Impact of health promotion in Lithuanian pupils smoking, alcohol and drug use

Background Health Promotion Schools (HPS) are engaged in targeted pupil's health promotion activities in accordance with the approved programs. Health promotion topics are integrated not only into subject lessons but also into extracurricular activities. HPS is believed to provide ideal conditions for the prevention of harmful habits, but there is a lack of research into the effectiveness of these schools. This determined the aim of the research - to evaluate the influence of HPS learning on smoking, alcohol and drug use among Lithuanian adolescents. Methods During the prevalence research 3574 ninth and tenth grade pupils from 44 HPS were surveyed, as well as 66 schools outside the HPS network (response rate 74.7%). The contribution of individual characteristics (class, sex, place of residence, grade point average, mother's and father's education) and school characteristics (school affiliation, school type, school location) were analysed using logistic regression models with 95% of CI. Results 18.1% of pupils smoke regularly. Learning at HPS did not reduce the odds of smoking (OR = 1.08 (95% CI: 0.88; 1.31)), but pupils smoking was significantly associated with gender, class, school type, grade point average and school location. The majority of pupils (74.4%) have tasted alcoholic beverages. HPS pupils had significantly lower odds of tasting alcoholic beverages (OR = 0.77 (95% CI: 0.51;0.98)). Alcoholic tasting was also significantly linked to class and father's education. 9.3% of pupils tried to use drugs. Pupils from schools outside the HPS network had a 1.38 (95% CI: 1.05;1.80) odds of using drugs. Drug use was significantly associated with gender, class, place of residence, type of school, and grade point average. Conclusions HPS learning significantly reduces pupils alcohol tasting and drug use but is not significantly associated with lower smoking. Individual and school characteristics have a significant impact on pupils smoking, alcohol, and drug use. Key messages HPS pupils have a lower chance of tasting alcohol and drug abuse, so it is important to encourage schools to join the HPS network to reduce the incidence of harmful habits. It is important to consider individual and school characteristics that have a significant impact on pupils smoking, alcohol and drug use when designing prevention measures.