) Across America, a variety of policies and programs are being implemented in an effort to reduce adolescent tobacco use, despite the lack of empirical evidence regarding the relative value of these practices in changing prevalence. We propose to collect such evidence via a collaborative effort between the Oregon Health Division, the Oregon Office of Alcohol and Drug Abuse Programs, and Oregon Research Institute. A prospective, nested, three- year longitudinal study will be conducted to discover the effects of both tobacco control practices and individual risk factors on the prevalence of tobacco use among High School and Middle School students. Using a cluster sampling frame compatible with existing state and federal surveillance systems, proctored questionnaires, telephone surveys, field probes, and summaries of state and local record systems will be used to collect data on: (a) classroom-based tobacco prevention programs; (b) policies concerning adolescent tobacco use; (c) access reduction activities; (d) youth anti- tobacco activities; (e) family communications about tobacco; (f) cessation programs for youth, (g) adolescent and parental exposure to media about tobacco use; and (h) the price of cigarettes. The study also will measure the prevalence of adolescent tobacco use in the sampled schools as well as individual and family factors associated with such use. These measures of community/school practices and individual factors will be related to the prevalence of tobacco use in the participating schools within and across assessment points using a hierarchical linear modeling approach. These analyses will identify the relative influence of tobacco prevention programs and practices on current prevalence as well as whether changes in these practices are predictive of changes in prevalence at the school level. This information should be of more than passing utility to both the research community and agencies faced with difficult choices as to how resources should be allocated to maximize their impact on adolescent tobacco use.
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