PREVENTION OF SMOKELESS TOBACCO USE IN CHILDREN

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This project is a Phase IV prevention study which long-term objectives (1) to test the effectiveness of an integrated school- based smokeless tobacco prevention intervention in deterring smokeless tobacco use in children and (2) to characterize the onset process for smokeless tobacco use among children. The specific aims of this project are (1) to integrate realistic and behaviorally and educationally sound school-based smokeless tobacco prevention components with an existing school-based smoking prevention curriculum for grades 6 and 7; (2) to implement the integrated smokeless tobacco prevention intervention in a realistic fashion; (3) to evaluate using a randomized controlled design the extent to which the integrated tobacco prevention intervention can reduce the prevalence of smokeless tobacco use at the end of 7th grade, and maintain the recuction in prevalence through and beyond high school; (4) to evaluate the cost and cost-effectiveness of the intervention; and (5) to characterize the smokeless tobacco use onset process among children. The integrated nature of the SLT prevention intervention, which responds to educators' need for interventions that are comprehensive and can fit annat a crowded school curricula, is designed to enhance the likelihood of subsequent successful dissemination and contribution to the goals of the National Cancer Program. The excellent existing collaborative relationship between the Hutchinson Center and school districts in the state of Washington, and the ongoing randomized controlled trial in school-based smoking prevention, will be used as timely and cost-efficient vehicles for the school-based implementation and long-term evaluation of the smokeless tobacco prevention intervention. This plan will allow the smokeless tobacco prevention components to be readily integrated with smoking prevention, timely start of the implementation and completion of short-term evaluation, and significant cost savings for the research.