Minnesota Tobacco-Use Prevention Initiative
                    1989-1990: a report to the 1991 legislature.
    Supplier No.: 
                    93-3594
    Corp. Author: 
                    Minnesota Department of Health, Section for
                    Nonsmoking and Health.
    Pub. Year: 
                    1991
    Pagination: 
                    170 pp.
    Pub. Date: 
                    1991
    Pub. Info: 
                    Minnesota Department of Health, Section for
                    Nonsmoking and Health.
    Abstract: 
                    This report to the Minnesota Legislature provides
                    information about Minnesota's Tobacco-Use
                    Prevention Initiative and the programs that have been
                    developed from this initiative. The programs include:
                    (1) an international award-winning media campaign,
                    (2) a community grants program, (3) an evaluation
                    effort, (4) comprehensive policy initiatives, and (5)
                    innovative school programs. This is the third report in
                    a series of biennial reports to the Legislature. In
                    preparing this report, the Section for Nonsmoking and
                    Health of the Minnesota Department of Health has
                    provided brief summaries of data pertinent to the
                    Legislature. The tobacco- use prevention activities of
                    the Minnesota Department of Education also are
                    included in this report. Sections in this report include:
                    (1) Executive Summary, (2) Legislative History, (3)
                    Update on Tobacco Use as a Public Health Problem,
                    (4) Mass Media and Market Research, (5)
                    Community and Statewide Grants Projects, (6) School
                    Programs, (7) Technical Assistance for the Minnesota
                    Clean Indoor Air Act, (8) Evaluation of the Minnesota
                    Tobacco-Use Prevention Initiative, and (9) Future
                    Directions.

Title: Meta-analysis on the Association Between Environmental Tobacco Smoke
(ETS) Exposure and the Prevalence of Lower Respiratory Tract Infection in Early
Childhood.
Supplier No.: 99-0374
Author: Li, J.S.M.;Peat, J.K.;Xuan, W.;Berry, G.
Author Affiliation: Royal Prince Alfred Hospital, Camperdown, New South
Wales, Australia.
Pub. Year: 1999
Journal Name: Pediatric Pulmonology
Volume: 27
Issue No.: 1
Pagination: 5-13
Pub. Date: January 1999
Abstract: This journal article describes a study that used meta-analysis techniques
to measure the association between environmental tobacco smoke (ETS) exposure
and the prevalence of serious respiratory tract infections (LRTIs) in infancy and
early childhood. Twenty-one relevant publications were identified on the
relationship between ETS and the prevalence of serious LRTI by reviewing
reference lists in relevant reports and by conducting manual and computer searches
of published reports between 1966 and 1995. Thirteen studies were included in a
quantitative overview using random effects modeling to derive pooled odds ratios.
Sensitivity analyses were conducted to test the decision rules used in extracting odds
ratio data. Analyses reveal that the results of community and hospital studies were
broadly consistent and show that the child of a parent who smokes was at
approximately twice the risk of having a serious respiratory tract infection in early
life that required hospitalization. This association was pronounced in children
younger than age two and diminished after the age of two. The combined odds ratio
for hospitalization for lower respiratory tract infections in infancy or early
childhood was 1.93. The combined odds ratios of prevalence of serious LRTI at
ages less than two years, between zero and six years, and between three and six
years were 1.71, 1.57, and 1.25, respectively. There was no evidence of
heterogeneity across the studies in these combined odds ratios. The article concludes
that the meta-analysis provides strong evidence that exposure to ETS causes adverse
respiratory health outcomes, including a serious LRTI or hospitalization for LRTI.
Therefore, new public health campaigns are urgently needed to discourage smoking
in the presence of young children.

Title: ADHD Is Associated With Early Initiation of Cigarette Smoking in Children
and Adolescents.
Supplier No.: 97-0358
Author: Milberger, S.;Biederman, J.;Faraone, S.V.;Chen, L.;Jones, J.
Author Affiliation: Pediatric Psychopharmacology Unit, Massachusetts General
Hospital, Boston, MA.
Pub. Year: 1997
Journal Name: Journal of the American Academy of Child and Adolescent
Psychiatry
Volume: 36
Issue No.: 1
Pagination: 37-44
Pub. Date: January 1997
Abstract: This article describes a study that examined the association between
attention deficit hyperactivity disorder (ADHD) and cigarette smoking in children
and adolescents. Subjects were boys between the ages of six and 17 who were
followed prospectively for four years. At the four-year follow-up, 128 of the 140
DSM-III-R ADHD children and 109 of the 120 non-ADHD controls seen at baseline
were successfully recruited. Information on cigarette smoking was obtained in a
standardized manner blind to the subject's clinical status. Cox proportional hazard
models were used to predict cigarette smoking at follow-up using baseline
characteristics as predictors. Results indicate that ADHD was a significant predictor
of cigarette smoking at follow-up into mid-adolescence. Findings also reveal that
ADHD was associated with an early initiation of cigarette smoking. This was the
case even after controlling for socioeconomic status, intelligence quotient, and
psychiatric comorbidity. In addition, among children with ADHD, there was a
significant positive association between cigarette smoking and conduct, major
depressive, and anxiety disorders. ADHD, particularly the comorbid subtype, is a
significant risk factor for early initiation of cigarette smoking in children and
adolescents. Considering the prevalence and early childhood onset of ADHD,
findings highlight the importance of smoking prevention and cessation programs for
children and adolescents with ADHD.

itle: Tobacco Use Measurement, Prediction, and Intervention in Elementary
Schools in Four States: The CATCH Study.
Supplier No.: 97-0033
Author: Elder, J.P.;Perry, C.L.;Stone, E.J.;Johnson, C.C.;Yang, M.;Edmundson,
E.W.;Smyth, M.H.;Galati, T.;Feldman, H.;Cribb, P.;Parcel, G.S.
Author Affiliation: Division of Health Promotion, Graduate School of Health,
San Diego State University, San Diego, CA.
Pub. Year: 1996
Journal Name: Preventive Medicine
Volume: 25
Issue No.: 4
Pagination: 486-494
Pub. Date: July-August 1996
Abstract: This article discusses the changes in school tobacco-use policies and
smoking experimentation among students. The Child and Adolescent Trial for
Cardiovascular Health (CATCH) is a multistate field trial that examined the effects
of school environment, classroom curricula, and family intervention components in
promoting cardiovascular health in elementary school students. Changes in school
tobacco use policies and smoking experimentation among students was assessed.
Smoking experimentation was measured in all CATCH elementary schools when the
students were in fifth grade. A total of 6,527 fifth graders in 96 schools in
California, Louisiana, Minnesota, and Texas answered questions about behaviors
and potential correlates of the CATCH health behavior questionnaire in spring 1994.
School tobacco-use policy, an important complement to classroom- and home-based
prevention efforts, was promoted as part of the CATCH intervention. The degree to
which such policy was implemented was measured using surveys of school officials.
At the end of fifth grade, 4.8 percent of the subjects indicated that they had
experimented with tobacco. School intervention condition was not a factor in the
prediction of the experiment. Those whose best friends or siblings smoked, or who
had access to cigarettes at home, were more likely to have experimented with
smoking. Three years of study indicate that the percentages of tobacco free schools
went up from 49.7 percent to 76.8 percent. The rate of policy adoption could not be
directly attributed to the CATCH intervention, but the implementation of the
tobacco-free schools policies did vary substantially from state to state.

Title: Guidelines for School Health Programs to Prevent Tobacco Use and
Addiction.
Supplier No.: 98-1445
Corp. Author: U.S. Department of Health and Human Services, Centers for
Disease Control and Prevention, National Center for Chronic Disease Prevention
and Health Promotion.
Pub. Year: 1994
Journal Name: MMWR. Morbidity and Mortality Weekly Report
Volume: 43
Issue No.: RR-2
Pagination: 1-18
Pub. Date: February 25, 1994
Pub. Info: Atlanta, GA: U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention, National Center for Chronic Disease
Prevention and Health Promotion.
Abstract: These guidelines summarize school-based smoking prevention
strategies most likely to be effective in preventing tobacco use among youth. They
were developed by the Centers for Disease Control and Prevention in
collaboration with experts from 29 national, federal, and voluntary agencies and
with other leading authorities in the field of tobacco-use prevention to help school
personnel implement effective tobacco-use prevention programs. These
guidelines, which are based on an in-depth review of research, theory, and current
practice in the area of school-based tobacco-use prevention programs, recommend
that all schools develop and enforce a school policy on tobacco use; provide
instruction about the short- and long-term negative physiologic and social
consequences of tobacco use, social influences on tobacco use, peer norms
regarding tobacco use, and refusal skills; provide tobacco-use prevention
education in kindergarten through twelfth grade; provide program-specific training
for teachers; involve parents or families in support of school-based programs to
prevent tobacco use; support cessation efforts among students and all school staff
who use tobacco; and assess the tobacco-use prevention program at regular
intervals.


