Cigarette smoking among adolescents has increased over the past decade. This trend is particularly important given that more than 80% of adult smokers initiated smoking prior to age 18. In response to this problem, researchers and public health officials have placed an increased emphasis on reducing youth cigarette smoking in recent years. The most pervasive form of youth tobacco control is prevention of smoking. Although many prevention programs have been developed and implemented in recent decades, the success rates of most of these programs has been modest. More recently, researchers and clinicians have increased efforts in the area of smoking cessation for adolescents. However, smoking cessation for youth is still in its incipient phase, and the success rates of cessation interventions have also been modest. One understudied area for research and intervention is relapse-prevention for adolescents. This is significant because adolescents quit smoking more frequently than adults, and also relapse more frequently than adults. The current proposal aims to capitalize upon the advances made in adult relapse-prevention by applying and adapting these techniques to adolescents. Ultimately our intervention will consist of a series of booklets modeled after the Stay Quit booklets, which have been successful at reducing relapse among the general population of adult recent quitters. We will adapt the booklets to meet the specific needs of adolescents. The adaptation of the intervention will be based upon qualitative evaluations including a series of focus groups, in-depth interviews, and learner verification interviews (Study I). Study II will be a feasibility intervention study using our redesigned relapse-prevention booklets, and will follow Study I. Adolescents who have quit smoking will be recruited from six public high schools and will receive the series of 8 booklets sent every three weeks. Assessments will be conducted at one month, three months, and five months after the beginning of treatment. Study II will allow us to assess the procedures and mechanics of administering a mail-based intervention to adolescent ex-smokers, and will also provide us with preliminary data regarding the acceptability of our mail-based program, and the feasibility of our recruitment and consent procedures.
