ORGANIZING SOCIAL INFLUENCES TO PREVENT SMOKING

我们的主要目标是减少经常吸烟的人数

Our major aim is to reduce the incidence of regular cigarette smoking among adolescents through a strategy based on education and communication principles. This effect will be achieved through changes in skills for resisting pressure from peers to initiate smoking; changes in beliefs and norms of adelescents, especially those at highest risk for adoption of smoking; and changes in adolescents' perceptions of the expectations of family members and other adult community members for their behaviors related to cigarette smoking. The latter will be mediated by changes in adult behavior accomplished by program components directed at family members and the general community. Our data collection techniques will enable us to describe individual patterns of change in smoking-related behaviors of participating adelescents. We propose a multi-level community-based strategy that combines 1) school programs for target group adolescents with 2) workshops in communication skills for parents, teachers, and other adults having contact and influence with adolescents; 3) programs in school for older youth, including older siblings of study cohort adolescents; 4) the advice, initiative, and participation of local community advisory councils; and 5) coordinated mass media programs. Adolescents will be identified at the beginning of their sixth grade school year and will be followed into the tenth grade; interventions will be provided during sixth through ninth grade years. Twelve communities will be assigned to one of four study groups: the three communities in the first experimental groups will receive the complete treatment; those in the second experimental group will receive the school program only; and those in the third and fourth groups will be control communities, the latter being studied in the first and fifth years only. For the first three groups, the adolescent cohort will complete an annual self-report questionnaire, and will provide saliva samples for thiocyanate analysis. All data for individual students will be linked. This project will draw on our expertise in public and school health education, communication, biostatistics, and pulmonary medicine. Our long-term objective is to reduce lung disease mortality in Vermont related to cigarette smoking.