The aims of this research are to 1) reduce the lifetime risk of cancer by preventing smoking onset in youth, 2) reduce the lifelong risk of cancers of the oral cavity, larynx and esophagus by reducing onset of heavy alcohol consumption in conjunction with smoking, 3) bring about behavioral changes supportive of non-smoking lifestyles, 4) test the relative efficacy of a narrowly targeted program (i.e., smoking prevention only) versus broadly focused programs (drug abuse prevention and healthy lifestyle promotion) in preventing cigarette smoking, 5) test the effect of school and family interventions on the smoking of school-aged children and their families, and 6) test the effectiveness of a cancer prevention television series delivered via commercial television to the entire Los Angeles basin. Two studies are proposed. In study I, experimental programs will be tested in two cohorts (greater than 12,000 each) of seventh grade students. The experimental design for each cohort is a 3x2 factorial with 3 levels of program breadth (smoking prevention, drug abuse prevention, and healthy lifestyle promotion) and 2 levels of family involvement (parents and siblings of students involved and uninvolved). A non-intervention control group will be measured for comparison. Measures of cigarette smoking, alcohol and marijuana use, and other health-related behaviors will be collected from students and parents each year, grades 6-10 for the first cohort and 6-9 for the second cohort. Suspected mediating variables will be measured as well. In study II, beginning in year 3, a cancer prevention program will be delivered in 20, 5 minute segments via commercial television during the 6 p.m. and 11 p.m. news hours. Smoking and other cancer-related behaviors of 7th grade students and their families will be assessed as in study I. In a random sample of Los Angeles county schools a 12-session in-school program developed in study I will be delivered in conjunction with the television series (TV and school). In another random sample of schools (TV only) participation in the television series will be actively recruited, but no in-school program will be provided. A third randomly selected sample of schools will provide a no-intervention control group. Measures of smoking, dietary, cancer screening and related behaviors will be collected prior to immediately following, and one-year following the interventions.
