Curbing Tobacco Use in Suburban and Rural Schools

描述（由申请人提供）：青少年吸烟仍然是一个主要的公共卫生问题。在过去二、三十年中，在制定面向青少年的烟草控制规划方面取得了相当大的进展。现在有几个节目通过互联网提供。然而，这些程序中的许多没有充分利用现有的现代技术，如互动性、动画、视频片段、视频游戏组件和其他对当代精通计算机的年轻人具有巨大吸引力的功能。我们的长期目标是制定以青少年为导向的烟草控制计划，这些计划在说服年轻人避免使用烟草制品，或者如果他们已经在使用此类产品，就戒烟方面非常成功。我们最近完成了由nci资助的研究“透过光碟预防青少年吸烟及戒烟”（ASPIRE计划），采用了对青少年友好的现代科技，并显示出显著的有益影响，特别是在预防吸烟方面。拟议的项目是ASPIRE项目的延续，将以ASPIRE项目的优势为基础，并在重要方面对其进行扩展。与以往基于cd - rom的干预不同，新的干预将是基于互联网的。虽然最初的项目是为市中心主要的少数族裔青少年（白人占6%）设计和测试的，但新项目将针对郊区和农村的高中生群体，他们的种族构成（白人约占50%）和社会经济地位特征有很大不同。最初的ASPIRE项目干预措施将经过大量重新设计，并仔细考虑新的目标人群和干预环境。由于在非城市青少年烟草使用者中，吐痰烟草消费的流行率很高（根据我们的初步研究，这一比例为35%），因此，新规划也将解决吐痰烟草问题。最后，在新项目中，课堂课程将加强一个强大的二维社会支持组成部分：(1)通过互联网公告板和聊天室在家中提供虚拟支持；(2)通过训练有素的学校人员（教师、教练、辅导员和护士）提供人力支持。我们的具体目标是确定新的干预措施是否导致(1)吸烟开始减少，(2)戒烟增加，(3)对吐痰烟草使用产生积极影响，(4)通过跨理论模型的吸烟和吐痰烟草使用变化阶段的积极进展，以及(5)与标准护理条件相比，已知的调节烟草使用的关键变量发生积极变化。这项研究将是一项分组随机对照试验，2000名参与者年龄在14-16岁之间，来自德克萨斯州东南部郊区和农村的16所高中。随访评估将在6周、6个月、12个月和18个月进行。

DESCRIPTION (provided by applicant): 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 (approximately 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.