Effectiveness of a School‐Based Substance Use Prevention Program in Reducing Primary School Students' Intentions to Use Tobacco, Alcohol or Other Drugs in the Future

ISSUE ADDRESSED: Tobacco, alcohol and other drug use contribute significantly to the global burden of disease, with initiation typically occurring during childhood and adolescence. School-based substance use prevention interventions are recommended globally, are commonly implemented in Australian primary schools and require rigorous evaluation to determine whether they deliver intended benefits. This study aimed to determine the effectiveness of a routinely implemented Australian school-based substance use prevention program in reducing primary school students' intentions for future use, awareness, knowledge and confidence to avoid tobacco, alcohol and other drugs. METHODS: A waitlist-controlled pre-post study was conducted with Year 5 students attending government primary schools (28 intervention, 15 control) in 2018 in NSW, Australia. Baseline and follow-up student surveys were conducted in all schools. Intervention school students received the Program immediately after baseline data collection, control students after follow-up data collection. Generalised linear mixed models compared follow-up data. RESULTS: Analysis of follow-up data from 943 students identified no between group differences on intentions for future use, awareness, or confidence to avoid tobacco, alcohol or other drugs. Intervention students had higher knowledge scores for tobacco, alcohol and other drugs at immediate (tobacco-mean difference [MD]: 0.61 [95% Confidence Interval (CI): 0.41,0.80]; alcohol-MD: 0.69 [95% CI: 0.35,1.03]; other drugs-MD: 0.82 [95% CI: 0.52,1.11]) and 6-month (tobacco-MD: 0.47 [95% CI: 0.31,0.63]; alcohol-MD: 0.39 [95% CI: 0.18,0.61]; other drugs-MD: 0.43 [95% CI: 0.18,0.67]) follow-up compared to control students. SO WHAT?: Despite the consistent beneficial effect on knowledge, the lack of effect on all other outcomes, including intentions to use in future, suggests further at-scale evidence of effectiveness is required following optimisation of the Program to support routine and widespread implementation.