PREVENTING CHANGE TO REGULAR SMOKING IN COLLEGE STUDENTS

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Tobacco use is responsible for 30 percent of all cancer deaths. Although the overall prevalence of adult cigarette smoking is declining in the US, the prevalence among young adults is increasing, especially among college students where an estimated 28 percent smoke. Career development: Activities include training in cancer prevention and control, advanced biostatistics, advanced epidemiology, nicotine addiction, and medical ethics. Research Program: The goals of the research program are to better understand the smoking behaviors of college students and to identify and test the feasibility of an intervention. The plan involves three studies that address six research questions. Studies will be conducted in collaboration with the Student Health Center and Wellness Center at University of Missouri- Columbia (MU). Study 1 details the natural history of smoking in college students. Measures adapted from existing assessments will be administered to 3,500 students in introductory classes at MU. Students will construct identifiers, which will be used to maintain confidentiality and to match students' responses to a follow-up survey administered in study year 4, when the cohort will be in their senior year. Study 1 will provide information on the progression and correlates of smoking in college students, many of whom may smoke occasionally as freshman but progress to daily smoking while in college. Study 2 consists of conducting three single-gender focus groups and follow-up interviews among each of two distinct groups, occasional (less than 5 cigarettes per day) and regular to heavy (at least 10 cigarettes per day) smokers. The goals of these twelve groups are to identify: a) interest in quitting and/or managing smoking, b) barriers to behavior change, c) strategies used to quit and/or manage smoking, and, d) intervention preferences across levels of smoking. Study 3 is a pilot study examining the feasibility and efficacy of a counseling intervention based on Motivational Interviewing and booster e-mail messages. Students will be randomized to either a tailored (n=40) or standard control (n=40) arm. Trained counselors will tailor two 15-minute sessions and three electronic mail messages based on students' interest in reducing or quitting. Primary outcomes include progression to regular smoking, cigarette consumption, and quit rates over two years. The research plan uses exploratory, descriptive, and intervention research to address tobacco use an understudied population, college students. Each study stands on its own, but is designed to build on the findings of the prior study. The proposed experiences will provide Dr. Harris with the skills to develop and launch a fully independent career in cancer prevention and control.