The Tabado prevention program targets apprentices and vocational high school students

A study indicates the relevance of the Tabado program, which alternates awareness sessions, smoking cessation consultations and motivational workshops, within technical and vocational education establishments.

Initiated by the University of Lorraine and the Nancy University Hospital, the Tabado program was tested from 2007 to 2009 in eight apprentice training centers (CFA) and was declared successful. During the 2019-2020 school year, it was rolled out to 142 establishments in twelve regions (including one overseas), funded by the Addictions Fund and coordinated by the National Cancer Institute.

A population that smokes more than other young people

The Tabado program is aimed at young apprentices and vocational high school students, who are more likely to use tobacco and have fewer negative perceptions of tobacco products. It offers not only awareness sessions on tobacco and quitting, but also individual consultations to help people quit smoking and up to four motivational group workshops, all within schools. The questionnaire completed at the start of the session by nearly two-thirds of the participants (63%, or 34,669 responses) provided a more detailed picture of this population, which confirms the value of this program [1].

Analysis of the questionnaires reveals that apprentices and vocational high school students are significantly more likely to smoke than the average person of their age. They are more likely to have experimented with tobacco products (64% versus 59%), to be daily smokers (27% versus 25%), and to have a consumption of more than ten cigarettes/day (9% versus 5%) [2]. More than half (54%) of smokers reported having tried at least once to quit smoking, including 26% two or three times and 13% more than three times. Attempts to quit smoking are more frequent among occasional smokers than among daily smokers with a high consumption. Apprentices are significantly more likely to consume tobacco than vocational high school students, whether in terms of daily smoking (+20%) or quantity smoked (+10%); They also show a lower intention to quit smoking. Age is a factor in increasing daily smoking, which becomes more significant from the age of 17.

Varied modes of consumption and poly-consumption

Shisha use is very widespread in this population (36% used it in the month), particularly among smokers consuming more than 10 cigarettes per day (64% used shisha in the month).

Tobacco use among these young people is also commonly associated with other forms of consumption. E-cigarette use is higher among these students and apprentices than among the average young person (10% versus 2%).

Among daily smokers, there is a more frequent joint consumption of tobacco products and e-cigarettes: 30% regular use of e-cigarettes, 64% recent use).

Tobacco consumption is, to a significant extent, associated with regular use of cannabis (30% of regular use among daily smokers) and alcohol.

A program that remains to be adapted to its population

The data from this study allow for more precise targeting of interventions: prevention sessions are suitable for all audiences, but individual consultations would benefit from targeting students and apprentices aged 17 and over. The different modes of tobacco consumption should be better taken into account, as should the associated use of alcohol or cannabis. Stakeholders must also be able to provide clear answers to these poly-consumption patterns and their evolution.

Upcoming evaluations of the Tabado program should provide a better measure of its effectiveness in smoking cessation. This will require developing a methodology more suited to the characteristics of this population in order to promote access to care for these young people. Raising awareness among these young people about the tobacco industry's marketing strategies that specifically target them could also help reduce the impact of social disparities. The implementation of this program in schools is a priori commendable, provided that schools begin by enforcing the smoking bans to which they are subject.