Condition category
Mental and Behavioural Disorders
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Dr Paul Aveyard


Contact details

Department of Public Health and Epidemiology
University of Birmingham
B15 2TT
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title


Study hypothesis

To examine whether a year long programme incorporating three sessions using an expert system computer programme and three whole class lessons based on the transtheoretical model (TTM) of behaviour change could reduce the prevalence of teenage smoking.

Ethics approval

Not provided at time of registration

Study design

Randomised controlled trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting

Not specified

Trial type


Patient information sheet


Mental and behavioural disorders: Addiction


The intervention group received six sessions of two types: one computer session and one class lesson for each of the three terms of year 9 (autumn 1997 to summer 1998). For the computer session, the research team set up a classroom with about 30 computers and removed these at the end of the day. Whole classes came in turns and each student used a computer with headphones. The computer program was based on that developed by Prochaska and colleagues, containing questionnaires measuring the key concepts of the transtheoretical model. After each questionnaire students received feedback both through the headphones and on screen of how their temptations, for example, compared to stage based data collected by Pallonen et al (normative feedback) and in second and third sessions, what change had occurred since last time (ipsative feedback). The questionnaires were interspersed with video clips of young people talking about their thoughts about smoking that were relevant to the stage of change of the student concerned. The other transtheoretical model intervention was a one hour lesson delivered by ordinary class teachers. The teachers attended a two day training course organised by Public Management Associates, who had developed licensed training and lesson plans in consultation with Prochaska and colleagues. The three lessons developed the young people's understanding of the stages of change and how the pros and cons of smoking would vary in different stages, and the lessons got young people to use these concepts. More details of how we delivered the intervention are available.

Our aim for students in the control group was that they would be exposed to no intervention other than the normal health education on tobacco, which is part of the English national curriculum. However, as a reward for participation, teachers in control group schools were given three lesson plans and handouts on smoking. These lessons consisted of quizzes on facts about tobacco and one lesson on different ways of persuading someone to stop smoking. The content of the lessons was all taken from generally available teaching support material. The lesson plans and materials were provided to all control group schools, but teachers in these schools received no training in smoking issues or delivery of the lessons and it was up to the individual schools whether or not they used the materials.

Intervention type



Not Applicable

Drug names

Primary outcome measures

Prevalence of teenage smoking and proportion of positive stage movements 12 months after the start of the intervention.

Secondary outcome measures

Not provided at time of registration

Overall trial start date


Overall trial end date


Reason abandoned


Participant inclusion criteria

52 schools in the West Midlands region.

Participant type


Age group



Not Specified

Target number of participants


Participant exclusion criteria

Not provided at time of registration

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Department of Public Health and Epidemiology
B15 2TT
United Kingdom

Sponsor information


NHS R&D Regional Programme Register - Department of Health (UK)

Sponsor details

The Department of Health
Richmond House
79 Whitehall
United Kingdom
+44 (0)20 7307 2622

Sponsor type




Funder type


Funder name

NHS Executive West Midlands (UK)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary


Publication citations

  1. Aveyard P, Markham WA, Almond J, Lancashire E, Cheng KK, The risk of smoking in relation to engagement with a school-based smoking intervention., Soc Sci Med, 2003, 56, 4, 869-882.

  2. Aveyard P, Lancashire E, Almond J, Cheng KK, Can the stages of change for smoking acquisition be measured reliably in adolescents?, Prev Med, 2002, 35, 4, 407-414.

  3. Aveyard P, Sherratt E, Almond J, Lawrence T, Lancashire R, Griffin C, Cheng KK, The change-in-stage and updated smoking status results from a cluster-randomized trial of smoking prevention and cessation using the transtheoretical model among British adolescents., Prev Med, 2001, 33, 4, 313-324, doi: 10.1006/pmed.2001.0889.

  4. Aveyard P, Cheng KK, Almond J, Sherratt E, Lancashire R, Lawrence T, Griffin C, Evans O, Cluster randomised controlled trial of expert system based on the transtheoretical ("stages of change") model for smoking prevention and cessation in schools., BMJ, 1999, 319, 7215, 948-953.

Additional files

Editorial Notes