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Unplugged is a universal drug prevention program consisting of 12 lessons and intended for primary schools. In the school year 2017/2018, Unplugged was implemented in the Slovak Republic in the 7th grade. Objective To examine the effectiveness of Unplugged on lifetime prevalence of drunkenness and alcohol use during the last 30 days as well as the moderation effect of gender in these relationships. Furthermore, the role of smoking in relation to alcohol use and drunkenness was monitored. Methods The study has been designed as a cluster randomized controlled trial with data collection before the program implementation and immediately after the implementation. In total, 486 schoolchildren participated in the trial (M = 13.05; 49.6% boys) and were randomly assigned to either an experimental (N = 277) or control group (N = 209). Binary logistic regression was applied and adjusted for gender and baseline risk behaviour. Results There was no significant effect of Unplugged and no moderation effect of gender with regard to lifetime prevalence of drunkenness. However, smoking was also reported by those schoolchildren who reported drunkenness (OR 6.735; 95%CI 3.210-14.132). A significant program effect was found regarding the prevalence of alcohol use during the last 30 days. The schoolchildren in the experimental group had lower alcohol use in comparison to the control group (OR 0.501; 95%CI 0.253-0.993). The moderation effect of gender showed that the program had an effect on alcohol consumption in boys. After completing Unplugged, alcohol consumption in boys decreased significantly (OR 3.222; 95%CI 1.158-8.962). The results also confirmed that smoking is related to the prevalence of alcohol use during the last 30 days (OR 3.109; 95% CI 1.226-7.885). Conclusions The findings confirmed that Unplugged reduced alcohol use among boys. It has been also shown that smoking is a significant predictor of alcohol use and drunkenness. Key messages The findings point to the role of gender differences in the effectiveness of a prevention program. The effectiveness of the preventive program is more pronounced for those schoolchildren who are more likely to use alcohol before the program, especially boys.

Effectiveness of a drug use prevention program on alcohol use and drunkenness among schoolchildren