Unplugged: an European school-based program for preventing tobacco, alcohol and drugs use among adolescents

Background: In the school-based drug abuse prevention field, a large number of programs have been developed. However, in most cases the effectiveness of the program in reducing drugs use has not been evaluated. A recent Cochrane Review showed that, among school-based programs, only those skills-based are effective. However, most of the programs included in the review were conducted in the United States. Recognizing a lack of research on effectiveness in Europe, the EC funded in 2003 the EU-Dap multicentric study. Methods: “Unplugged” is the first school-based prevention programme developed in an international collaboration in Europe. It was designed by an international group of experts experienced in drug prevention in the frame of EU-Dap study. It was then implemented and evaluated through a randomised controlled trial conducted between 2004 and 2006. The effectiveness evaluation showed that the program is effective in preventing cigarette use, drunkenness episodes and use of cannabis. In the second phase of the project (EU-Dap 2), the teacher handbook was largely revised, mainly based on teacher feedback. Moreover, to complement the new teacher’s handbook, a student’s workbook was developed, intended as a personal workbook of the student, and containing activities that students are to work through during the Unplugged units. The quiz cards, a set of cards used to teach the risks of drugs use, have also been revised. Apart from the revision of the contents, a new appealing graphic version was developed, and the new program, together with the student workbook and the cards, is freely available in the project’ website (www.eudap.net). Results: Unplugged is based on the comprehensive social influence approach, and includes training of personal and social skills with a specific focus on normative beliefs. It is a strongly interactive program and consists of 12 units, each one with a standard structure. Specific instructions for implementing the 12 units are described in the “Teacher’s Handbook” and specific material is provided per each unit in the student’s workbook. Unit 1 introduces the programme to the pupils, explaining what the programme is about and establishing some rules to create a respectful climate. Units 3, 5 and 9 are designed to deal mainly with adolescents’ knowledge and attitudes. Units 2, 7 and 8 deal with interpersonal skills (peer group feelings and expressions of feelings). Unit 4 includes activity on normative belief: the perceived prevalence of drug use at the students’ age is compared with the actual prevalence, as measured by national or local surveys. Units 6, 10, 11 e 12 deal with intrapersonal skills: students can practice refusal skills, assertive attitudes and coping strategies. At the end of the “Teacher’s Handbook”, material on life-skills, energizers, information on drugs and on prevalence of drug use is provided to the teacher. Conclusions: The Unplugged programme has a high degree of standardization: this makes it suitable to be disseminated in the different contexts of the European schools as well as to be adaptable to several language- and culture-specific settings.