Title: Expectations of preschool children to protect themselves from cigarette
smoke: results of a smoking prevention program for preschool children.
Supplier No.: 91-5065
Author: Philips, B.U., Jr.;Longoria, J.M.;Parcel, G.S.;Ebeling, E.W.
Author Affiliation: (Auth. Abs.)
Pub. Year: 1990
Journal Name: Journal of Cancer Education
Pagination: 5(1):27-31
Pub. Date: 1990
Abstract: Because preschoolers and first graders show signs of readiness to try
smoking and because they are already learning about smoking through their
environment, smoking prevention at the preschool level is appropriate. The large
numbers of children seen in primary care practices and day care facilities are
indicative of the numbers that could be exposed to smoking prevention instruction
through these settings. This study assessed the future expectations of children to
protect themselves from sidestream smoke after participating in a preschool
smoking prevention program offered in four primary care settings. Through this
program, children and their parents read stories and complete activities concerning
the human body and the health risks of smoking. Using a randomized
posttest-only case control design, the authors found that children who were
exposed to the curriculum were more than twice as likely as others to report the
intention to act to protect themselves from adult sidestream smoke.


Title: Preschool behavior disorders: Their prevalence in relation to determinants.
Supplier No.: 89-4002
Author: Larson, C.P.;Pless, I.B.;Miettinen, O.
Author Affiliation: (Auth. Abs.)
Pub. Year: 1988
Journal Name: Journal of Pediatrics
Pagination: 113(2):278-85
Pub. Date: Aug 1988
Abstract: The occurrence of behavior disorders was investigated in a prospectively
followed 3-year-old birth cohort. Of 1116 eligible children, the parents of 918 were
successfully contacted. All agreed to complete a telephone interview and were
mailed a Childhood Behavior Checklist (CBCL) standardized for 2- to 3-year-old
children; 756 (82%) returned the CBCL. The prevalence of one or more of the
deviant behavior syndromes identified by the CBCL was 11.1%. From a number of
subject characteristics recorded throughout infancy, age-specific determinants for
the occurrence of these deviant behaviors were identified. Characteristics most
consistently associated with preschool psychopathology included the mother's ill
health and lack of social support, the presence of chronic illness in the child, and
the frequent use of hospital emergency services. These and other determinant (risk)
indicators were entered into logistic regression (LR) models to derived adjusted
relative risk estimates for the occurrence of a behavior disorder. The derived LR
equations emphasize the important role of both the mother as well and the father and
the health of the child.


Title: Effects of Primary Grades Health Curriculum Project on Student and Parent
Smoking Attitudes and Behavior.
Supplier No.: 840907
Author: Andrews, R. L.;Hearne, J. T.
Pub. Year: 1984
Journal Name: Journal of School Health
Pagination: 54(1): 18-20
Pub. Date: January 1984
Abstract: Recent research indicates that school health programs using cognitive
and affective strategies are the most successful in producing behavioral change in
adolescents and adults, and that these programs may have secondary benefits for
family members. Few studies, however, have investigated the effectiveness of such
programs in younger children. The Primary Grades Health Curriculum Project
investigated the relationship between an experiential, activity-centered educational
program and (1) positive health attitudes; (2) experimentation with smoking and
alcohol, and anticipated future smoking; and (3) changes in parental smoking
behavior. In 1977, 600 kindergarten students in two New York school districts,
pretested for entry level knowledge and health attitudes, were assigned to
experimental or control groups. By the end of the third grade, data indicated that
experimental students possessed significantly more positive health attitudes, were
less apt to have experimented with alcohol and smoking, and were less exposed to
peers who engaged in drinking compared with controls. Nonsignificant differences
were found for anticipated future smoking. A significant number of parents of
experimental group students reported changes in smoking habits as a result of the
child's participation in the program.
Stage: CDP


Title: Long-term Prevention of Tobacco Use Among Junior High School
Students: Classroom and Telephone Interventions.
Supplier No.: 93-4048
Author: Elder, J.P.;Wildey, M.;de Moor, C.;Sallis, J.F.;Eckhardt, L.;Edwards,
C.;Erickson, A.;Golbeck, A.;Hovell, M.;Johnston, S.;et al.
Pub. Year: 1993
Journal Name: American Journal of Public Health
Volume: 83
Issue No.: 9
Pagination: 1239-1244
Pub. Date: September 1993
Abstract: This study evaluates the effectiveness of a tobacco use prevention
program for junior high school students in San Diego County, California. The
Students Helping Others Understand Tobacco (SHOUT) intervention was
delivered by college undergraduates over a three-year period. Eleven schools
participated in the psychosocial, school-based intervention and 11 others served as
controls. Following two years of classroom refusal skills and related antitobacco
training, subjects received newsletters and personalized booster phone calls as a
followup. Students were surveyed four times during the three-year period, ending
in the ninth grade. At the final post-test, the student sample (n = 2,668) was
composed of nearly equal numbers of males and females, with an average age at
baseline of approximately 12 years, including 57 percent white/non-Hispanic, 24
percent Hispanic, and 19 percent composed of other ethnic groups. The
intervention included classroom videos, discussions, education on tobacco
products, skills-building to resist peer pressure, skits, and other techniques. The
third-year program consisted of mail and telephone contacts. At the end of the
third year, the prevalence of tobacco use within the past month was 14.2 percent
among the intervention students and 22.5 percent among the controls. The authors
conclude that the SHOUT intervention model using undergraduate students as
change agents and using mail and one-to-one phone call interventions provides
cost-effective tobacco-related behavior modification.


Title: Why Children Start Smoking Cigarettes: Predictors of Onset.
Supplier No.: 93-3599
Author: Conrad, K.M.;Flay, B.R.;Hill, D.
Pub. Year: 1992
Journal Name: British Journal of Addiction
Volume: 87
Issue No.: 12
Pagination: 1711-1724
Pub. Date: December 1992
Abstract: Researchers reviewed findings from 27 prospective studies conducted
since 1980 on the onset of cigarette smoking. Almost 300 measures of predictors
of smoking onset were examined and 74 percent of them provided multivariate
support for predictors of onset derived from theory and previous empirical
findings. Expected relationships were strongly reported for (1) socioeconomic
status, with students with compromised status being more likely to try smoking;
(2) social bonding variables, particularly peer and school bonding, with less
support for family bonding; (3) social learning variables, especially peer smoking
and approval, prevalence estimates, and offers/availability, with less consistent
support for parent smoking and approval; (4) refusal skills self-efficacy; (5)
knowledge, attitudes, and intentions, with the expected stronger predictions from
intentions than from attitudes or knowledge; and (6) broad indicators of
self-esteem. The few investigators who analyzed their data separately by age,
gender, or ethnicity found many differences by these factors, though there were
too few of them to detect any pattern of confidence. Findings indicate that family
smoking, bonding, and approval each received unexpectedly low support. Future
prospective studies need to be theory-driven, use measurements of known
reliability and validity, report analyses of scale properties, and use statistical
methods appropriate to the hypotheses or theories under study. Finally, the
researchers encourage more investigations of the potentially different predictors of
transitions to experimental or regular cigarette smoking.


Title: Assessing skills for refusing cigarettes and smokeless tobacco.
Supplier No.: 91-6534
Author: Sallis, J.F.;Elder, J.P.;Wildey, M.B.;de Moor, C.;Young, R.L.;Shulkin,
J.J.;Helme, J.M.
Author Affiliation: (Auth. Abs.)
Pub. Year: 1990
Journal Name: Journal of Behavioral Medicine
Pagination: 13(5):489-503
Pub. Date: Oct 1990
Abstract: Hops and colleagues developed an audiotaped refusals skills test in
which students respond to cigarette offers and their responses are scored for content.
The present study employed a modified analogue skills test. Modifications included
adding a separate subscale for smokeless tobacco, emphasizing repeated offers and
group pressure, and rating the quality of responses (good, fair, poor). The test was
evaluated in four seventh-grade classrooms (N = 78). Half had participated in a
refusals skills training program; the others were controls. Intervention subjects
provided more " good: responses and fewer "poor: responses than controls. In a
multiple regression, repeated and group offers were associated with the quality of
response, while offerer's gender and type of tobacco variables were not associated.
In a second regression, experimental condition was associated with quality of the
responses, while gender, ethnicity, exposure to tobacco, use of tobacco, and
attitudes toward the test were not associated.

