Curbing Tobacco Use in Suburban and Rural Schools

青少年中的烟草使用仍然是一个主要的公共卫生问题。在过去的二三十年里， 在制定面向青少年的烟草控制方案方面取得了相当大的进展。几个 节目现在都是通过互联网提供的。然而，其中许多计划未能充分利用 现有的现代技术，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。我们的长期合作 目标是制定以青少年为对象的烟草控制计划，这些计划在说服青少年方面非常成功 建议年轻人避免使用烟草产品，或者，如果他们已经在使用这种产品，则戒烟。 我们最近完成了一项由NCI资助的研究--《通过光盘预防和戒烟青少年吸烟》 (项目ASPIRE)，采用了适合青少年的现代技术，并展示了重要的 有益的影响，特别是在防止吸烟方面。拟议的项目是项目的延续 ASPIRE，并将在ASPIRE项目的优势基础上再接再厉，并在重要方面加以扩展。新的 与其基于CD-ROM的前身不同，干预将以互联网为基础。虽然最初的节目是 这项新计划是为市中心主要是少数族裔青少年(6%的白人)设计并测试的 将针对一群具有显著不同种族的郊区和农村高中生 构成(-50%为白人)和社会经济地位特征。原创项目Aspire干预 将在仔细考虑新的目标人群和干预措施的情况下进行大幅重新设计 布景。因为非城市青少年烟草中唾液烟草消费的高流行率 吸烟者(根据我们的初步研究，有35%)、吐痰烟草也将在新计划中得到解决。 最后，在新方案中，课堂课程将以强大的、二维的社会 支持组件：(1)通过互联网公告栏和聊天室在家中提供虚拟支持；(2)人工支持 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痰烟草使用变化阶段的进展， 以及(5)与标准护理相比，调节烟草使用的关键变量发生了积极的变化 条件。这项研究将是一项随机分组对照试验，有2000名年龄在14-16岁的参与者参加 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点进行 6周、12个月和18个月。

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.