Primary prevention of chronic diseases in adolescence: effects of the Midwestern Prevention Project on tobacco use.

This article reports six-month, one-year, and two-year effects of a longitudinal multicomponent community program directed toward delaying the onset of cigarette smoking in adolescence. Results are based on a longitudinal panel of sixth and seventh grade students from eight schools in the Kansas City Standard Metropolitan Statistical Area (n = 1,122). In the fall of 1984, schools were assigned to either a program group, which received school, booster, parent, and mass media program components, or a control group that received regular health education programming in school and mass media exposure. By six months, there was a significant effect of the program on recent smoking, with the prevalence of smokers in the program group increasing more slowly than in the control group. At two years, 19% of students in the program group reported smoking in the last month versus 29% of students in the control group; and 12% versus 19%, respectively, reported smoking in the last week. The lifetime prevalence rate showed a marginal program effect at two years, with 57% of students in the program group having smoked once or more compared with 65% in the control group. The program was also effective across different levels of cigarette use ranging from no current use to use of one pack or more per day at two years.