Title: Acquisition of smoking refusal skills in junior high school students.
Supplier No.: 90-5026
Author: Katz, R.C.;Robisch, C.M.;Telch, M.J.
Author Affiliation: (Auth. Abs.)
Pub. Year: 1989
Journal Name: Addictive Behaviors
Pagination: 14(2):201-4
Pub. Date: 1989
Abstract: This study examined the effects of a smoking prevention program on the
acquisition of refusal skills among junior high school students. Two conditions
were compared: one in which the subjects participated in a videotaped training
program on resisting pressures to smoke, and the other an untreated control group.
As predicted, the results showed significant improvement in the skill training group,
while the untreated controls showed no change relative to their pretest performance.
These findings suggest that smoking prevention programs which focus on resisting
social pressures can enhance the young person's ability to say "no" to smoking.
Descriptor: Health education;Mass media;Adolescents;Students;Peer groups


Title: Longitudinal Changes in Adolescent Cigarette Smoking Behavior: Onset
and Cessation.
Supplier No.: 89-4571
Author: Ary, D.V.;Biglan, A.
Pub. Year: 1988
Journal Name: Journal of Behavioral Medicine
Volume: 11
Issue No.: 4
Pagination: 361-382
Pub. Date: August 1988
Abstract: Employing a 1-year longitudinal design, this study examined factors
related to change in adolescent smoking. Predictors of smoking onset differed
from predictors of continued smoking, underscoring the importance of studying
factors related to adolescent smoking onset separately from mechanisms
associated with changes in smoking among current smokers. Peer smoking
predicted continuation of smoking after smoking initiation. Smokers received over
26 times more offers to smoke than did nonsmokers, suggesting that smokers
attempting to quit need effective refusal skills to be successful. Habitual
smoking was found to develop slowly, providing a substantial time window for
refusal skill training and other prevention efforts. Predictors of smoking onset
differed by developmental level. Peer smoking and marijuana use were stronger
predictors of smoking onset for high-school students, and number of cigarette
offers predicted better among middle-school students. Parent variables were not
significant predictors of later smoking. Intention to smoke was unrelated to onset
and was redundant with pretest smoking behavior in predicting cessation


Title: How generalizable are the effects of smoking prevention programs?
Refusal skills training and parent messages in a teacher-administered program.
Supplier No.: 93-4749
Author: Biglan, A.;Glasgow, R.;Ary, D.;Thompson, R.;Severson,
H.;Lichtenstein, E.;Weissman, W.;Faller, C.;Gallison, C.
Author Affiliation: (Auth. Abs. Mod.)
Pub. Year: 1987
Journal Name: Journal of Behavioral Medicine
Pagination: 10(6):613-628
Pub. Date: December 1987
Abstract: This study investigated both substantive and methodological issues
associated with school-based smoking prevention programs. Substantive issues
included the efficacy of a refusal skills training curriculum and of parent
messages mailed to students' homes. Methodological issues included the effects of
assigning classroom versus entire schools to experimental conditions and
determination of the effects of attrition on internal and external validity. Results
revealed differential impact for different subgroups of adolescents. The results
showed that the refusal skills program produced lower rates of smoking than the
control condition for students who were smokers at the pretreatment assessment
but may have produced detrimental effects among males who were nonsmokers at
pretest. The provision of parent messages did not affect outcome. Method of
assignment (school versus classroom) failed to produce significant effects, and
attrition did not affect internal validity. However, the researchers asserted that the
differential findings, as well as the impact of attrition on external validity, raise
questions concerning the generalizability of smoking prevention programs.


Title: The Cardiovascular Effects of Nicotine During Stress.
Supplier No.: 870818
Author: Perkins, K.A.;Epstein, L.H.;Jennings, J.R.;et al.
Pub. Year: 1986
Journal Name: Psychopharmacology
Pagination: 90(3):373-378
Pub. Date: 1986
Abstract: Acute cardiovascular effects of smoking during stress may be greater
than those of either smoking or stress alone. Cardiovascular increases from a video
game stress task alone or with 1.0 mg nicotine were compared in 12 healthy males
aged 18 to 29 years who smoked 20 to 40 cigarettes/day for at least 1 year. Each
participated in four conditions on separate days: stress plus nicotine, stress plus
placebo, rest plus nicotine, and rest plus placebo. Effects of stress and nicotine were
additive for heart rate but less than additive for systolic and diastolic blood pressure.
The combined effects of stress and nicotine may be relevant to understanding the
prevalence of CHD among smokers. The effects of each on cardiovascular activity
may be different, as the effects are independent for heart rate but overlap for blood
pressure. This interrelationship between stress and smoking behavior may help
explain the differential development of CHD among smokers even in the absence of
a particular additive physiological relationship between stress and nicotine


Title: The Cardiovascular Effects of Nicotine During Stress.
Supplier No.: 870818
Author: Perkins, K.A.;Epstein, L.H.;Jennings, J.R.;et al.
Pub. Year: 1986
Journal Name: Psychopharmacology
Pagination: 90(3):373-378
Pub. Date: 1986
Abstract: Acute cardiovascular effects of smoking during stress may be greater
than those of either smoking or stress alone. Cardiovascular increases from a video
game stress task alone or with 1.0 mg nicotine were compared in 12 healthy males
aged 18 to 29 years who smoked 20 to 40 cigarettes/day for at least 1 year. Each
participated in four conditions on separate days: stress plus nicotine, stress plus
placebo, rest plus nicotine, and rest plus placebo. Effects of stress and nicotine were
additive for heart rate but less than additive for systolic and diastolic blood pressure.
The combined effects of stress and nicotine may be relevant to understanding the
prevalence of CHD among smokers. The effects of each on cardiovascular activity
may be different, as the effects are independent for heart rate but overlap for blood
pressure. This interrelationship between stress and smoking behavior may help
explain the differential development of CHD among smokers even in the absence of
a particular additive physiological relationship between stress and nicotine

Title: Self-help Quit Smoking Interventions: Effects of Self-help Materials,
Social Support Instructions, and Telephone Counseling.
Supplier No.: 92-5756
Author: Orleans, C.T.;Schoenbach, V.J.;Wagner, E.H.;Quade, D.;Salmon,
M.A;. Pearson, D.C.;Fiedler, J.;Porter, C.Q.;Kaplan, B.H.
Pub. Year: 1991
Journal Name: Journal of Consulting and Clinical Psychology
Volume: 59
Issue No.: 3
Pagination: 439-448
Pub. Date: June 1991
Abstract: Smokers requesting self-help materials for smoking cessation (n =
2,021) were randomized to receive (a) an experimental self-quitting guide
emphasizing nicotine fading and other nonaversive behavioral strategies, (b) the
same self-quitting guide with a support guide for the quitter's family and friends,
(c) self-quitting and support guides along with four brief counselor calls, or (d) a
control guide providing motivational and quit tips and referral to locally available
guides and programs. Subjects were predominantly moderate-to-heavy smokers
with a history of multiple previous quit attempts and treatments. Control subjects
achieved quit rates similar to those of smokers using the experimental quitting
guide, with fewer behavioral prequitting strategies and more outside treatments.
Social support guides had no effect on perceived support for quitting or on 8- and
16-month quit rates. Telephone counseling increased adherence to the quitting
protocol and quit rates.

Title: Evaluation of a Three-year Urban Elementary School Tobacco Prevention Program.
Supplier No.: 98-0529
Author: Price, J.H.;Beach, P.;Everett, S.;Telljohann, S.K.;Lewis, L.
Author Affiliation: Department of Health Promotion, University of Toledo, Toledo, OH.
Pub. Year: 1998
Journal Name: Journal of School Health
Volume: 68
Issue No.: 1
Pagination: 26-31
Pub. Date: January 1998
Abstract: This journal article describes a longitudinal study conducted to compare effects of
varying amounts of tobacco instruction (one, two, and three years), on the knowledge,
attitudes, and behavioral intentions of urban elementary school students. A three-year,
fourth-through-sixth grade tobacco prevention curriculum was developed based on the Centers
for Disease Control and Prevention's Guidelines for School Health Programs to Prevent
Tobacco Use and Addiction. The curriculum comprised five, 45-minute lessons per year. The
same trained instructor taught the curriculum all three years. Six intervention schools were
taught the curriculum, and two control schools were not. A 49-item questionnaire was used to
assess tobacco knowledge, attitudes, and behavioral intentions. The experimental group's
posttest knowledge and attitude scores were significantly higher than the control groups'
posttest scores. No significant differences occurred in posttest behavioral intention scores
between the control and intervention groups



                       Cognitive Susceptibility to Smoking and Initiation of Smoking
                       During Childhood: A Longitudinal Study.
   Supplier No.: 
                       98-0214
   Author: 
                       Jackson, C.
   Author Affiliation:
                       Department of Health Behavior, School of Public Health, University
                       of North Carolina, Chapel Hill, NC.
   Pub. Year: 
                       1998
   Journal Name: 
                       Preventive Medicine
   Volume: 
                       27
   Issue No.: 
                       1
   Pagination: 
                       129-134
   Pub. Date: 
                       January 1998
   Abstract: 
                       This journal article describes a longitudinal study that examined
                       susceptibility to smoking as a predictor of smoking initiation in a
                       preadolescent sample. At baseline, the sample included 788
                       third-grade students and 682 fifth-grade students enrolled in 12
                       elementary schools in a county school district in central North
                       Carolina. Of these, 913 students completed three surveys
                       administered in February through March of 1994, 1995, and 1996.
                       Of the 913 students with complete longitudinal data, 125 students
                       reported initiation of smoking at baseline, leaving 788 students who
                       had never smoked as of the 1994 survey. Results indicate that, at
                       baseline, 51 percent of the students had either single or multiple
                       indicators of susceptibility to smoking. Over two years, children with
                       single indicators of susceptibility were 80 percent more likely to
                       initiate smoking, and children with multiple indicators of
                       susceptibility were four times as likely to initiate smoking as
                       nonsusceptible peers. Susceptibility was a stronger predictor of
                       initiation than all other predictors examined, including exposure to
                       family members and friends who smoke cigarettes. The article
                       concludes that children as young as eight years of age vary in
                       susceptibility to smoking and that susceptibility to smoking is a
                       strong predictor of progression to the initiation stage of smoking.
                       Therefore, reducing children's susceptibility to smoking could
                       strengthen efforts to prevent early onset of cigarette smoking.


