Cigarette smoking has multiple deleterious effects on health. Smoking experimention occurs most often during the early teenage years; teenagers who acquire the habit tend to become life long smokers. Prevention of the initiation of smoking during the vulnerable period is an issue worthy of attention. We propose to design and implement a multi-demensional anti-smoking program for teenagers directed at the psycho-social determinants of smoking and to provide tools to resist pressures to smoke. The specific objectives of the program are 1) to educate teenagers about the social and health consequences of smoking, 2) to test and demonstrate the utility of competition and reward as means of reducing cigarette use in intra/inter school and inter community situations, 3) to evaluate the effectiveness of each component (school curriculum, competition, reward, community press) of the intervention individually and in combination, and 4) to continue basic research into the determinants of teenage smoking. The target population are the 7th graders from three similar Iowa communities. They will be initially surveyed for smoking prevalence as assessed by self-reported and salivary thiocyanate analysis, smoking attitudes, and knowledge about smoking. The three communities will then receive varying interventions ranging from school curriculum alone, to school curriculum plus community press; these will be associated with systems of competition and reward. By varying the intensity of """"""""treatment,"""""""" it may be possible to assess the contribution of each variable. If the evaluation of the program shows it to be effective, the long term objective would be to modify ir for use by other schools and communities. This project is a multidisciplinary effort with contributions from Pediatrics, Sociology, Communication, Educational Psychology, Biostatistics and Preventive Medicen and the cooperation of the participating school systems and communities.
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