Implementation of the Tobacco Smoking Cessation in Vocational Training Centers the "TABADO" program

Key Contextual Factors

• The responsible body: INCa, French National Agency in charge of the development and implementation of Cancer control policies and Cancer Research over the whole French territory.
• The name/type of organizations: INCa, Health regional agencies, regional non-governmental organizations in health promotion.
• The particular target groups: students enrolled in vocational (high) schools.
• The National Cancer Institute (INCa) received funds from the National State Health Insurance Office to implement this program in VCT schools, or schools with high smoking prevalence in rural, suburban or urban settings.

Key Components/Steps

• The program is coordinated by François Alla, the Apemac Research team, which brings together researchers from the University of Lorraine and healthcare professionals from the Nancy hospital, and first experimented in Lorraine before spreading to other regions.
• It took 3 years to set up progressive implementation, marketing social tools development and evaluation:
  • 2018-2019: 7 regions, 60 schools, 5 000 students.
  • 2019-2020: 13 regions, 142 schools, 50 000 students.
  • 2020-2021: 14 regions, 160 schools, 70 000 students.
  • 2021-2022 : 16 regions, 237 schools, 85 000 students.

• In 2021, an evaluation was conducted which led to a proposal for the scaling-up deployment including monitoring and follow-up by a steering committee. One part of the evaluation in progress will consist of estimating the overall cost of the program and to define the cost(s) per student with a view to generalization of the program.

Main Impacts / Added Value

• Collaboration with the educational institution and other national institutions to be facilitators.
• Heterogeneity of the resources and organization models for the different type of school implicated (school nurse or not for example).
• Skills of regional actors.
• Developing tools to standardize the quality of the intervention and facilitate the deployment for local actors.
• Deliver a free and local opportunity to be coached in tobacco cessation at school.
• Reduction of smoking prevalence in youth population.

Lessons Learned

Logistical difficulty in implementing the intervention at school for young people who are alternating at school and at work.

Main key success factors:

• Evidence-based program (scientific publication about its efficacy).
• Obtain a specific funding dedicated to this program deployment included evaluation.
• Setting up of a national steering committee with all stakeholders to raise barriers during the deployment phase (regulatory barrier, …).
• Maintain a national animation of regional actors (global session of formation and share feedback twice a year, monthly phoning points with each regional actor).
• Progressive round up of the program.
• Standardization of the main elements of the program and its tools.
• Evaluate the quality and verify the efficacy of the program when developed at a large scale.
• The TABADO intervention combined a general program aimed at all participant, in the form of an information sessions on tobacco consumption (one hour), with a specific enhance program for voluntary smokers who decide to join the program:
  • from one to four  individual consultation with a team of physicians specialized in tobacco addiction;
  • from one to four motivational workshops (a small goup approach consisting of discussion sessions to share experiences, strengthen, and relapse).

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