The general objective is to test, in a controlled (randomized) experimental field study in a defined population, the relative and overall effectiveness of different approaches to implementing a comprehensive and integrated smoking prevention/cessation program designed to reduce the number of children who will become cigarette smokers and to encourage current smoking adults and students to reduce or quit smoking. Targeted primarily at school age children and their families, the program is composed of four integrated components: five 5-minute TV segments on smoking prevention aired on commercial TV each evening for one week during the early evening news hour; five corresponding 45-60 minute classroom sessions delivered to grade 7 and 8 health education classes during the same week; encouragement of family involvement by the use of homework assignments and provided written materials; and five 5-minute segments the following week on smoking cessation targeted at all smokers, but particularly at smoking students and parents. The program is comprehensive in that while if focusses on developing an awareness of the social pressures to smoke and providing the behavioral skills needed to resist such pressures, it also provides information on both physiological and social effects of smoking as well as the long-term health consequences, and teaches decision making skills so that adolescents can reach informed decisions about their behavior. The proposed research calls for three types of studies. Implementation/process evaluation (manipulation checks) will determine the integrity and strength of the program as implemented under various conditions. School based experimental and quasi-experimental studies will determine the effects of the program on beliefs, attitudes, intentions, and smoking behavior of grade 7 and 8 children and their parents. Components of the design will determine the effects of the program and its various components, and the cost-effectiveness of providing special training to teachers. Samples of other adults will be surveyed to determine the effects of the program on adults without grade 7 and 8 children, as well as their level of involvement in the program. Random assignment of some parents and requesters to receive a phone-in maintenance program will determine the efficacy and cost-effectiveness of such a strategy for preventing relapse by quitters.
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