in the last 30 days). At one year follow-up, the effect on drunkenness episodes was maintained, with a reduction of 20% for sporadic and of 38% for regular drunkenness episodes. Conclusions The EU-Dap project is the first large European evaluation of a comprehensive drug prevention program for adolescents. The program is effective in reducing drunkenness episodes and the effect is maintained at one year follow-up. The program can therefore be recommended as an effective tool to prevent alcohol and drug use among adolescents.