Preventing the use of smokeless tobacco and cigarettes by teens: results of a classroom intervention

Severson, Herbert H.; Glasgow, Russell E.; Wirt, Roger; Brozovsky, Paul; Zoref, Leslie; Black, Carol M.; Biglan, Anthony; Ary, Dennis V.; Weissman, Wendy

doi:10.1093/her/6.1.109

Cited by 36 publications

(19 citation statements)

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“…2005). Although the suggestion that ST use precedes cigarette smoking has been in the literature for some time (Hatsukami & Severson, 1999;Severson et al, 1991), recent policy discussions on whether ST can serve as a safer alternative to cigarette smoking and whether ST manufacturers could adjust their warning labels have highlighted this issue. Our findings support the position that ST use appears to be a gateway to cigarette smoking among adolescent males in rural areas and presents a serious public health concern.…”

Section: Discussionmentioning

confidence: 99%

Smokeless tobacco cessation cluster randomized trial with rural high school males: Intervention interaction with baseline smoking

Walsh

Langer

Kavanagh

et al. 2010

Nicotine & Tobacco Research

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Methods Study design, power analysis, and eligibilityThis stratified randomized controlled trial was approved by the Institutional Review Board at the University of California, San Francisco. Given a two-sided alpha = .05 chi-square test adjusted for clustering within high schools with an intracluster correlation of .02, a total sample size of 40 high schools each with an average enrollment of 150 male ST users was estimated to be needed to provide 90% power to detect a significant difference AbstractIntroduction: Adolescent males in rural areas use smokeless tobacco (ST). We assessed the efficacy of a school-based nursedirected ST intervention among rural high school males.Methods: Study high schools were randomly selected from a public high school list of California rural counties. Consenting high schools were stratified by school size and randomly assigned within strata to intervention or no-intervention groups. After gaining parental consent, male students completed baseline and 1-year follow-up questionnaires. The intervention included peer-led educational sessions and an oral exam by the school nurse who also provided brief tobacco cessation counseling. We used binary generalized estimating equation (GEE) models accounting for clustering within schools to test no difference between groups after adjusting for year in high school using both completers only and multiple imputation for those lost to follow-up. Subgroup analyses assessed Baseline Factor × Group interaction in GEE models.Results: Twenty-one rural counties (72%), 41 randomly selected high schools (56%), and 4,731 male students (50%) participated with 65% retention. Nonsmoking ST users in the intervention group were significantly more likely to stop using ST at follow-up than those in the no-intervention group; there was no intervention effect among baseline ST users who also smoked. A higher percentage of baseline nonsmoking ST users reported smoking at follow-up than baseline non-ST-using smokers who reported using ST.Discussion: A school-based nurse-directed ST cessation program was efficacious among rural nonsmoking ST-using high school males. The potential program reach holds significant public health value. Baseline ST use facilitated smoking at follow-up.

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Section: Discussionmentioning

confidence: 99%

Smokeless tobacco cessation cluster randomized trial with rural high school males: Intervention interaction with baseline smoking

Walsh

Langer

Kavanagh

et al. 2010

Nicotine & Tobacco Research

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“…The curriculum addressing the physical consequences of tobacco use involves education about the addiction to nicotine, and the health consequences associated with tobacco use. Additional curriculum components involve messages mailed to parents about skills their children are learning on how to refuse tobacco use, health effects from tobacco and the child's commitment not to use ST or smoke cigarettes (Severson et al, 1991). Other components include community activism and positive reinforcement for abstinence as well as personalized booster telephone calls and messages during the year following the formal prevention curriculum (Elder et al, 1993).…”

Section: School-based Prevention Programsmentioning

confidence: 99%

“…Three school-based prevention-studies have shown promising short-term results, although the effects tend to be modest (Severson et al, 1991;Elder et al, 1993;Dent, Sussman, Stacy & Craig, 1995). One study out of the four studies found no difference between the active intervention and control groups (Stevens, Freeman, Mort, Youells, & Linsey, 1993).…”

