The effectiveness of a tobacco prevention program with adolescents living in a tobacco-producing region.

OBJECTIVES: This study investigated the efficacy of a social-influences tobacco prevention program conducted with adolescents living in a high tobacco production area. METHODS: Students in 10 experimental schools completed the tobacco prevention program and a booster intervention. Control students received health education as usual. RESULTS: After 2 years of treatment, smoking rates in the treatment group (vs the control group) were lower for 30-day, 7-day, and 24-hour smoking. The intervention had more of an impact on those who were involved in raising tobacco than it did on those not involved in raising tobacco. CONCLUSIONS: Although modest, effects were achieved with minimal intervention time in a high-risk group, indicating that social-influences prevention programs may be effective in such groups.

Relationship of personal tobacco-raising, parental smoking, and other factors to tobacco use among adolescents living in a tobacco-producing region.

This study examined factors related to tobacco use among youth from tobacco-raising (TRH) and nonraising households (NRH). The subjects were 3,851 seventh-grade students from 19 middle schools located in a tobacco-raising region. Valid self-reports of tobacco use were encouraged by the use of a test for carbon monoxide in expired air. Cigarette use was higher when (a) at least one parent smoked, and/or (b) the student personally raised tobacco. A boy who personally raised tobacco and had at least one parent who smoked was 10.2 times more likely to have smoked in the last 7 days than a boy from a nonraising household in which neither parent smoked. For girls, the odds ratio was 5.6:1. Tobacco use among students in this high-risk group was higher than rates reported in national or regional studies. Other results were: (1) use began very early--16% of the students had tried cigarettes and 13% of the boys had tried smokeless tobacco (SLT) in Grade 3 or earlier; and (2) users reported more lenient rules at home regarding tobacco use than did nonusers. Years from now, these high-risk students are likely to be major contributors to increased morbidity and mortality due to tobacco use. Implications for tobacco prevention in tobacco-raising areas are discussed.