The Prevention of Cigarette Smoking in Children: A Comparison of Four Strategies

Adolescent cigarette smoking remains a serious public health problem. Recent preventive efforts have concentrated on the social influences which encourage smoking onset. They appear more effective than earlier efforts which considered primarily the long term health risks of smoking. In spite of this progress, it has not been possible to identify the necessary or sufficient conditions for the reported treatment effects due largely to issues of research design. We report data from two consecutive studies designed to address this problem. In each study, four treatment strategies were compared for their effectiveness in deterring smoking onset and in minimizing future smoking levels. In the second study, an untreated reference condition was also included. Approximately 7000 students participated in the two studies. Baseline data were gathered in September of the seventh-grade year, interventions were conducted during the full year, and post-test and followup data were collected annually beginning in May of that year. These data suggest that a program which teaches specific skills to resist social pressures to begin smoking and which teaches students about the short term physiological consequences of smoking is more effective than a program which concentrates on long term health consequences. Perhaps most important, the use of same-age peer leaders as teachers appears to be a necessary condition for successful use of this intervention program.