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This paper presents the rationale, development and application of "Unplugged', a new school programme for the prevention of substance abuse, which is based on the comprehensive social influence approach (CSI). The programme was developed, implemented and evaluated by a cross-disciplinary group of experts in the frame of a multi-centre study in seven European countries. The basic curriculum consists of 12 units, which are delivered by class teachers to a target population of 12-14 year-old students. Additional programme components were workshops for the students' parents and debriefing sessions led by class peers. The programme's application was monitored by means of structured report forms. This process monitoring allowed for the analysis of problems in implementation, as well as of participatory aspects. "Unplugged" is the first comprehensive social influence school curriculum in Europe of which the efficacy has been evaluated in a field trial, and it also constitutes an example of a theory- and evidence-based programme against youths' substance use. This report can provide public health and school decision makers with tools to make an informed choice on these kinds of programmes and to survey their application. (Contains 2 figures, 4 tables and 1 note.)

Abstract: Objective: To evaluate the effectiveness of the school-based drug abuse prevention program developed in the EU-Dap study (EUropean Drug Abuse Prevention trial) in preventing the use of tobacco, alcohol and drugs at the post-test. Methods: Cluster Randomised Controlled Trial. Seven European countries participated in the study; 170 schools (7079 pupils 12–14 years of age) were randomly assigned to one of three experimental conditions or to a control condition during the school year 2004/2005. A pre-test survey assessing past and current substance use was conducted before the implementation of the program. The program consisted in 12-hour class-based curriculum based on a comprehensive social-influence approach. A post-test survey was carried out in all participating schools, 3 months after the end of the program. The association between program condition and change in substance use at post-test was expressed as adjusted Prevalence Odds Ratio (POR), estimated by multilevel regression model. Results: Program effects were found for daily cigarette smoking (POR=0.70; 0.52–0.94) and episodes of drunkenness in the past 30 days (POR=0.72; 0.58–0.90 for at least one episode, POR=0.69; 0.48–0.99 for three or more episodes), while effects on Cannabis use in the past 30 days were of marginal statistical significance (POR=0.77; 0.60–1.00). The curriculum was successful in preventing baseline non-smokers or sporadic smokers from moving onto daily smoking, but it was not effective in helping baseline daily smokers to reduce or stop smoking. Conclusion: School curricula based on a comprehensive social-influence model may delay progression to daily smoking and episodes of drunkenness. [Copyright &y& Elsevier]