                        Longitudinal Study Predicting Patterns of Cigarette Smoking in Late
                        Childhood.
   Supplier No.: 
                        98-1162
   Author: 
                        Jackson, C.;Henriksen, L.;Dickinson, D.;Messer, L.;Robertson,
                        S.B.
   Author Affiliation: 
                        Department of Health Behavior and Health Education, School of
                        Public Health, University of North Carolina, Chapel Hill, NC.
   Pub. Year: 
                        1998
   Journal Name: 
                        Health Education & Behavior
   Volume: 
                        25
   Issue No.: 
                        4
   Pagination: 
                        436-447
   Pub. Date: 
                        August 1998
   Abstract: 
                        This journal article describes a longitudinal study that examined risk
                        factors associated with initiation of cigarette smoking among
                        elementary school students. Risk factor categories included
                        personal attributes of children and smoking-specific socialization
                        factors. Participants were students enrolled in 12 elementary
                        schools composing a county school district in central North
                        Carolina. They were surveyed annually in fifth through seventh
                        grades. Results indicate that modeling of smoking by parents and
                        friends was sufficient to influence children to initiate smoking,
                        particularly when children also had behavioral self-control. The
                        study also found that, when modeling occurred in combination with
                        poor adjustment to school, low parental monitoring, easy access to
                        cigarettes, and other risk attributes, early initiators were
                        significantly more likely to continue smoking. Results suggest that
                        delaying initiation of smoking without also modifying child
                        attributes and socialization factors that predict early initiation and
                        persistent smoking is unlikely to reduce the proportion of children
                        who become habitual smokers. Moreover, if interventions could
                        modify risk attributes such as low behavioral self-control and
                        parental monitoring, such modifications have the potential to
                        prevent rather than delay the onset of cigarette smoking.


                         National Assessment of Early Elementary Teachers' Perceived
                         Self-efficacy for Teaching Tobacco Prevention Based on the CDC
                         Guidelines.
    Supplier No.: 
                         98-0095
    Author: 
                         Perry-Casler, S.M.;Price, J.H.;Telljohann, S.K.;Chesney, B.K.
    Author Affiliation: 
                         The James and Jennifer Harrell Center for the Society of Domestic
                         Violence, College of Public Health, University of South Florida,
                         Tampa, FL.
    Pub. Year: 
                         1997
    Journal Name: 
                         Journal of School Health
    Volume: 
                         67
    Issue No.: 
                         8
    Pagination: 
                         348-354
    Pub. Date: 
                         October 1997
    Abstract: 
                         This journal article describes a study that assessed early elementary
                         teachers' perceived self-efficacy for teaching tobacco prevention
                         based on the Centers for Disease Control and Prevention guidelines
                         for kindergarten through grade three. A national random sample of
                         300 second-grade teachers and 300 third-grade teachers received a
                         47-item survey instrument to determine their perceived
                         self-efficacy for teaching tobacco prevention education, their
                         training status on tobacco prevention, and their level of teaching
                         about tobacco prevention. A total of 531 surveys were returned,
                         and data from 505 surveys were used for the final analyses.
                         Results indicate that most of the teachers were white females who
                         held a bachelor's or master's degree, had never smoked, and had
                         not received formal tobacco prevention training. The teachers'
                         scores were high for efficacy expectations and for outcome
                         expectations. Conversely, for outcome value, teachers ranked
                         tobacco prevention fifth out of six health topics, as the most
                         important health topic to teach elementary school students. Also,
                         teachers trained in four tobacco areas or more had statistically
                         significantly higher scores for efficacy expectations than those
                         trained in three or fewer areas. Statistically significant positive
                         associations were also found between years of teaching tobacco
                         prevention and efficacy and outcome expectation scores and
                         between the amount of time that tobacco prevention was taught
                         during the past school year and outcome value.

                       Outdoor Tobacco Advertising in Six Boston Neighborhoods:
                       Evaluating Youth Exposure.
   Supplier No.: 
                       98-1128
   Author: 
                       Pucci, L.G.;Joseph, H.M.;Siegel, M.
   Author
   Affiliation: 
                       Social and Behavioral Sciences Department, Boston University
                       School of Public Health, Boston, MA.
   Pub. Year: 
                       1998
   Journal Name: 
                       American Journal of Preventive Medicine
   Volume: 
                       15
   Issue No.: 
                       2
   Pagination: 
                       155-159
   Pub. Date: 
                       August 1998
   Abstract: 
                       This journal article describes a cross-sectional study that determined
                       the prevalence, type, and proximity to public schools of all stationary,
                       outdoor tobacco advertising in six Boston, MA, neighborhoods. The
                       study also related the location and placement of these advertisements
                       to the neighborhoods' demographic and socioeconomic characteristics.
                       The main outcome measure was advertising density within buffer
                       zones around public schools. In 1996 FDA regulations prohibited
                       outdoor tobacco advertising within 1,000 feet of schools. Four
                       observer teams collected data on advertising sites. Results reveal that
                       16 of 26 elementary schools in the six neighborhoods were exposed
                       to tobacco advertising with a density ranging from 2.9 to 24.5 units
                       per million square feet. All eight middle schools were exposed. The
                       advertising density ranged from 1.3 to 19.1 units per million square
                       feet. Three of the four high schools were exposed to tobacco
                       advertising, with an advertising density ranging from 8.0 to 21.3 units
                       per million square feet. Seventy-three percent of the advertising sites
                       were within public school buffer zones. The majority of the
                       advertising units were on store fronts. 32 percent of the advertising
                       units were at children's eye level. The top five youth brands
                       (Marlboro, Camel, Newport, Kool, and Winston) accounted for 77
                       percent of all advertising units. The majority of outdoor tobacco
                       advertising was in neighborhoods with the lowest median household
                       incomes or with the greatest proportions of African American and
                       Hispanic residents. These tobacco advertising strategies are consistent
                       with accepted professional marketing practices that target adolescents
                       for other products. The article concludes that, given the pervasive
                       nature of outdoor tobacco advertising found in the study, the only
                       way to protect youth from exposure seems to be by eliminating it
                       from the community.


                      Coogan, P.F.;Adams, M.;Geller, A.C.;Brooks, D.;Miller, D.R.;Lew,
                      R.A.;Koh, H.K.
    Author
    Affiliation: 
                      Department of Epidemiology and Biostatistics, Boston University
                      School of Public Health, Boston, MA.
    Pub. Year: 
                      1998
    Journal Name: 
                      American Journal of Preventive Medicine
    Volume: 
                      15
    Issue No.: 
                      1
    Pagination: 
                      17-24
    Pub. Date: 
                      July 1998
    Abstract: 
                      This journal article describes a study conducted to determine
                      behavioral and attitudinal factors associated with smoking among
                      elementary school (grades four through six), middle school (grades
                      seven and eight), and high school (grades nine through 12) students in
                      Connecticut. Data was gathered from eight years (1988-1996) of an
                      anonymous, self-administered health risk appraisal survey given to
                      children and adolescents in self-selected public and private schools.
                      The study compared the proportion of smokers and nonsmokers who
                      reported various behaviors and attitudes and compared them with the
                      chi-square test. Fifteen percent (4,884) of the total population (31,861)
                      were current smokers. At all grade levels, current smokers were more
                      likely than nonsmokers to engage in risk-taking behaviors and to report
                      more stress and depression. Indicators of risk-taking and stress were
                      also associated with the intent to smoke among children in grades four
                      through six. Smoking occurs within the context of other risk-taking
                      behavior and psychological distress among both children and older
                      adolescents. The data provide support for the idea of early
                      identification and targeting of children at high risk of smoking in
                      elementary school, possibly as early as grade four.


