Smoking Prevention and the Concept of Risk1

Abstract

Sixth‐grade children in 22 schools received either a social‐influences smoking‐prevention program or routine health education. The social‐influences program was designed to teach youth about peer, parent, and media influences affecting smoking onset and to provide them with skills in resisting these influences. Comparison schools were given no program, but were permitted to continue their usual provision of health education. Program impact was evaluated as a function of pretreatment risk of future smoking. Risk was defined with respect to both (a) the prevalence of social models who smoked and (b) previous smoking experience. Two‐and‐a‐half‐year results show program impact to vary with both kinds of risk. Smoking‐experience risk interacted such that, at first, there was greater impact on children with experience, but on later follow‐up the pattern reversed, with the greater treatment effects seen for those initially with limited experience. Social‐models risk showed a direct relationship, with greater risk being associated with greater program impact. Implications both for evaluation research and prevention programs are discussed.