Curbing Tobacco Use in Suburban and Rural Schools

青少年吸烟仍然是一个重大的公共卫生问题。在过去的二三十年里， 在制定以健康为导向的烟草控制方案方面取得了相当大的进展。几 现在通过互联网提供节目。然而，这些程序中有许多未能充分利用 可用的现代技术，如互动，动画，视频片段，视频游戏组件， 以及其他对当代精通计算机的年轻人具有巨大吸引力的功能。我们的长期 我们的目标是制定以戒烟为导向的烟草控制计划，这些计划在说服 青年人避免使用烟草产品，如果他们已经在使用这类产品，则应戒烟。 我们最近完成的国家癌症研究所资助的研究，“青少年吸烟预防和戒烟通过光盘” （ASPIRE项目），采用了对难民友好的现代技术， 有益的影响，特别是在预防吸烟。拟议项目是项目的延续 ASPIRE将以ASPIRE项目的优势为基础，并以重要的方式加以扩大。新 干预措施与其以光盘为基础前身不同，将以因特网为基础。虽然最初的计划是 这项新计划是为市中心的少数民族青少年（6%是白人）设计和测试的， 将针对一群郊区和农村的高中生， 化妆（-50%白人）和社会经济地位特征。最初的ASPIRE项目干预 将在认真考虑新的目标人群和干预措施的情况下， 设置.由于在非城市青少年吸烟者中， 使用者（根据我们的初步研究为35%），吐出的烟草也将在新方案中得到解决。 最后，在新方案中，课堂课程将强化一个强大的，二维的社会 支助部分：（1）通过因特网公告栏和聊天室在家里提供虚拟支助，（2）人工支助 通过训练有素的学校人员（教师、教练、辅导员和护士）提供支持。 我们的具体目标是确定新的干预措施是否会导致（1）减少吸烟 开始，（2）戒烟增加，（3）对吐痰烟草的使用产生积极影响，（4）积极 通过跨理论模型的吸烟和吐出烟草使用的变化阶段的进展， 和（5）与标准护理相比，已知介导烟草使用的关键变量发生了积极变化 条件该研究将是一项分组随机对照试验，有2000名年龄在14-16岁的参与者 来自德克萨斯州东南部郊区和农村的16所高中。后续评估将于6时进行 在6周、12个月和18个月时。

Tobacco use among adolescents remains a major public health problem. Over the past 2-3 decades, considerable progress has been made in developing adolescent-oriented tobacco control programs. Several programs are now being offered via the Internet. However, many of these program fail to take full advantage of available modern technology such as interactivity, animations, video segments, video-game components, and other features that hold tremendous appeal for contemporary, computer-savvy youth. Our long-term goal is to develop adolescent-oriented tobacco control programs that are extremely successful in convincing young people to avoid using tobacco products or, if they are already using such products, to quit. Our recently completed NCI-funded study, "Teen Smoking Prevention and Cessation via CD-ROM" (Project ASPIRE), incorporated adolescent-friendly modern technology and demonstrated a significant beneficial impact, particularly in smoking prevention. The proposed project is a continuation of Project ASPIRE and will build on the strengths of Project ASPIRE and expand it in important ways. The new intervention, unlike its CD-ROM-based predecessor, will be Internet-based. While the original program was designed for and tested among inner-city, predominantly minority adolescents (6% whites), the new program will be targeted at a group of suburban and rural high school students with a substantially different ethnic make-up (-50%whites) and socio-economic status characteristics. The original Project ASPIRE intervention will be substantially redesigned with careful consideration of the new target population and intervention setting. Because of the high prevalence of spit tobacco consumption among non-urban teenage tobacco users (35% according to our preliminary study), spit tobacco will also be addressed in the new program. Finally, in the new program, the classroom curriculum will be fortified with a strong, two-dimensional social support component: (1) virtual support at home via Internet bulletin boards and chat rooms and (2) human support via trained school personnel (teachers, coaches, counselors, and nurses). Our specific aims are to determine whether the new intervention results in (1) a reduction in smoking initiation, (2) an increase in smoking cessation, (3) a positive impact on spit tobacco use, (4) positive progression through the transtheoretical model's stages of change in both smoking and spit tobacco use, and (5) positive change in key variables known to mediate tobacco use compared to a standard care condition. The study will be a group-randomized, controlled trial with 2000 participants aged 14-16 years from 16 high schools in suburban and rural southeast Texas. Follow-up assessments will be conducted at 6 weeks and at 6, 12, and 18 months.