                      Coogan, P.F.;Adams, M.;Geller, A.C.;Brooks, D.;Miller, D.R.;Lew,
                      R.A.;Koh, H.K.
    Author
    Affiliation: 
                      Department of Epidemiology and Biostatistics, Boston University
                      School of Public Health, Boston, MA.
    Pub. Year: 
                      1998
    Journal Name: 
                      American Journal of Preventive Medicine
    Volume: 
                      15
    Issue No.: 
                      1
    Pagination: 
                      17-24
    Pub. Date: 
                      July 1998
    Abstract: 
                      This journal article describes a study conducted to determine
                      behavioral and attitudinal factors associated with smoking among
                      elementary school (grades four through six), middle school (grades
                      seven and eight), and high school (grades nine through 12) students in
                      Connecticut. Data was gathered from eight years (1988-1996) of an
                      anonymous, self-administered health risk appraisal survey given to
                      children and adolescents in self-selected public and private schools.
                      The study compared the proportion of smokers and nonsmokers who
                      reported various behaviors and attitudes and compared them with the
                      chi-square test. Fifteen percent (4,884) of the total population (31,861)
                      were current smokers. At all grade levels, current smokers were more
                      likely than nonsmokers to engage in risk-taking behaviors and to report
                      more stress and depression. Indicators of risk-taking and stress were
                      also associated with the intent to smoke among children in grades four
                      through six. Smoking occurs within the context of other risk-taking
                      behavior and psychological distress among both children and older
                      adolescents. The data provide support for the idea of early
                      identification and targeting of children at high risk of smoking in
                      elementary school, possibly as early as grade four.


                         Early Use of Alcohol and Tobacco: Its Relation to Children's
                         Competence and Parents' Behavior.
    Supplier No.: 
                         97-0877
    Author: 
                         Jackson, C.;Henriksen, L.;Dickinson, D.;Levine, D.W.
    Author Affiliation: 
                         School of Public Health, University of North Carolina at Chapel
                         Hill, Chapel Hill, NC.
    Pub. Year: 
                         1997
    Journal Name: 
                         American Journal of Public Health
    Volume: 
                         87
    Issue No.: 
                         3
    Pagination: 
                         359-364
    Pub. Date: 
                         March 1997
    Abstract: 
                         This journal article presents a study that attempted to identify
                         developmental correlates of tobacco and alcohol use among
                         elementary school children. Cross-sectional surveys were used to
                         measure tobacco and alcohol use, multiple indicators of child
                         competence, parenting behaviors, and parental modeling of
                         tobacco and alcohol use in a sample of 1,470 third- and fifth-grade
                         children. Both self-report and teacher-rated assessments were
                         obtained, which allowed collateral testing of study hypotheses.
                         Children's tobacco and alcohol use was strongly related to low
                         scores on several measures of child competence, both self-reported
                         and teacher rated. Children's tobacco and alcohol use was also
                         associated with less effective parenting behaviors and with parental
                         use of tobacco and alcohol. Children's early experience with
                         tobacco and alcohol is associated with weak competence
                         development and exposure to socialization factors that promote
                         risk taking. Interventions to prevent early use of tobacco and
                         alcohol are needed.

Chilcoat, H.D.;Dishion, T.J.;Anthony, J.C.
    Author Affiliation: 
                         Etiology Branch, National Institute on Drug Abuse, Addiction
                         Research Center, Baltimore, MD.
    Pub. Year: 
                         1995
    Journal Name: 
                         American Journal of Epidemiology
    Volume: 
                         141
    Issue No.: 
                         1
    Pagination: 
                         25-31
    Pub. Date: 
                         1995
    Abstract: 
                         This journal article describes a prospective study of
                         urban-dwelling children ages eight to 10 years residing in
                         Baltimore, MD, that was undertaken to test the hypothesis that
                         close monitoring and supervision by parents might reduce the
                         risk of drug use in the elementary school years. Drug use,
                         monitoring by parents, peer drug use, and other suspected risk
                         factors for early drug use were first assessed in 1989, identifying
                         947 children with no prior history of drug use. The study found
                         that, one year later, 4.2 percent of these children had started
                         using alcohol, tobacco, or other drugs on their own for the first
                         time during the follow-up observation interval. The most
                         frequently mentioned drug was tobacco, followed by alcohol,
                         inhalants, marijuana, and cocaine. Risk of starting drug use was
                         higher for children with lower levels of parent monitoring. In
                         addition, for children with declining levels of parent monitoring,
                         there was an increased risk of starting to use drugs on their own.
                         The article concludes that, although the study provided direct or
                         indirect control over several suspected risk factors for early drug
                         use, the issue of whether the observed associations actually have
                         causal significance remains to be determined.


                     Peer education in friendship cliques: prevention of adolescent
                     smoking.
    Supplier No.: 
                     93-2080
    Author: 
                     Wiist, W.H.;Snider, G.
    Pub. Year: 
                     1991
    Journal Name: 
                     Health Education Research
    Pagination: 
                     6(1):101-108
    Pub. Date: 
                     March 1991
    Abstract: 
                     In seven elementary schools in one school district of a suburban
                     community, researchers pilot tested and evaluated a smoking
                     prevention peer education program based upon friendship cliques
                     concepts. The program evaluation compared peer leaders teaching
                     their friendship cliques with model students teaching their classmates
                     and adult classroom teachers teaching their students. The study
                     identified peer leader education groups using a sociometric
                     questionnaire and computer analysis; researchers formed friendship
                     cliques by selecting groups of individuals clustered most closely on
                     the program's dendogram output and by selecting as peer leaders
                     individuals identified by most students as both a best friend and as an
                     individual whom they would like to emulate. At the beginning of
                     sixth grade, 21 peer leaders (15 female, 6 male), an average of 3 peer
                     leaders per clique, taught the curriculum to eight cliques with an
                     average of 13 students per clique. The curriculum focused on social
                     skills to prevent smoking and consisted of eight weeks of education
                     (one 45-minute session per week) during the sixth and seventh grade
                     years of 347 adolescents. Of the total number of participants, 133
                     students were taught by a peer leader, 80 were taught by a model
                     student, 99 were teacher taught, and 35 received no instruction; all
                     students completed the pretest and posttest behavioral questionnaires.
                     The program evaluation compared the friendship cliques with model
                     students (identified by school officials) who taught their classmates
                     and with adult teachers instructing their students. Student teachers,
                     both peer leaders and model students, received ten weeks of training
                     (1 hour per week) prior to teaching their peers or classmates. The
                     student teachers taught their groups for ten sessions and the student
                     teachers received an additional hour of training each week in sixth
                     grade and four additional teaching sessions on the organization of
                     health campaigns in seventh grade. Adult teachers received a 2-hour
                     workshop on the use of the curriculum; both student and adult
                     teachers taught from a manual that gave step-by-step instructions.
                     Program evaluation preliminary findings showed that smoking
                     prevention rate was highest, though not statistically significant, in the
                     peer leader group at both six-month and one-year followups.
                     Preliminary findings suggest that conducting adolescent health
                     education programs in sociologically relevant groups, taught by the
                     influential individuals within those groups, might improve the
                     effectiveness of peer education groups.

Evaluation of the effectiveness of a planned diffusion process: the
                     Smoke- Free Class of 2000 project in Texas.
    Supplier No.: 
                     93-2163
    Author: 
                     Brink, S.G.;Levenson-Gingiss, P.;Gottlieb, N.H.
    Pub. Year: 
                     1991
    Journal Name: 
                     Health Education Research
    Pagination: 
                     6(3):353-362
    Pub. Date: 
                     September 1991
    Abstract: 
                     Researchers evaluated the first year of the Texas Triagency Coalition
                     Smoke-free Class of 2,000 Project (SFC2000), a project designed to
                     eliminate tobacco use among young people, using a descriptive model
                     developed from diffusion theory to ascertain the project's adoption
                     rate and implementation. The project made tobacco-prevention
                     education materials available to all first-grade teachers within the
                     State. A random sample survey of 213 teachers indicated that 96
                     (44.7 percent) had received the materials. By May 1989, 64.2 percent
                     of those teachers receiving materials had adopted and implemented
                     the program, and 25.3 percent had adopted and intended to use the
                     materials. Almost all (96.8 percent) of those teachers who received
                     the kit indicated that they would maintain the first grade program in
                     the coming school year. Of respondents to a 1-year followup survey,
                     41.1 percent used it the first year only, 27.3 percent used it both
                     years, 12.5 percent used it only in year two, and 18.2 percent did not
                     use it either year. Of those receiving the kits, 48 percent indicated
                     that they had not previously taught tobacco-prevention education and
                     thus were introduced to the concept of tobacco-prevention education
                     through the SFC2000 kits. Receptivity was highest (over 90 percent
                     agreement) for including tobacco-prevention education in elementary
                     school curricula, with fewer teachers strongly agreeing with items
                     tapping personal involvement with tobacco-prevention education. The
                     tobacco- prevention education evaluation reinforces the need to
                     consider the dissemination and implementation of materials when
                     planning large- scale interventions and evaluating their impact.

