The Smoking Prevention Study

Title  Effectiveness of graphic images of mouth cancer in reducing the prevalence of smoking among 12/13-year-old school students in the UK.
Acronym  N/A
Study Type Randomised controlled trial
Status  Completed in 2008 – to be repeated
Funding  TBC
Ethics TBC


Tobacco in all its forms – smoking and chewing, remains one of the most important cause of oral cancer. In addition, it causes more depression and anxiety, more experience of pain and lower overall health. In England, 1% of 11-year olds smoke but that increases to 6.5% in 15-year olds.


In 2005, we conducted a prospective randomised controlled trial with approximately 16,000 11-year-old English pupils to discourage tobacco use. We partnered up with Oral and Maxillofacial (OMF) surgeons who talked for 15 minutes to approximately 200 pupils in school assembly with graphic images and patients’ stories about mouth cancer. The pupils completed three smoking-related questionnaire at baseline, 3-months post-intervention and at 3 years post-intervention. In total, 84 schools were involved but 52 completed the questionnaire at follow-up.


77% of the pupils remembered the talk 3 years later. We discovered that the pupils in the intervention arm had more knowledge related to tobacco-use and mouth cancer compared to the control group. In addition, there was a statistically significant reduction in the number of regular smokers in the intervention group compared to the control group in boys.

This research shows that surgeons can deliver powerful health messages, which are valued by both the schools and pupils, and that this brief intervention has a long lasting effect.

What next

We would now like to develop a four-arm randomised controlled trial to determine if presentations delivered by OMF surgeons of any experience are effective in reducing the uptake of smoking in children.

For further information, please contact Fran Ridout.