Cancer Control Research5R01CA074536-04
SMOKING PREVENTION AND CESSATION AMONG OLDER ADOLESCENTS
DESCRIPTION (Applicant's Description) The national prevalence of past month smoking among 9th - 12th graders has increased steadily, from 27.5 percent in 1991 to 34.5 percent in 1995. Although extensive research has been conducted to change adolescent smoking behavior, the scope of these studies has been limited in that they have largely focused on the primary prevention of smoking onset, have targeted young adolescents, and have mostly taken place in school settings. The reduction of overall smoking among high school-aged adolescents requires effective interventions that incorporate both smoking prevention and cessation, yet such research is lacking. We propose to conduct a randomized controlled trial to assess the effectiveness of a non-school based, multi-component intervention strategy to reduce prevalence of past month smoking by 1) changing normative expectations around the issue of smoking among adolescents, ages 14-17, and 2) providing cessation assistance for those adolescents who smoke. A total of 3000 adolescents who are dependents of members belonging to a large health maintenance organization and who respond to a mailed survey to collect baseline data will be randomized to receive either the multi-component intervention or usual care. The intervention will take place over 2 years and consist of 1) a youth advisory group, 2) youth action teams, 3) behavioral prescriptions, sent to all adolescents at regular intervals during the intervention, 4) a contest to increase motivation, and 5) cessation assistance to smoking adolescents using motivational interviewing techniques. A follow-up survey will be conducted at the end of the intervention period. The proposed intervention proposes to achieve a 5-6 percent reduction from baseline in the overall smoking prevalence among adolescents in the intervention compared to those in the control. The overall expected difference of 5-6 percent in smoking prevalence as a result of this study would have dramatic public health impact at the population level, and would be especially important, given the clear need for new, effective approaches to reverse the smoking trends in this population.