Demographic and Predictive Correlates of Smokeless Tobacco Use in
                     Elementary School Children.
    Supplier No.: 
                     93-2145
    Author: 
                     Lisnerski, D.D.;McClary, C.L.;Brown, T.L.;Martin, J.P.;Jones,
                     D.R.
    Pub. Year: 
                     1991
    Journal Name: 
                     American Journal of Health Promotion
    Pagination: 
                     5(6):426-431
    Pub. Date: 
                     July/August 1991
    Abstract: 
                     This study evaluates the demographic and predictive correlates of
                     smokeless tobacco use in elementary school children. A stratified
                     random sample of 559 rural and urban first, third, fifth, and seventh
                     graders in western North Carolina were surveyed regarding
                     experimentation with smokeless tobacco in order to assess the basic
                     demographics and predictive correlates of smokeless tobacco use in
                     school-age children. Two versions of a survey were developed: a
                     shorter version administered orally to first graders and a longer
                     version provided to others. Reported percentages across demographic
                     variables were broken down in a 4 x 2 x 2 analysis of variance;
                     correlations were used to assess the relationships among potentially
                     predictive variables. Results indicated that 36 percent of male rural
                     first graders had tried smokeless tobacco, increasing to 20 percent by
                     the seventh grade. Overall, rural males were more likely to have tried
                     or be regularly using smokeless tobacco than were urban males or
                     females. Other questions correlating with smokeless tobacco use
                     indicated that it is predicted by three general concerns:(1) perceived
                     flavor, (2) self-concept and presentation to peers, and (3) family
                     influence. The authors state that (1) educational interventions must
                     begin at the kindergarten or first grade levels; (2) programs for
                     adolescents must provide for alternative ways of receiving perceived
                     social image benefits of smokeless tobacco use and (3) familial
                     support must be considered in all programming.

Junior high school students as facilitators of elementary school health
                     education carnivals.
    Supplier No.: 
                     92-5180
    Author: 
                     Hosick, D.K.;Watts, P.R.
    Pub. Year: 
                     1988
    Journal Name: 
                     Health Education (Washington)
    Pagination: 
                     19(5):83-5
    Pub. Date: 
                     Oct-Nov 1988
    Abstract: 
                     During the early 1980's, Watts and Stinson began to advocate health
                     education carnivals for elementary school students. These carnivals
                     are similar to traditional health education fairs which have been
                     popular for years. However, where a typical health fair includes
                     screening tests, the health education carnival does not. The latter is
                     actually comprised of a wide variety of health education activities
                     incorporated into a festive setting. Health education carnivals expose
                     undergraduate elementary education majors to the natural learning
                     patterns of children prior to a formal student teaching experience. A
                     recent health education carnival gave junior high school students the
                     opportunity to take facilitative roles in the planning and
                     implementation of the carnival. The smoking, alcohol, and drug
                     education effort at this carnival employed a smoking machine to
                     demonstrate the effects of cigarette smoke on the lungs along with the
                     encouragement to not smoke. Participants played a game which
                     included basic questions about drugs, alcohol, and tobacco products
                     with emphasis on the advantages of not using these substances.


                     Skills Intervention to Prevent Cigarette Smoking Among Adolescents.
    Supplier No.: 
                     851860
    Author: 
                     Schinke, S.P.;Gilchrist, L.D.;Snow, W.H.
    Pub. Year: 
                     1985
    Journal Name: 
                     American Journal of Public Health
    Pagination: 
                     75(6):665-667
    Pub. Date: 
                     June 1985
    Abstract: 
                     Skills training was evaluated with 689 sixth-grade students (53
                     percent female, median age 11.76 years) from nine elementary
                     schools in lower to middle socioeconomic neighborhoods. Following
                     pretest measurement of smoking habits and health knowledge, three
                     schools were randomly assigned to each of three conditions: skills
                     training, information, and control. Subjects assigned to skills training
                     or information only conditions received 10 1-hour weekly preventive
                     intervention sessions that included health and smoking-related films,
                     peer testimonials, and homework. Skills training also included how to
                     (1) solve cigarette use problems, (2) resist smoking-related urges and
                     temptations, and (3) deal with interpersonal pressures to smoke. At
                     6-, 12-, and 24-month followup, skills condition subjects had higher
                     smoking knowledge scores, lower scores on intentions to smoke in
                     high school, and lower cigarette smoking rates than subjects who
                     received health information only and those who received no
                     intervention. Data add support to the concept of skills training for
                     prevention of smoking among youth and lend empirical evidence to
                     the observation that school health education can be effective not only
                     in informing students but also in enhancing decision-making and
                     social interaction skills.


                     Primary Prevention of Chronic Disease in Childhood: Changes in
                     Risk Factors After One Year of Intervention.
    Supplier No.: 
                     860601
    Author: 
                     Walter, H.J.;Hofman, A.;Connelly, P.A.;et al.
    Pub. Year: 
                     1985
    Journal Name: 
                     American Journal of Epidemiology
    Pagination: 
                     122(5):772-781
    Pub. Date: 
                     November 1985
    Abstract: 
                     A 5-year program for primary prevention of chronic disease,
                     consisting of a curriculum focusing on cigarette smoking, nutrition,
                     and physical fitness, was initiated in 1980 in 22 elementary schools
                     in the Bronx, New York. Participants were 2,283 fourth graders
                     randomly assigned by school to receive the ""Know Your Body''
                     program (n=14) or to a control condition (n= 8). The intervention
                     group (1.3 percent current smokers) had a mean serum thiocyanate
                     value of 38.6 mumol/L; controls (1.0 percent current smokers) had a
                     mean serum thiocyanate level of 34.6 mumol/L. At 1-year followup
                     (1) mean thiocyanate level had decreased in the intervention group
                     (36.8 mumol/ L) and had increased in the control group (37.6
                     mumol/L); (2) systolic blood pressure had increased less in the
                     intervention group than among controls; (3) diastolic pressure had
                     decreased in both groups, but more in intervention than control
                     subjects; and (4) total cholesterol had decreased in the intervention
                     group and increased among controls. Observations indicate that
                     although the effects were relatively small, the intervention appears to
                     have had favorable effects on risk factors. In addition, the program
                     proved feasible and was acceptable to school personnel, students, and
                     parents.

How Specific Are the Early Predictors of Teenage Drug Use?
    Supplier No.: 
                    840243
    Author: 
                    Kellam, S. G.;Stevenson, D. L.;Rubin, B. R.
    Pub. Year: 
                    1983
    Pagination: 
                    pp. 329-334
    Pub. Date: 
                    April 1983
    Pub. Info: 
                    In: Harris, L. S. (Editor). Problems of Drug Dependence 1982. U.S.
                    Department of Health and Human Services, Public Health Service,
                    Alcohol, Drug Abuse, and Mental Health Administration, NIDA
                    Research Monograph Series No. 43
    Abstract: 
                    Aggressiveness in first grade predicts future heavy cigarette, drug, and
                    alcohol use as well as delinquency in males but not in females.
                    Students from elementary schools in a black, poor, urban
                    community, first rated in 1966-1967 (n=1,242), were interviewed 10
                    years later (n=705) to determine the social adaptation characteristics
                    predictive of future behaviors. All predictors are behavioral responses
                    rated by teachers or scored on tests of classroom task performance.
                    Shyness predicts an inhibition of both substance use and delinquency,
                    but also predicts higher anxiety levels in adolescence. First grade tests
                    of readiness and IQ are clearly related to drug and alcohol use, but not
                    smoking, in both males and females. The higher the child's score, the
                    higher the probability of future use. Results indicate that (1) prevention
                    efforts that might reduce the risk for aggressive first graders could be
                    counterproductive for brighter children; (2) sex differences in
                    developmental behavior patterns are important; and (3) studying one
                    outcome in isolation from others loses much information about the
                    meaning and function of the predictors.

An Educational Imperative: Evaluating the Effectiveness of an Anti-
                     Smoking Program.
    Supplier No.: 
                     811253
    Author: 
                     Williamson, J. A.;Campbell, L. P.
    Pub. Year: 
                     1981
    Journal Name: 
                     Journal of School Health
    Pagination: 
                     51(3): 146-147
    Pub. Date: 
                     March 1981
    Abstract: 
                     In the fall of 1977 an antismoking program was instituted for 300
                     sixth grade students in three elementary schools involving the use
                     of high school peer models who performed the primary teaching
                     function. The program included classroom demon__stration,
                     handouts, pre- and posttest instruments. A control group of 300 sixth
                     grade students in three similar schools were tested but not exposed to
                     the program. Results showed that elementary students who
                     experienced the antismoking program were significantly more
                     knowledgeable regarding smoking hazards. A 2-year followup study
                     of the 600 youth was conducted to determine the extent to which
                     changes had occurred in both populations. Results showed that the
                     experimental group students' knowledge of and attitude toward
                     smoking had regressed during the 2-year period. It is apparent that a
                     need exists for a spiral curriculum that builds upon and reinforces
                     antismoking concepts learned earlier. This includes utilizing
                     principles of motivation and personal decisionmaking in an approach
                     that combines the affective with the cognitive.



