Research to date provides overwhelming evidence that low socio-economic status (SES) youth are at an increased risk for smoking. Converging evidence from developmental studies, psychopathology studies, intervention studies, and basic research on self-control abilities, have identified working memory and distress tolerance as potential crucial modifiable risk factors to prevent smoking onset in this cohort. To confirm the value of these targets, this study is designed to evaluate the individual and combined influence of working memory and distress tolerance interventions on risk of smoking initiation. We are targeting a high-risk (low SES adolescents) population at a highly relevant period (high school) for smoking onset, and studying crucial covariates--parental smoking, peer smoking, and sensation seeking -- of particular relevance to the study cohort in order to provide more-precise estimates of the influence of the experimental variables and to more fully characterize variables of influence for the population under study. The effects of the interventions are studied against a backdrop of a standard antismoking informational intervention - the sort of intervention that has shown less success with low SES adolescents. Overall, we propose to randomize at least 150 adolescents to one of three intervention conditions: (1) a control condition offering health education combined with a smoking prevention informational intervention (C+SPII), (2) a working memory intervention delivered prior to a smoking prevention informational intervention (WM+SPII), and (3) a distress tolerance training intervention delivered prior to a smoking prevention informational intervention (DI+SPII). The effect of these conditions on proximal smoking risk variables as well as one-year smoking outcomes will be assessed.
Most smokers begin smoking before the age of 18 years, and rates of smoking initiation are higher for low-income youth. This project is designed to provide fundamental knowledge to inform drug prevention interventions by attending to working memory and distress tolerance as crucial risk factors for smoking initiation among low-income youth. We will study the usefulness of interventions designed to enhance working memory capacity and distress tolerance for reducing proximal risk for smoking and actual smoking behavior among low-income high school students.
