This developmental proposal is a Stage 1a grant that will develop and test the feasibility, acceptability and preliminary efficacy of a novel incentive-based behavioral intervention to promote a tobacco-free lifestyle among high school adolescents. Nicotine dependence is a progressive, relapsing disorder, predominantly initiated during adolescence with few existing smoking cessation strategies and minimally efficacious prevention strategies. The focus on a """"""""tobacco free"""""""" lifestyle will allow for high school wide implementation of this project and decrease rates of potential deception in self-reports of smoking status. This project will be conducted in two sites, CT and NY and combines the expertise of two strong research groups, one at Yale with extensive experience in high school based research and one at Roswell Park with extensive experience in developing and testing community based incentive programs for adult smoking cessation. This multi-site trial will first conduct focus groups with adolescents and administrators in high schools to develop the """"""""Tobacco Free and Win"""""""" campaign and program. The program will be administered over two year period. In the first year, one school each from CT and NY will serve as the intervention school and the other two will serve as control schools. Interested students will make a pledge to be tobacco free during the academic year and will be entered into monthly drawings for various prizes and will also receive tobacco educational literature including information on prevention and cessation. Monthly drawings will be held for six months and incentives will be provided to those not using tobacco products (self-reports with biochemical validation). Surveys of tobacco use behaviors and attitudes towards such behaviors will be conducted prior to the start of the campaign and at the end of the program period. In the second year, intervention will be continued in the schools that received it in the first year and initiated in the schools that served as the control schools in the fist year. Focus groups at the end of the two year program period will evaluate methods to enhance its efficacy and reach. The following specific aims will be addressed: 1. To design an incentive based intervention;2. To assess the feasibility and acceptability of this incentive based intervention in high schools;and 3. To examine preliminary efficacy of the intervention, determine optimal duration of the program, and determine an effect size estimate for a larger trial. Estimates of effect size and other information obtained from this pilot proposal will be used to design a larger Stage 1b trial to test the efficacy of the intervention. Development of this intervention will follow the guidelines outlined by NIH for stage-wide development of behavioral therapies for substance use and will address the major goal of reducing rates of adolescent tobacco use put forth by the Surgeon General.
Tobacco use is mostly initiated during adolescence and we have few effective smoking cessation or prevention strategies for high school aged smokers. This project will develop and test an innovative high-school based intervention that will be designed to provide incentives to motivate adolescents to maintain a tobacco free lifestyle. This intervention could provide a cost-effective method to reach and motivate a large number of adolescents to not use tobacco products.
