Research project The core components of the tobacco prevention program Tobaksfri Duo is being evaluated by Umeå University and the Karolinska Institute to obtain updated knowledge about the program's effect on young people.
Most people who start using tobacco do so during their teens. If you abstain from tobacco during this time, the chance of remaining tobacco-free for life is high. Tobacco-free duo is a multi-component tobacco prevention program that is implemented in schools and is based on a contract between a student and an adult of their own choice.
The program was started by Västerbotten County Council in the early 1990s in collaboration with the county's schools. It is used in around 80 municipalities in Sweden. In Topas, the core components of the program are evaluated by Umeå University and Karolinska Institutet to gain updated knowledge about the program's effect on young people.
The Tobacco Free Duo program
The evaluated program consists of six core components: the tobacco-free duo (a student and an adult sign an agreement to stay tobacco-free till the end of grade nine), student information about tobacco, parental information about tobacco, membership cards for participants that can be linked to discounts or a chance to win prices, annual assurance that the contract is still valid and structured education about tobacco. This evaluation - the Topas study - was carried out by Umeå University and Karolinska Institutet during the years 2017-2021. This was commissioned and financed by the Public Health Agency of Sweden.
The Topas study comprises a cluster randomized controlled trial, an observational study and a health economic evaluation. The study's final report and three scientifically published articles are published on this page. Due to the changes in data protection legislation in 2018 (GDPR) and the covid-19 pandemic, the number of dropouts of participating students was higher than expected, which has affected the scientific strength of the Topas study results.
Cluster randomized controlled studie
Cluster randomized controlled trial:
The purpose was to investigate the program's effect on young people's tobacco onset and tobacco use during junior high school. Schools were recruited and randomly allocated to the Tobacco Free duo program (T-schools) or to minimal intervention (U-schools).
Observational study
The aim was to investigate whether the introduction of the Tobacco-free duo program had an effect on the whole school (T-schools), i.e. also on students who were not directly intended as the target group for the intervention. Pupils in schools with minimal intervention (U-schools) served as comparison groups together with pupils from reference schools, where no intervention was carried out.
Health economic evaluation
The evaluation was done by Umeå University and Karolinska Institutet between 2017 and 2021, commissioned and funded by the Swedish Public Health Agency. The Topas study comprises a cluster randomised controlled trial, an observational study and a health economic evaluation. The study's final report and three scientific papers are published on this page. Due to changes in data protection legislation (GDPR) and the covid-19 pandemic, the dropout rate of participating students was higher than expected, which has affected the strength of the Topas study results.
