Tobacco use is responsible for 30% of all cancer deaths. Although the overall prevalence of adult cigarette smoking is declining in the US, the rate among college students has increased, and recent estimates suggest the prevalence may be as high as 33%. The primary aim of this study is to assess the efficacy of a motivational interviewing counseling intervention focused on smoking (Tx) versus an attention control condition focused on fruits and vegetables (C) for smoking cessation among members of college Greek (fraternity and sorority) organizations. Since few college students who smoke do so every day, students reporting a wide range of tobacco smoking (i.e., out of the past 30 days, smoking cigarettes from 1 to 30 days) will be recruited through their Greek organizations to participate in a health intervention. Students will be encouraged to participate regardless of their interest in quitting. This study will use a group-randomized design with two arms. Over two months, students in the Tx and C arms will receive 4 individual sessions using motivational interviewing counseling. Students in both Tx and C will receive quit tip sheets developed specifically for college students in this study. Randomization will occur at the level of fraternity and sorority to minimize potential contamination and to maximize recruitment and retention of participants. We project that 24 Greek groups with 20 eligible smokers in each will be required to detect the proposed treatment effect. To increase inclusiveness we will also enroll students from historically black Greek letter organizations, who will form two extra clusters each with about 10 smokers for a total of 26 clusters comprised of 500 college smokers. The primary hypothesis is that, at 6 months from randomization, smokers receiving motivational interviewing focused on smoking (Tx) will have significantly higher 30-day point prevalence abstinence (defined as no cigarettes in the past 30 days) than smokers receiving a attention controlled condition (C). We will also test the effect of the intervention on short term (7-day) and long-term (90-day) abstinence, on cigarette reduction, and on movement along the stages of change. At the conclusion of the intervention, we will conduct focus groups stratified by smoking status to identify factors that contributed to the intervention success or failure. Ultimately, we envision that the intervention, if efficacious, could be used as a pre-packaged intervention disseminated through the Greek community, residential housing, and student health/counseling centers.