Title: Impact of Mass Media and Interpersonal Health Communication on Smoking
Cessation Attempts: A Study in North Karelia, 1989-1996.
Supplier No.: 98-0809
Author: Korhonen, T.;Uutela, A.;Korhonen, H.J.;Puska, P.
Author Affiliation: National Public Health Institute, Department of Epidemiology and
Health Promotion, Helsinki, Finland.
Pub. Year: 1998
Journal Name: Journal of Health Communication
Volume: 3
Issue No.: 2
Pagination: 105-118
Pub. Date: April-June 1998
Abstract: This journal article describes an impact evaluation of the North Karelia Project
(Finnish Countrywide Integrated Noncommunicable Diseases Intervention program) on
smoking cessation attempts. During the period 1989-1996, data were collected by annual
surveys, with response rates varying from 66 to 76 percent. This study included 1,694 adult
current smokers or persons who had quit smoking during the past year, out of a total of
6,011 respondents. Smoking cessation during the past 12 months was examined as a
dependent variable. Reported exposures to mass media and interpersonal health
communication were examined as possible determinants of smoking cessation. Weekly
exposure to mass media health messages was significantly associated with cessation attempts
among men only. In contrast, interpersonal health communication or social influence was a
significant determinant of cessation attempts among both sexes. Exposure to both mass
media and interpersonal health communication had an even stronger impact on cessation
attempts. Interpersonal communication appears to be an important catalyst of community
programs, and its inclusion should be emphasized to obtain a higher impact with
community programs.

RURAL


Title: "Ready to Quit Chew?" Smokeless Tobacco Cessation in Rural Nebraska.
Supplier No.: 99-0734
Author: Boyle, R.G.;Stilwell, J.;Vidlak, L.M.;Huneke, J.T.
Author Affiliation: HealthPartners Research Foundation, Minneapolis, MN.
Pub. Year: 1999
Journal Name: Addictive Behaviors
Volume: 24
Issue No.: 2
Pagination: 293-297
Pub. Date: March-April 1999
Abstract: This journal article describes a study examining the efficacy of a quit chew media campaign, that targeted a 10-county region of south-central Nebraska. The campaign involved television and radio appearances, newspaper articles, and paid billboard advertisements. Smokeless tobacco users who called a toll-free helpline were provided quitting resources. Twelve months after the campaign ended, follow up contact was completed with 104 out of 205 chewers (51 percent) who received the quit kits. A majority (70 percent) reported making some change, such as using less or switching brands, and 49 percent had made a quit attempt. The point prevalence quit rate was 11.5 percent. 

Birth Outcome From a Prospective, Matched Study of Prenatal
                        Crack/Cocaine Use: II. Interactive and Dose Effects on
                        Neurobehavioral Assessment.
   Supplier No.: 
                        99-0583
   Author: 
                        Eyler, F.D.;Behnke, M.;Conlon, M.;Woods, N.S.;Wobie, K.
   Author Affiliation:
                        Department of Pediatrics, University of Florida, Gainesville, FL.
   Pub. Year: 
                        1998
   Journal Name: 
                        Pediatrics
   Volume: 
                        101
   Issue No.: 
                        2
   Pagination: 
                        237-241
   Pub. Date: 
                        February 1998
   Abstract: 
                        This journal article describes a study conducted to determine the
                        effects of prenatal cocaine use on the neurodevelopmental
                        outcomes of infants from a historically understudied rural health
                        population. More than 2,500 women were interviewed prenatally,
                        and 154 cocaine users and matched controls were identified. Drug
                        testing was required at enrollment and at delivery. Detailed
                        demographic, psychosocial, and drug histories were taken at each
                        available trimester and follow-up visit. After birth, certified
                        evaluators, blinded to maternal history of drug use, administered
                        the Brazelton Neonatal Behavioral Assessment Scale (BNBAS)
                        under controlled conditions. After adjusting for the effects of
                        marijuana, alcohol, and tobacco use, the following results
                        remained. There were significant drug group interactions on the
                        BNBAS Qualifier Score of Alert Responsiveness that
                        demonstrated lower scores among infants who were exposed to
                        both cocaine and tobacco and among those exposed to both
                        marijuana and tobacco. There were also significant correlations
                        between the amount of cigarettes, alcohol, marijuana, and cocaine
                        exposure and several BNBAS scores. The reported amount of
                        cocaine use in the third trimester was negatively related to scores
                        of Orientation, Cost of Attention, and Alert Responsiveness.
                        When the effects of marijuana, alcohol, and tobacco were
                        partialled out, the amount of cocaine use in the third trimester was
                        negatively related to Regulation of State, a precursor of alertness,
                        and the infant's ability to orient to the environment.

Birth Outcome From a Prospective, Matched Study of Prenatal
                        Crack/Cocaine Use: I. Interactive and Dose Effects on Health and
                        Growth.
   Supplier No.: 
                        99-0582
   Author: 
                        Eyler, F.D.;Behnke, M.;Conlon, M.;Woods, N.S.;Wobie, K.
   Author Affiliation:
                        Department of Pediatrics, University of Florida, Gainesville, FL.
   Pub. Year: 
                        1998
   Journal Name: 
                        Pediatrics
   Volume: 
                        101
   Issue No.: 
                        2
   Pagination: 
                        229-237
   Pub. Date: 
                        February 1998
   Abstract: 
                        This journal article describes a study conducted to determine the
                        effects of prenatal cocaine use on the pregnancy outcomes of
                        women from a historically understudied rural public health
                        population. More than 2,500 women were interviewed prenatally,
                        and 154 cocaine users and 154 matched controls were identified.
                        Drug testing was required at enrollment and at delivery. Detailed
                        demographic, psychosocial, and drug histories were taken at each
                        available trimester and follow-up visit. After birth, neonatal nurse
                        practitioners, blinded to maternal history of drug use, examined
                        the infants to assess gestational age and take growth
                        measurements. The cocaine users had significantly higher Hobel
                        Prenatal and Total Risk Scores and more preterm infants but not a
                        significantly greater number of fetal deaths. After controlling for
                        the effects of marijuana, alcohol, and tobacco use, the following
                        results remained. There was no difference in gestational age,
                        Ponderal Index, birth weight, or length between infants born to
                        cocaine users and controls. There was a significant interaction
                        effect such that infant head and chest circumference were smaller
                        in cocaine users who also smoked tobacco. Significant correlation
                        coefficients demonstrated the effects of the amount of drug usage
                        on fetal growth during each trimester of pregnancy. The average
                        cocaine use per day for trimesters one and three and for the entire
                        pregnancy was negatively related to birth length. The mean
                        amounts used in trimesters two and three were negatively related
                        to head circumference. Amounts of tobacco and alcohol use in
                        pregnancy were also inversely related to fetal growth measures.
                        When the effects of marijuana, alcohol, and tobacco were
                        partialled out, there continued to be a negative relationship
                        between the amount of cocaine used in the third trimester and
                        infant length and head circumference


                         Predicting Alcohol and Tobacco Use in a Sample of Rural
                         Adolescents.
    Supplier No.: 
                         98-1493
    Author: 
                         Chopak, J.S.;Vicary, J.R.;Crockett, L.J.
    Author Affiliation: 
                         Department of Health and Kinesiology, Georgia Southern
                         University, Statesboro, GA.
    Pub. Year: 
                         1998
    Journal Name: 
                         American Journal of Health Behavior
    Volume: 
                         22
    Issue No.: 
                         5
    Pagination: 
                         334-341
    Pub. Date: 
                         September-October 19
    Abstract: 
                         This journal article describes a study that examined adolescent
                         perception of risk and the behavior and attitudes of parents and
                         friends to evaluate which best predicts alcohol and tobacco use
                         in a sample of rural adolescents. Data were collected from one
                         rural school district using a paper and pencil survey of 548
                         adolescents. Specific items related to personal, friends', and
                         parents' use of alcohol and tobacco, and risk perceptions about
                         use of these substances. These responses were analyzed using a
                         multiple regression model for each substance. Friends' use of
                         alcohol and tobacco predicted adolescent use, while perception
                         of use did not have any effect in the multiple regression model.
                         Although this study failed to support the idea that perception of
                         risk was a strong influence on adolescent substance use, it did
                         support other studies that have found friend or peer influence to
                         be a key factor in initiation and subsequent substance use. 25
                         references and 6 tables.

Alcohol, Tobacco, and Other Drug Use Among Rural/Small Town
                        and Urban Youth: A Secondary Analysis of the Monitoring the
                        Future Data Set.
    Supplier No.: 
                        97-1278
    Author: 
                        Cronk, C.E.;Sarvela, P.D.
    Author
    Affiliation: 
                        Center for Rural Health and Social Service Development,
                        Southern Illinois University at Carbondale, Carbondale, IL.
    Pub. Year: 
                        1997
    Journal Name: 
                        American Journal of Public Health
    Volume: 
                        87
    Issue No.: 
                        5
    Pagination: 
                        760-764
    Pub. Date: 
                        May 1997
    Abstract: 
                        This article describes a study conducted to compare prevalence of
                        substance use among high school seniors in rural and urban areas
                        from 1976 through 1992. The authors used data collected for these
                        years from urban (75,916) and rural (51,182) high school seniors.
                        Thirty-day prevalence for alcohol, cigarettes, marijuana, cocaine,
                        LSD, and inhalant use, binge drinking, smoking a pack or more of
                        cigarettes a day, and daily alcohol and marijuana use were
                        evaluated. Substance use declined from 1976 through 1992. In
                        1976, urban students had greater prevalence for most substances,
                        but by 1992, rural and urban students were similar, with rural
                        students having higher prevalence for alcohol and cigarette use.
                        Trends were similar for both sexes, though rural girls showed a
                        later catch-up to use levels of urban girls. Rural students are
                        currently at risk approximately equal to that of urban students.
                        Other studies have demonstrated the association of substance use
                        with increased morbidity and mortality.


