Findings from a process evaluation of the delivery of ASSIST (A Stop Smoking in Schools Trial): an update to the existing evidence base

First published: 10 May 2019 | Last updated: 20 May 2019

Background: ASSSIT (A Stop Smoking in Schools Trial) is a UK peer led, smoking prevention social network intervention that encourages the dissemination of non-smoking norms. Students (aged 11-13) are nominated by their peers to become peer supporters. They receive training and support to have informal conversations with other students about the risks of smoking and the benefits of being smoke-free. ASSIST is an evidence based programme with results from a large cluster randomised trial showing a reduction in smoking prevalence. However, these findings are now 12 years out of date and adolescent smoking prevalence has continued to decline. In 2013 the Scottish Government ‘s Tobacco control Strategy made a commitment to pilot ASSIST in Scotland and commissioned a process elevation of its delivery. This presentation will present key findings from the Scottish evaluation and reflect on delivery of ASSIST since the 2004 RCT, offering points for consideration for the future delivery of ASSIST and further research areas.Method: Mixed method study with a range of stakeholders (school staff, trainers, students, policy and commissioning leads n=101) via in-depth interviews, paired interviews, mini focus groups, observation and a before and after student survey (n=2166, at follow-up).Results: Three different delivery models were piloted. This did not impact on fidelity or acceptability which was rated highly. Partnership working, from the onset, was viewed as being key to successful delivery and securing school participation. Feedback was overwhelmingly positive regarding the wider benefits of taking part in ASSIST for peer supporters (i.e. personal and communication skills) but also for the school and communities. There was less certainty regarding the extent of message diffusion and the impact this may have an adolescence smoking prevalence. Student survey results showed no significant change in self-reported smoking prevalence between baseline (2.5%) and follow-up (3%) and conversation recall with a peer supporter was low at 9%.Conclusions: ASSIST is a well delivered, popular programme with additional benefit for students, their wider social network, school and community. Yet, there is uncertainty regarding the extent of message diffusion within the school year which raises questions around the continued contribution of the programme to lowering the adolescent smoking prevalence rate. Further research is needed to update the existing evidence base.


Ms Fiona Dobbie, University of StirlingJennifer McKell, University of StirlingNadine Dougall, Edinburgh Napier University Dr James White, Cardiff University Professor Rona Campbell, University of Bristol Professor Amanda Amos, University of Edinburgh Professor Laurence Moore, University of Glasgow Professor Linda Bauld, University of Stirling

Conflicts of interest:

no conflict of interest

Dr Richard Purves