Evaluation of California's in-school tobacco use prevention education (TUPE) activities using a nested school-longitudinal design, 2003–2004 and 2005–2006

BACKGROUND: Current legislative language requires the California Department of Public Health, California Tobacco Control Program, to evaluate the effectiveness of the school-based Tobacco Use Prevention Education (TUPE) programme in California every 2 years. The objective of the study was to measure change and to identify the impact of school-based tobacco use prevention education activities on youth smoking prevalence and attitudes over time, spanning two school year surveys (2003–2004 and 2005–2006). METHODS: Evaluation focused on school-based tobacco use prevention activities in 57 schools (student sample size, n=16 833) that participated in the in-school administration of the 2003–2004 and 2005–2006 California Student Tobacco Surveys. Hierarchical linear models were used to predict student tobacco use and precursors to tobacco use. RESULTS: Overall, student tobacco use, intention to smoke, number of friends smoking and perceived smoking prevalence by peers increased as students moved through grades 9 and 10 to grades 11 and 12. TUPE-related activities showed a suggestive association (p=0.06) with reduced rate in student tobacco use between the two surveys after adjusting for other contextual factors such as each school's socioeconomic characteristics. CONCLUSIONS: TUPE activities appears to be beneficial in reducing tobacco use in California high school students over time. Other contextual factors were important moderating influences on student tobacco use.