Articles scientifiques
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In France, the issue of youth smoking remains a major challenge for public health. If the peer influence can encourage tobacco use, we observe that the peer education has therefore a beneficial potential to change smoking behavior of adolescents. Moreover, it was demonstrated that Theory of Planned Behaviour (TPB) has yielded the best prediction of intentions and behavior in several health domains. In P2P program, voluntary students in professional high schools conceived and performed their own intervention, based on the TPB (with help of trained educators), to reduce their schoolmates smoking. The main objective of this study is to measure the 2 years impact of the P2P program on a highly exposed young population composed by students from professional schools. Between 2013 and 2014, a cluster randomized controlled trial was performed among 1573 students enrolled in 15 professional high schools in France. 749 students in the interventional arm received a program (P2P) in which voluntary peers of each school have designed and carried out anti-smoking actions based on TPB within their own institution. After the intervention and 24 months after baseline assessment, daily smoking prevalence was determined. Secondary endpoints included smoking behaviors and noted a posteriori the level of theoretical implementation of the peer-led actions. P2P program prevented an increase of 6.5 points in daily smoking prevalence at the end of the intervention. A high level of implementation increases the impact of the intervention, mainly among smokers, and appears to strengthen their subjective norms against tobacco. These results showed the potential benefit for participants in this experiment to reduce their likelihood of smoking. 

Acknowledgement: this research was supported by a grant from INCa (Institut National du Cancer) RISP 2013 and SIRIC of Montpellier (Grand INCa-DGOS-Inserm 6045)