The Project EX program has been rigorously tested in the U.S. and globally. Nearly 4,500 youth across ethnic and socioeconomic backgrounds have participated in the evaluation research in the U.S and in multiple other countries. These international partnerships have demonstrated that the Project EX curriculum is adaptable and translatable to a variety of diverse youth. Studies include implementation and data collected in the U.S., China, Israel and partners, Russian Federation, Spain, India, Korea, and Thailand.
In the first evaluation (Project EX-1), 18 schools were assigned to one of three conditions using a randomized block design. A total of 335 tobacco users participated in the study. The Project EX program successfully led to a doubling of the quit rate for those receiving the program, and at the 3-month follow-up period (five months after the quit day), 17% of the students enrolled in the clinics (intent-to-treat quit rate) had quit using tobacco for at least the last 30 days, compared to only 8% of students in the control condition over the same time period.
The second evaluation (Project EX-2) tested the cessation program in Wuhan, a large city in Central China, in both regular and vocational school settings. An 11% adjusted quit rate was achieved in this trial, which was about 4 times greater than the naturally occurring quit rate observed (3%).
Nicotine replacement therapy is generally not effective for teens. Another trial (Project EX-3) evaluated the use of nicotine gum as a pharmacologic adjunct in a randomized two-condition study. Participants received the Project EX program and also received either nicotine gum or a herbal gum placebo. At 6-month follow-up, the intent-to-treat 7-day quit rates were 16% in the nicotine gum condition, and 15% in the herbal gum placebo condition. While pharmacological adjuncts failed to provide additional cessation effects, the EX program was again effective in providing youth cessation.
The fourth evaluation (Project EX-4) was a randomized trial that tested the effects of the a prevention/cessation version of Project EX in a classroom based setting. In this study, tobacco users were provided with cessation material and non-users were provided with prevention material to serve as support persons for those trying to quit. Over 1,097 youth in alternative high schools in California participated in the research. At 6-month follow-up, the weekly smoking prevalence was reduced by 8% and the monthly smoking rate by 6% compared to control. At 1-year follow-up, the program condition provided a 5% reduction in weekly smoking, and 7% reduction in monthly smoking compared to the control condition.
See the list of published manuscripts below for data from additional evaluation studies.
Published Manuscripts
UNITED STATES
Sussman, S., Dent, C.W., & Lichtman, K.L. Project EX: Outcomes of a teen smoking cessation program. Addictive Behaviors 26, 425-438, 2001.
Sussman, S., McCuller, W.J., Zheng, H., Pfingston, Y.M., Miyano, J., & Dent, C.W. Project EX: A program of empirical research on adolescent tobacco use cessation. Tobacco Induced Diseases, 2(3), 119-132, 2004.
*Sussman, S., Miyano, J., Rohrbach, L.A., Dent, C.W., & Sun, P. Six-month and one-year effects of Project EX4: A classroom-based smoking prevention and cessation intervention program. Addictive Behaviors 32, 3005-3014, 2007.
*Sussman, S., Miyano, J., Rohrbach, L.A., Dent, C.W., & Sun, P. Corrigendum to “Six-month and one-year effects of Project EX4: A classroom-based smoking prevention and cessation intervention program”. Addictive Behaviors, 35(8), 803, 2010.
CHINA
Zheng, H., Sussman, S., Chen, X., Wang, Y., Xia, J., Gong, J., Liu, C., Shan, J. Unger, J., & Johnson, C.A. Project EX – A teen smoking cessation initial study in Wuhan, China. Addictive Behaviors, 29, 1725-1733, 2004.
RUSSIA
Idrisov, B., Sun, P., Akmadeeva, L., Arpawong, T.E., Kukhareva, P., & Sussman, S. Immediate and six-month effects of Project EX Russia: A smoking cessation intervention pilot program. Addictive Behaviors, 38(8), 2402-2408, 2013.
SPAIN
Espada, J.P., Gonzálvez, M.T., Orgilés, M., Guillén-Riquelme, A., Soto, D., & Sussman, S. Pilot clinic study of Project EX for smoking cessation with Spanish adolescents. Addictive Behaviors 45, 226-231, 2015.
*Gonzálvez, M.T., Espada, J.P., Orgilés, M., Soto, D., & Sussman, S. One-year effects of Project EX in Spain: A classroom-based smoking prevention and cessation intervention program. PLOS ONE, 10(6), 1-9, 2015.
Espada, J.P., Gonzálvez, M.T., Orgilés, M., & Sussman, S. One-year effects of Project EX: A smoking intervention pilot program with Spanish adolescents. Journal of Health Psychology 22(8), 1067-1074, 2017.
*Gonzálvez, M.T., Espada, J.P., Orgilés, M., & Sussman, S. Two-year effects of Project EX: A classroom-based smoking prevention and cessation intervention program. European Addiction Research 23(3), 122-128, 2017.
INDIA
*Sidhu, A.K., Sussman, S., Tewari, A., Bassi, S., & Arora, M. Project EX-India: A classroom-based tobacco use prevention and cessation intervention program. Addictive Behaviors 53(1), 53-57, 2016.
THAILAND
Chansatitporn, N., Charoenca, N., Sidhu, A., Lapvongwatana, P., Kungskulniti, N., & Sussman, S. Three-month effects of Project EX: A smoking intervention pilot program with Thai adolescents. Addictive Behaviors 61(10), 20-24, 2016.
ISRAEL & partners
Isralowitz, R., Afifi, M., Reznik, A., & Sussman, S. Cigarette smoking among youth: A regional health problem. In: R. Isralowitz & P.A. Findley (Eds.), Mental Health and Addiction Care in the Middle East, Advances in Mental Health and Addiction. Cham, Switzerland: Springer International, pps. 93-108 (Chapter 7), 2016.
KOREA
Yu, S., Galimov, A., Sussman, S., Jeong, G.C., & Shin, S.R. Three-month effects of Project EX: A smoking intervention pilot program with Korean adolescents. Addictive Behavior Reports, 9, 100152, 6 pages, 2019.
Yu, S., Galimov, A., Sussman, S., Jeong, G.C., & Shin, S.R. Corrigendum to “Three-month effects of Project EX: A smoking intervention pilot program with Korean adolescents”. Addictive Behavior Reports, 9, 100152, 1 page, 2019.
*Includes Project EX tobacco prevention/cessation programming.