Preventing the use of smokeless tobacco and cigarettes by teens: results of a classroom intervention

Abstract

The purpose of this study was to evaluate the efficacy of a school-based smokeless tobacco (ST) and cigarette smoking prevention/cessation program. This multicomponent intervention program was delivered by regular classroom teachers or same age peer leaders, and was presented to intact classrooms in randomly assigned schools. The program emphasized refusal skills training. A total of 2552 students in 13 middle schools and nine high schools began the study and 1768 were assessed at 1-year follow-up. The intervention had a beneficial effect of reducing ST use among males, especially at the middle school level. Analyses failed to reveal a positive intervention effect on cigarette smoking. Attrition analyses revealed few problems with internal validity, but strong and consistent differences between subjects available for follow-up assessment and those not assessed. These results provide limited support for the efficacy of the ST intervention program, but also suggest the need for different types of intervention programs capable of impacting a larger percentage of high risk adolescents.