Project EX

Placement on the Continuum of Evidence Promising Download icon Download PDF
Target Population: 
Alcohol/Drugs/Tobacco, Anger, Emotional Competency, Life Stress
Target Audience 

This program is for high school students who are 14 to 19 years old.


Project EX, a school-based program, is designed to teach students about the environmental, social, psychological, and emotional effects of tobacco use to help participants stop or decrease tobacco use.


In a randomized controlled trial in a non-traditional high school setting, results from a 3-month follow-up indicate that 17% of students participating in the program reported having quit smoking for at least 30 days compared to 8% of students in the control condition, and this was verified by biochemical analysis.  Six-month follow-up results from a quasi-experimental trial in a Russian summer camp indicate significantly less cigarette use and higher quit rates in treatment compared to control groups; however, no biochemical analysis was used to confirm these results.  An additional randomized controlled trial conducted in Spain demonstrated significant increases with intention to quit, motivation to quit, and decreases in nicotine dependence and number of cigarettes smoked in last 30 days during a 1-year follow-up when compared to control students.


Project EX is implemented in clinics of 8 to 15 students, and four clinics can operate simultaneously at one school.  The clinics are designed to be implemented during school hours.  To be eligible for the clinic, students must have used tobacco in the 30 days prior to the first session.  Various strategies may be implemented to recruit students to Project EX clinics, such as brief classroom presentations by a program facilitator.  In addition, schools may offer class credits or class release time, or students may be referred to the program by teachers.

Project EX delivers eight sessions to participants.  During the first two sessions, students are facilitated through the quitting process, and the last four sessions help students maintain this status.  Students participate in games, mock talk shows, and yoga during sessions.  Through these activities, students learn methods for coping with stress, understand how to handle nicotine withdrawal, develop techniques for relaxation, and acquire approaches to avoid relapse.  Overall session goals include self-control, anger management, mood management, goal-setting techniques, and self-esteem enhancement.

Previous Use 

This program has been implemented and evaluated in the United States, China, Russia, and Spain.


Teachers facilitate this program, and 1- to 2-day trainings with a trained health education specialist, who has experience with Project EX, are recommended.  Training is offered on-site or at Project EX headquarters.  Training costs depend on location and can range from $1,200 to $1,400 for 1 day or $1,900 to $2,100 for 2 days plus trainer expenses.


Considerations for implementing this program include acquiring teacher and participant buy-in; offering program training to teachers; acquiring funds for training, if teachers participate; securing a suitable space to implement the program; and incorporating sessions in an existing curriculum.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email


If you are interested in implementing Project EX, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email


The program is implemented in eight 40- to 45-minute sessions for 6 weeks.  There are two sessions a week for 2 weeks and one session a week for 4 weeks.


The teacher's manual, with CD, costs $60; a set of five student workbooks costs $35; research articles cost $2.50 each; student pretest and posttest cost $2.50 each.

Evaluation Plan 

To move Project EX to the Effective category on the Clearinghouse Continuum of Evidence at least one external evaluation with a strong study design must be conducted that demonstrates sustained, positive outcomes. This study must be conducted independently of the program developer.

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email


Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email:

You can also contact Leah Meza by mail USC Institute for Prevention Research, Soto Street Building, 3rd Floor, 2001 N. Soto Street, Los Angeles, CA 90032, phone 1-800-400-8461, fax 1-323-442-7254, email, or visit

References - Used For Placement 

Espada , J. P., Gonzalvez, M. T., Guillen-Riquelme, A., Sun, P., & Sussman, S. (2014). Immediate effects of Project EX in Spain: A classroom-based smoking prevention and cessation intervention program. Journal of Drug Education: Substance Abuse Research and Prevention, 44, 3-18.

Espada, J. P., Gonzalvez, M. T., Orgiles, M., & Sussman, S. (2017). One-year effects of Project EX: A smoking intervention pilot program with Spanish adolescents. Journal of Health Psychology, 22, 1067-1074.

Idrisov, B., Sun, P., Akhmadeeva, L., Arpawong, T. E., Kukhareva, P., & Sussman, S. (2013). Immediate and six-month effects of Project EX Russia: A smoking cessation intervention pilot program. Addictive Behaviors, 38, 2402-2408.

Sussman, S., Dent, C. W., & Lichtman, K. L. (2001). Project EX outcomes of a teen smoking cessation program. Addictive Behaviors, 26, 425-438.

References - Not Used For Placement - Adaptation/Revision 

Sun, P., Miyano, J., Rohrbach, L. A., Dent, C. W., & Sussman, S. (2007). Short-term effects of Project EX-4: A classroom-based smoking prevention and cessation intervention program. Addictive Behaviors, 3, 342-350.

Sussman, S., Miyano, J., Rohrbach, L. A., Dent, C. W., & Sun, P. (2007). Six-month and one-year effects of Project EX-4: A classroom-based smoking prevention and cessation intervention program. Addictive Behaviors, 32, 3005-3014.

References - Not Used For Placement - Secondary analysis/Meta analysis 

Sussman, S., Sun, P., & Dent, C. W. (2006). A meta-analysis of teen cigarette smoking cessation. Health Psychology, 25, 5, 549-557.

References - Not Used For Placement - Other 

McCuller, W. J., Sussman, S., Wapner, M., Dent, C., & Weiss, D. J. (2006). Motivation to quit as a mediator of tobacco cessation among at-risk youth. Addictive Behaviors, 31, 880-888.

Sussman, S., McCuller, W. J., Zheng, H., Pfingston, Y. M., Miyano, J., & Dent, C. W. (2004). Project EX: A program of empirical research on adolescent tobacco use cessation. Tobacco Induced Diseases, 2, 3, 119-132.

Zheng, H., Sussman, S., Chen, X., Wang, Y., Xia, J., Gong, J., … Johnson, C. A. (2004). Project EX – A teen smoking cessation initial study in Wuhan, China. Addictive Behaviors, 29, 1725-1733.

*Resources and associated costs reflect those identified at the time of fact sheet publication.