Project EX-India: A classroom-based tobacco use prevention and cessation intervention program

Area of Science:

• Public Health
• Adolescent Health
• Substance Abuse Prevention

Background:

• Adolescent tobacco use is a significant public health issue in India, particularly among the 15–24 age group.
• There is a critical need for evidence-based prevention and cessation programs tailored for Indian adolescents.
• Existing programs often lack context-specific adaptations for the Indian adolescent population.

Purpose of the Study:

• To evaluate the effectiveness of the Project EX program in preventing and cessation of tobacco use among Indian adolescents aged 16–18 years.
• To assess the impact of a culturally adapted, eight-session classroom-based curriculum delivered in Hindi.
• To compare outcomes between program participants and a control group receiving standard care.

Main Methods:

• A quasi-experimental design was employed with 624 students across four schools (two program, two control).
• The Project EX curriculum included motivation enhancement (talk shows, games) and coping skills (complementary and alternative medicine - CAM).
• Data were collected at baseline and a three-month follow-up to assess tobacco use prevention and cessation effects.

Main Results:

• Program participants rated CAM activities (meditation, yoga, breathing exercises) more favorably than talk shows and games.
• The Project EX program demonstrated a statistically significant prevention effect on tobacco use compared to the control group.
• No significant cessation effect was observed in the program participants compared to the control group.

Conclusions:

• The Project EX program shows promise as an effective tool for tobacco use prevention among Indian adolescents.
• Integrating complementary and alternative medicine (CAM) strategies may enhance engagement and effectiveness in adolescent tobacco control programs.
• Further research and program development are needed to improve cessation outcomes for Indian teens.