Changes in adult cigarette smoking in the Minnesota Heart Health Program.

Abstract

OBJECTIVES. The Minnesota Heart Health Program was a research and demonstration project designed to reduce risk factors for heart disease in whole communities. This paper describes smoking-specific interventions and outcomes. METHODS. Three pairs of matched communities were included in the study. After baseline surveys, one community in each pair received a 5-year education program, while both cross-sectional and cohort surveys continued in all sites. Adult education programs for smoking cessation included Quit and Win contests, classes, self-help materials, telephone support, and home correspondence programs. RESULTS. Encouraging short-term results were obtained for several adult education programs. Overall long-term outcomes were mixed, with evidence of an intervention effect only for women in cross-sectional survey data. Unexpectedly strong secular declines in smoking prevalence were observed in comparison communities. CONCLUSIONS. The findings suggest that community education may be unlikely to exceed dramatic secular reductions in smoking prevalence. The success of several key interventions and the incorporation of Minnesota Heart Health Program interventions by education communities are encouraging, however.

Randomized Trial of Reduced-Nicotine Standards for Cigarettes

“…A ran dom sample of residents surveyed before the start of the education program was resurveyed. For long-term smoking cessation, the cross-sectional survey data provided evidence of an intervention effect for women but not for men; no such effect was observed for ei ther sex in the cohort sample Lando et al 1995). Unexpectedly, large declines in smoking prevalence, especially among men, were ob served in comparison communities.…”

“…A meta-analysis of 62 studies comparing components of behavioral controls found that motiva tional rewards (contingency contracting) did not sig nificantly alter long-term cessation rates (Fiore et al 2000). In the final results of the Minnesota Heart Health Program, the failure of community education methods (which included motivational rewards for smoking cessation) to produce results that exceeded secular trends is an important demonstration of the difficulties in evaluating such modalities (Lando et al 1995).…”

“…By the end of this period, smoking prevalence-the only risk factor on which an impact could be demonstrated-had declined 13 percent more in the program communities than in the control ones. The Minnesota Heart Health Program failed to demonstrate an appreciable impact (Lando et al 1995). The Pawtucket Heart Health Program had little impact on smoking behavior; its first attempt at a smoking cessation program prompted only 11 smokers to quit (Elder et al 1986(Elder et al , 1987.…”

Helping women quit smoking: results of a community intervention program

“…In earlier trials, such as the North Karelia Project, 1 the Stanford Three-City Project, 2 and the Swiss National Research Program, 3 cigarette consumption or the prevalence of smoking was reduced. In more recent trials, such as the Stanford Five-City Project, 4 the Minnesota Heart Health Program, 5 the Pawtucket Heart Health Program, 6 and the Heart to Heart Project, 7 results were mixed, with some showing intervention effects on smoking behavior 4,5 but not others. 6,7 Several community trials have specifically addressed smoking.…”

Neighbors for a smoke free north side: evaluation of a community organization approach to promoting smoking cessation among African Americans.

“…Thus, individuals who may be isolated from one channel of information (e.g., by low literacy) may be reached by another.5 14 Unfortunately, results of several large community programs have been limited '5 or disappointing. 16 (Table 4). We also examined results separately for subgroups defined by and adjusted for education, income, and employment, variables that several analyses2 have indicated are primarily responsible for manifest differences in smoking between African Americans and Whites.…”