Abstract
This study evaluates the effects of a school-based smoking prevention program after 1 year, using school (22 middle/elementary schools, 15 high schools) as both the unit of randomization and the unit of analysis. The multigrade level (grades 6 through 9) intervention was designed to address comprehensively the social influence factors that encourage smoking. Teacher survey data indicated that treatment schools had a median of 10 classroom sessions devoted to tobacco/drug use education, 5 of which were the sessions designed for this evaluation, and control schools had also dedicated a median of 10 classroom sessions to tobacco/drug education. Thus, the study evaluated the incremental effects of the social influence intervention compared to “standard-care” curricula. Among those who reported smoking one or more cigarettes in the month prior to the intervention, there was a significant treatment effect on rate of smoking at one year, but no grade level, gender, or interaction effects. The 1-year covariate-adjusted smoking rate among pretest smokers in the treatment schools was 76.6 cigarettes per month, compared to 111.6 cigarettes per month in control schools, a 31.4% difference. These effects were not accounted for by differential subject attrition. The analyses for nonsmokers, however, showed no significant effects, and the program did not affect self-reported alcohol or marijuana use. Taken together with the results of other prevention studies, these results point to the need for the development and evaluation of new initiatives to prevent substance use.
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References
American School Health Association (1987).School Health in America: A Survey of State School Health Programs, 4th ed., American School Health Association, Kent, OH.
Ary, D. V., and Biglan, A. (1988). Longitudinal changes in adolescent cigarette smoking behavior. Onset and cessation.J. Behav. Med. 11(4): 361–382.
Bangert-Drowns, R. L. (1988). The effects of school-based substance abuse education: A meta-analysis.J. Drug Educ. 18: 243–264.
Barcikowski, R. S. (1981). Statistical power with group mean as the unit of analysis.J. Educ. Stat. 6: 267–285.
Bauman, K. E., and Dent, C. W. (1982). Influence of an objective measure on self-reports of behavior.J. Appl. Psychol. 67: 623–628.
Bell, D., and Associates (1977).The Feminine Mistake (film), Pyramid Films, Los Angeles.
Benowitz, N. L., Hall, S. M., Herning, R. I., Jacob, P., Jones, R. T., and Osman, A. L. (1983). Smokers of low-yield cigarettes do not consume less nicotine.N. Engl. J. Med. 309: 139–142.
Best, J. A., Flay, B. R., Towson, S. M. J., Ryan, K. B., Perry, C. L., and Brown, K. S. (1984). Smoking prevention and the concept of risk.J. Appl. Soc. Psychol. 14: 257–273.
Biglan, A., and Ary, D. V. (1985). Methodological issues in research on smoking prevention. In Bell, C., and Battjes, R. (eds.),Prevention Research: Deterring Drug Abuse Among Children and Adolescents, NIDA Research Monograph, U.S. Government Printing Office, Washington, DC.
Biglan, A., Severson, H. H., Bavry, J., and McConnell, S. (1983). Social influence and adolescent smoking: A first look behind the barn.Health Educ. Sept./Oct.: 14–18.
Biglan, A., Glasgow, R., Ary, D. V., Thompson, R., Severson, H. H., Lichtenstein, E., Weissman, W., Faller, C., and Gallison, C. (1987a). How generalizable are the effects of smoking prevention programs? Refusal skills training and parent messages in a teacher-administered program.J. Behav. Med. 10: 613–628.
Biglan, A., Severson, H. H., Ary, D. V., Faller, C. L., Gallison, C., Thompson, R., Glasgow, R., and Lichtenstein, E. (1987b). Do smoking prevention programs really work? Attrition nd the internal and external validity of an evaluation of a refusal skills training program.J. Behav. Med. 10: 159–171.
Biglan, A., James, L. E., La Chance, P. A., Zoref, L., and Joffe, J. (1988). Videotaped materials in a school-based smoking prevention program.Prev. Med. 17: 559–584.
Biglan, A., Wendler, C., Wirt, R., Ary, D. V., Noell, J., Ochs, L., French, C., and Hood, D. (in press). Social and behavior factors associated with high-risk sexual behavior among adolescents.J. Behav. Med.
Botvin, G. J., Baker, E., Renick, N., Filazzola, A. D., and Botvin, E. M. (1984). A cognitive-behavioral approach to substance abuse prevention.Addict. Behav. 9: 137–148.
Bry, B. H., McKeon, P., and Pandina, R. J. (1982). Extent of drug use as a function of number of risk factors.J. Abnorm. Psychol. 91: 237–279.
Bry, B. H., Pedraza, M., and Pandina, R. J. (1988). Number of risk factors predicts three year probabilities of heavy drug and alcohol use in adolescents. In Harris, L. S. (ed.),Problems of Drug Dependence, 1987, National Institute on Drug Abuse, Research Monograph #81:301, Rockville, Md.
