SPIT TOBACCO USE PREVENTION/CESSATION

在年轻的美国男性中，唾液(无烟)烟草(ST)的使用率正在上升，在农村地区的居民中尤其普遍，并使他们面临口腔癌和牙周组织破坏的风险。这项建议有以下具体目标：(1)确定在加州农村地区28所高中的男性学生中实施以学校为基础的护士指导、每名和牙医协助的ST干预计划的有效性，以及(2)确定农村高中男性学生成功停止ST的预测因素。该干预以认知社会学习理论和创新扩散理论为基础，运用了公共健康的视角，通过接近环境中的科技使用者和创新理论，并应用了公共健康的视角，通过接近环境中的科技使用者，试图改变社会规范来影响行为改变。加州的28所农村高中将根据男性使用ST的基线流行率和招生规模进行分层，并在分层内随机分配到干预组或控制组。干预措施包括学校顾问委员会；同伴主导的教育会议；由学校护士进行的口试和戒烟或戒烟的建议，护士通过自己的嘴巴或照片向使用者指出任何与ST相关的病变，提供简短的戒烟咨询，并促进三个小组跟踪复发预防会议，对患有ST相关口腔病变的学生进行为期1周的后续检查，并安排患有持续性病变的学生接受牙医的评估；以及由同行打两个后续电话电话以防止复发。在干预结束时和一年后，将比较不同组之间的生物化学验证的自我报告的戒烟率和自我报告的启动率。将分析对ST使用的基线和后续问卷评估，以确定与戒除ST使用有关的个人特征。研究结果将有助于掌握有关烟草预防和戒烟的知识，从而有助于口腔癌的一级和二级预防以及与烟草使用有关的其他负面口腔健康影响。

Use of spit (smokeless) tobacco (ST) is increasing in prevalence among young American males, is especially prevalent among those residing in rural areas, and puts them at risk of oral cancer, and periodontal tissue destruction. This proposal has the following specific aims: (1) to determine the efficacy of a school-based nurse-directed, per- and dentist-assisted ST intervention program among male students in 28 high schools in rural areas of California and (2) to determine predictors of successful ST cessation among male students in rural high schools. The intervention is based on Cognitive Social Learning Theory and Diffusion of Innovation Theory and applies a public health perspective by approaching ST users in their environment and Innovation Theory and applies a public health perspective by approaching ST users in their environment and attempting to change social norms to effect behavioral change. Twenty-eight rural high schools in California will be stratified on baseline prevalence of male ST use and size of enrollment and randomly assigned within strata to either the intervention or the control group. The intervention will consists of a school advisory board; peer-led educational sessions; an oral exam and advice to quit or to stay tobacco-free by a school nurse who points out any ST-associated lesions to users by their own mouths or in photographs, provides brief cessation counseling, and facilitates three group follow-up relapse prevention sessions, conducts 1-week follow-up examines of students with ST-related oral lesions, and schedules students with persistent lesions for evaluation by a dentist; and, two follow-up telephone cells by a peer to prevent relapse. Biochemically validated self-reported quit rates and self reported initiation rates at the end of the intervention and 1 year later will be compared between groups. Baseline and follow-up questionnaire assessments of ST use will be analyzed to identify individual characteristics that are associated with quitting ST use. Results will contribute to the body of knowledge related to tobacco prevention and cessation and thereby to the primary and secondary prevention of oral cancer and other negative oral health effects associated with tobacco use.