The long-term goal of this proposal is to reduce the prevalence of cigarette smoking and the future prevalence of lung cancer and other smoking-related diseases. The primary aim is to evaluate in young adulthood smoking prevention effects of a school and mass media intervention delivered in adolescence. We also will assess the hypothesized theoretical basis for these interventions and describe development of tobacco and alcohol use.
These aims will be accomplished using a longitudinal data set which includes intrapersonal, environmental and behavioral factors theoretically associated with smoking behavior, and measures of smokeless tobacco and alcohol use, assessed at seven time points, among cohort members who initially were 10-12 years old and who will be 21-23 years old at the time of the seventh survey. The original experiment was designed to test the ability of mass media interventions to add to the established efficacy of school smoking prevention programs. An inception cohort of 54-58 students in grades 4, 5, and 6 was established in 1985 in four matched communities in Vermont, New York and Montana. One community pair then received four years of a combined mass media and school smoking prevention program, while the other pair received the school program only. Annual surveys were conducted in the schools through 1989, and then again in 1991, two years after the interventions were completed, when students were in grades 10-12. The 1991 survey was completed with 86% of the original cohort. Analyses showed a sustained reduction in the proportion of smokers in the media-school communities, both for the students fully exposed to the interventions and for those partially exposed. Results also indicate significant effects on smoking behavior in 1991 for those identified in the baseline survey as at high risk for becoming regular smokers. For this proposal, we will again followup all students in the inception cohort through telephone interviews to be conducted by the survey research group at the University of Minnesota. Further analyses of data based on followup through 1991 and preparation of manuscripts for publication will be completed during the first two years of this proposal, while this survey is completed. In the third year the new survey responses will be linked with the existing data set, analyses related to persistence of prevention effects will be completed, and manuscripts related to these aims will be prepared for publication. This study represents a unique opportunity to document the persistence into adult years of smoking prevention effects achieved by educational strategies during adolescence.