Donovan, J. E., and Jessor, R. (1978). Adolescent problem drinking: Psychosocial correlates in a national sample study.J. Studies on Alcohol, 39(9): 1506–1524.
Evans, R. I., Hansen, W. B., and Mittelmark, M. (1977). Increasing the validity of self-reports of behavior in a smoking in children investigation.J. Appl. Psychol. 62: 521–523.
Flay, B. (1985). What do we know about the social influence approach to smoking prevention? Review and recommendations. In Bell, C., and Battjes, R. (eds.),Prevention Research: Deterring Drug Abuse Among Children and Adolescents, NIDA Research Monograph, U.S. Government Printing Office, Washington, DC.
Flay, B. (1986). Efficacy and effectiveness trials in the development of health promotion programs.Prev. Med. 15: 541–474.
Glynn, T. J. (1988). Essential elements of school-based smoking prevention programs: Research results.J. School Health, 59(5): 181–188.
Hansen, W. B., Collins, L. M., Malotte, C. K., Johnson, C. A., and Fielding, J. E. (1985). Attrition in prevention research.J. Behav. Med. 8: 251–276.
Hawkins, J. D., and Lishner, D. M. (1987). Schooling and delinquency. In E. H. Johnson (Ed.),Handbook on Crime and Delinquency Prevention, Greenwood Press, New York.
Hundleby, J. D., Carpenter, R. A., Ross, R. A., and Mercer, G. W. (1982). Adolescent drug use and other behaviors.J. Child Psychol. Psychiat. 23: 61–68.
Jessor, R., and Jessor, S. L. (1977).Problem Behavior and Psycho-social Development: A Longitudinal Study of Youth, Academic Press, New York.
Murray, D. M., Johnson, C. A., Luepker, R. V., and Mittelmark, M. B. (1984). The prevention of cigarette smoking in children: A comparison of four strategies.J. Appl. Soc. Psychol. 14: 274–288.
Murray, D. M., O'Connell, C. M., Schmid, L. A., and Perry, C. L. (1987). The validity of smoking self-reports by adolescents: A reexamination of the bogus pipeline procedure.Addict. Behav. 12: 7–15.
Newcomb, M. D., and Bentler, P. M. (1966). Cocaine use among adolescents: Longitudinal associations with social context, psychopathology, and use of other substances.Addict. Behav. 11: 263–273.
Newcomb, M. D., Maddahian, E., and Bentler, P. M. (1986). Risk factors for drug use among adolescents: Concurrent and longitudinal analyses.Am. J. Publ. Health 76: 525–531.
Oregon Research Institute (1986).Big Dipper (film), Independent Video Services, Eugene, OR.
Osgood, D. W., Johnston, L. D., O'Malley, P. M., and Bachman, J. G. (1988). The generality of deviance in late adolescence and early adulthood.Am. Sociol. Rev. 53: 81–93.
Patterson, G. R., DeBaryshe, B. D., and Ramsey, E. (1989). A developmental perspective on antisocial behavior.Am. Psychol. 44: 1–7.
Pechacek, T. F., Murray, D. M., Luepker, R. V., Mittelmark, M. B., Johnson, C. A., and Schultz, J. M. (1984). Measurement of adolescent smoking behavior: Rationale and methods.J. Behav. Med. 7: 123–140.
Pirie, P. L., Murray, D. M., and Luepker, R. V. (1988). Smoking prevalence in a cohort of adolescents, including absentees, dropouts, and transfers.Am. J. Publ. Health 78: 176–178.
Severson, H. H. (1984). Adolescent social drug use: School prevention programs.School Psychol. Rev. 13: 150–161.
Severson, H. H., and Ary, D. V. (1983). Sampling bias due to consent procedures with adolescents.Addict. Behav. 8: 433–437.
Severson, H. H., and Lichtenstein, E. (1986). Smoking prevention programs for adolescents: Rationale and review. In Krasnegor, N., and Cataldo, M. (eds.),Child Health Behavior, Wiley, New York.
Tobler, N. S. (1986). Meta-analysis of 143 adolescent drug prevention programs: Quantitative outcome results of program participants compared to a control or comparison group.J. Drug Issues 16(4): 537–567.
U.S. Department of Health and Human Services (1986).The Health Consequences of Involuntary Smoking. A Report of the Surgeon General, Publication No. 87-8398, U.S. Public Health Service.
U.S. Department of Health and Human Services (1987).Smoking and Health: A National Status Report, Publication No. 87-8396, U.S. Public Health Service.
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Research supported by grants from the National Cancer Institute (CA38273) and the National Institute of Drug Abuse (DA03635).
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Ary, D.V., Biglan, A., Glasgow, R. et al. The efficacy of social-influence prevention programs versus “standard care”: Are new initiatives needed?. J Behav Med 13, 281–296 (1990). https://doi.org/10.1007/BF00846835
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DOI: https://doi.org/10.1007/BF00846835