Section: School-based Prevention Programsmentioning

confidence: 99%

Oral spit tobacco: addiction, prevention and treatment

Hatsukami

Severson

1999

Nicotine & Tobacco Research

100

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The prevalence of smokeless tobacco is significant and reaches as high as 17% past month use in white males aged 18-25. Smokeless tobacco use is of concern because of the potential for addiction and the associated negative health consequences. This article reviews the basis for addiction to smokeless tobacco, examining the nicotine content in smokeless tobacco products, pharmacokinetics, psychoactive effects, tolerance, and withdrawal. It also explores the negative health consequences which include a number of oral pathologies and increased cardiovascular risk factors. Furthermore, it examines the factors associated with the initiation of smokeless tobacco use, and the current prevention programs that address these factors. Current smokeless tobacco treatment approaches are also discussed as well as predictors for abstinence. Finally, the future directions are discussed in light of the limited amount of research that has been conducted in the smokeless tobacco area, particularly related to prevention and treatment.

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“…11,19 As a result of the increase in the price of cigarettes, of the implementation of educational programs in schools and of the increased exposure of adolescents to government prevention campaigns, there is evidence that the consumption of cigarettes is in decline among young people in the USA. 5,[22][23][24] There are not, however, any population data on the evolution of consumption among young people in Brazil. In order that such analyses be possible, prevalence studies carried out over time are essential, which is the objective of the Survey on Smoking Among Schoolchildren (VIGESCOLA), 25 which aims to monitor the magnitude of the smoking problem among Brazilian adolescents aged 13 to 15 years, by means of periodic epidemiological surveys undertaken in public and private schools.…”

Section: Introductionmentioning

confidence: 99%

Prevalência e variáveis associadas ao hábito de fumar em crianças e adolescentes

Silva¹,

Rivera²,

Carvalho³

et al. 2006

J. Pediatr. (Rio J.)

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Objective: To identify the prevalence of smoking and the presence of variables associated with the habit in children and adolescents of both sexes, aged 7 to 17 years, resident in the city of Maceió. Methods:A cross-sectional epidemiological study of the student population of the both private and public education systems at elementary and high school level. Sample size was calculated based on the minimum predicted prevalence of a large number of variables, including smoking itself. Cluster sampling was employed. A questionnaire on smoking habits was completed during individual interviews with each student. Children who admitted having smoked on 1 or more day during the previous 30 were defined as current smokers. The variables analyzed were related to: the students (age, sex, previous experimentation with cigarettes and paid employment), their educational status (public/private school, daytime/evening lessons, grade and repeated years) and their families (economic status, smoking parents and separated parents).Results: A total of 1,253 students were analyzed (547 were male, mean age was 12.4±2.9 years). Observed smoking prevalence was 2.4%. Multivariate statistical analysis demonstrated significant associations between smoking and: increased age (odds ratio: 1.31); previous experimentation with cigarettes (odds ratio: 33.96); studying during the evening (odds ratio: 5.43). It was observed that 286 students (22.8%) admitted having experimented with cigarettes (9% from 7 to 9 years; 21% from 10 to 14 years; 36% from 15 to 17 years). Conclusions:The prevalence of smoking among children and adolescents in the Maceió educational system is 2.4%, being most common among students aged 15 to 17 years, studying in the evening. Students who had experimented with cigarettes exhibited a 34 times greater chance of becoming smokers.

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Preventing the use of smokeless tobacco and cigarettes by teens: results of a classroom intervention

Cited by 36 publications

References 0 publications

Smokeless tobacco cessation cluster randomized trial with rural high school males: Intervention interaction with baseline smoking

Smokeless tobacco cessation cluster randomized trial with rural high school males: Intervention interaction with baseline smoking

Oral spit tobacco: addiction, prevention and treatment

Prevalência e variáveis associadas ao hábito de fumar em crianças e adolescentes

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