Preventing uptake of smoking by young people; proposing a school based peer intervention - opinions of pupils (age14/15) and their teachers

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


To understand the views of young people and teachers on smoking prevention and current practice in schools in a UK rural county (Norfolk).


An online survey followed by discussion groups explored school policies, smoking prevention teaching, experience/acceptability of interventions, optimal age for delivering smoking prevention interventions.


More than 200,000 (5.5%) UK children aged 11 – 15 years start smoking each year.  Whilst rates of smoking uptake have decreased significantly, the social gradient in young people taking up smoking remains marked.

The evidence based ASSIST approach of peer-led school-based intervention for preventing smoking uptake involves training influential children to encourage their peers not to smoke.

Findings and conclusion:

22 teachers and 249 pupils completed the surveys, 37 pupils from three schools participated in discussion groups.

Staff and Pupils reported current teaching practice in Science or PSHE. Information about the health threats of smoking was perceived as the most effective means of preventing smoking uptake.  The use of peers to discourage smoking initiation was rarely reported.


The ASSIST intervention is the ‘gold standard’ evidence based approach. However, many Norfolk schools are not implementing this intervention.  There is a need to reassess the most appropriate form of intervention for smoking prevention in a changing landscape of reduced smoking prevalence at a population level, but where pockets of inequality suggest sustained high levels of smoking amongst some young people. Locally, we found opportunity and willingness to implement effective interventions. A targeted approach to intervention in high risk settings may be appropriate.


Ms Brioney Gee, Ms Vivienne Maskrey, Ms Annie Blythe; Prof Richard Holland, Dr Caitlin Notley Norwich Medical School, University of East AngliMs

Conflicts of interest:

Funding Sources: Primary and Community Care Research Capability Funding, Norfolk and Suffolk Primary and Community Care Research Office, NHS South Norfolk

CCG No conflict of interest

Dr Caitlin Notley