                        Trial of Church-based Smoking Cessation Interventions for Rural
                        African Americans.
    Supplier No.: 
                        98-1011
    Author: 
                        Schorling, J.B.;Roach, J.;Siegel, M.;Baturka, N.;Hunt,
                        D.E.;Guterbock, T.M.;Stewart, H.L.
    Author
    Affiliation: 
                        Division of General Medicine, Department of Internal Medicine,
                        University of Virginia Health Sciences Center, Charlottesville,
                        VA.
    Pub. Year: 
                        1997
    Journal Name: 
                        Preventive Medicine
    Volume: 
                        26
    Issue No.: 
                        1
    Pagination: 
                        92-101
    Pub. Date: 
                        January-February 199
    Abstract: 
                        This journal article discusses the organization and philosophy of
                        the Alliance of Black Churches Health Project and describes a
                        study that evaluated the effects of a smoking cessation program
                        both among church members directly exposed to the program and
                        among the entire African American population of the two counties
                        involved in the study. The smoking cessation program combined
                        one-on-one counseling with self-help materials and
                        communitywide activities. Up to two smoking cessation
                        counselors were trained from participating churches. The impact
                        of the program was evaluated using population-based cohorts of
                        smokers that were assembled in each county using a door-to-door
                        survey. A total of 652 African American smokers completed the
                        baseline survey. Respondents were recontacted after 18 months.
                        Of the initial survey respondents, 452 were reinterviewed.
                        Smoking cessation, stages of change, and exposure to the
                        interventions were assessed. Results indicate that the overall
                        smoking prevalence at baseline was 25.8 percent. At follow-up,
                        the smoking cessation rate in the intervention county was 9.6
                        percent and in the control county 5.4 percent. Among those
                        attending church once a month or more, the respective quit rates
                        were 10.5 percent and 5.9 percent. There was significantly more
                        progress along the stages of change in the intervention than in the
                        control county. There was also higher awareness of and contact
                        with smoking cessation programs in the intervention county
                        compared with the control county. The article concludes that
                        smoking cessation interventions for African Americans can be
                        successfully implemented through a church coalition.


                    Smoking Cessation Interventions in Rural Family Practices: An
                    UPRNet Study.
    Supplier No.: 
                    97-1481
    Author: 
                    Sesney, J.W.;Kreher, N.E.;Hickner, J.M.;Webb, S.
    Author
    Affiliation: 
                    Upper Peninsula Campus of the College of Human Medicine,
                    Michigan State University, Escanaba, MI.
    Pub. Year: 
                    1997
    Journal Name:
                    Journal of Family Practice
    Volume: 
                    44
    Issue No.: 
                    6
    Pagination: 
                    578-585
    Pub. Date: 
                    June 1997
    Abstract: 
                    This journal article describes a study that determined if patients'
                    reasons for visits to physicians and their self-reported readiness to quit
                    smoking were associated with likelihood and type of smoking
                    cessation intervention offered by family physicians. The study was
                    conducted in the Upper Peninsula Research Network (UPRNet), a
                    voluntary association of family physicians in 15 medical clinics
                    located in rural areas of northern Michigan. Practice coordinators
                    administered a one-page exit questionnaire to every other adult patient
                    seen by a participating physician immediately after the office visit.
                    Clinics were blinded to the specific purpose of the questionnaire.
                    During the study, 2,317 questionnaires were administered, yielding
                    information on 455 smokers. Results indicate that the overall rate of
                    physicians' providing any smoking cessation intervention at any type
                    of visit was 47 percent. There was a significant association between
                    frequency of smoking cessation intervention and reasons for visits.
                    There was a statistically significant difference between stages of
                    readiness to quit and frequency of smoking cessation intervention
                    offered. Clinicians offered smoking cessation interventions to smokers
                    in the precomtemplative stage significantly less often than to smokers
                    in the contemplation, preparation, or action stages. UPRNet
                    practitioners varied the frequency of smoking cessation interventions
                    according to patients' reasons for the medical visit and their readiness
                    to quit smoking.


                     Oral Snuff Substitute Tested in Study of Youths in Southern Illinois.
                     (Special Section: Semifinalists of the Secretary's Award for
                     Innovations in Health Promotion and Disease Prevention.)
    Supplier No.: 
                     96-0562
    Author: 
                     Chakravorty, B.
    Pub. Year: 
                     1992
    Journal Name: 
                     Public Health Reports
    ISBN: 
                     ISSN: 0033-3549
    Volume: 
                     107
    Issue No.: 
                     1
    Pagination: 
                     226
    Pub. Date: 
                     March-April 1992
    Abstract: 
                     Traditional approaches to achieving cessation of smokeless tobacco
                     use can be difficult, time consuming and costly. A
                     nonpharmacological food grade product designed as a substitute for
                     snuff offers a direct, low cost way to reduce habitual use among rural
                     adolescent males. Researchers recruited 70 smokeless tobacco users
                     to participate in a study of ninth- through 12th-graders from six
                     southern Illinois high schools who were interested in changing their
                     tobacco habits. They were randomized to a MintSnuff treatment, a
                     chewing gum control, or waiting list-lecture control group. With their
                     parents consent, they agreed to attend a two-session, school-based
                     cessation and reduction clinic and received a five-dollar gift certificate
                     for attending both sessons. At the first session, all 70 participants
                     completed a short questionnaire concerning current and past use of
                     smokeless tobacco, demographic information, motivation to quit, and
                     degree of tobacco dependence. The chewing gum group received 30
                     packages of sugar-free, mint-flavored gum and were instructed to use
                     this instead of tobacco. Those in the MintSnuff intervention received
                     a month's supply of the mint leaf-based smokeless tobacco cessation
                     aid. One month later, the groups again answered questions about


                        Effects of parental behavior on tobacco use by young
                        male adolescents.
    Supplier No.: 
                        93-5449
    Author: 
                        Melby, J.N.;Conger, R.D.;Conger, K.J.;Lorenz, F.O.
    Author
    Affiliation: 
                        (Auth. Ab. Mod.)
    Pub. Year: 
                        1993
    Journal Name: 
                        Journal of Marriage and the Family
    Pagination: 
                        55(2):439-454
    Pub. Date: 
                        May 1993
    Abstract: 
                        Researchers evaluate a social-developmental model with a
                        sample of 204 seventh-grade boys and their parents in
                        order to investigate theoretically relevant dimensions of
                        the adolescent's social environment that might increase the
                        risk of early adolescent tobacco use, particularly
                        characteristics of the adolescent's family and peers. Each
                        family was visited twice in their own home by a trained
                        interviewer. During the first visit family members
                        completed questionnaires focusing on family processes,
                        individual family member characteristics, and
                        demographic information. Between visits and during the
                        second visit, approximately 2 weeks later, family
                        members completed additional questionnaires. These
                        questionnaires dealt with information concerning beliefs
                        about parents, goals and values, friends, and plans for the
                        future. During the second visit, family members were also
                        videotaped as they engaged in four structured interaction
                        tasks. The first interaction task that involved all family
                        members discussing various aspects of daily living, such
                        as parenting, performance in school, household chores,
                        and sibling interactions was evaluated. Trained observers
                        coded the videotapes using the Iowa Family Interaction
                        Rating Scales. Using data from the young adolescents,
                        their parents, and siblings, the researchers examined the
                        influence of parental childrearing strategies
                        (harsh/inconsistent and nurturant/involved) and reported
                        parent, sibling, and peer tobacco use on tobacco
                        involvement by early adolescents. Four models were
                        analyzed: (1) mother's harsh and inconsistent childrearing,
                        (2) father's harsh and inconsistent childrearing, (3)
                        mother's nurturant and involved childrearing, and (4)
                        father's nurturant and involved childrearing. Researchers
                        conducted correlational analyses and structured equation
                        modeling. Results supported three of the four proposed
                        models. Even after controlling for the effects of parental
                        and sibling tobacco use, positive relationships were found
                        between harsh/inconsistent parenting and adolescent
                        tobacco use, and negative relationships between nurturant/
                        involved parenting behaviors and adolescent tobacco use.
                        Results also showed that parenting behaviors had both
                        direct and indirect effects on adolescent tobacco use
                        through the adolescent's associations with tobacco- using
                        peers. current tobacco use, quit attempts and strategies for quitting Although specific results of the study are not provided, it appears that
                     MintSnuff is acceptable to adolescents and that it may be an
                     appropriate substitute for smokeless tobacco.


                     Long-term Prevention of Tobacco Use Among Junior High
                     School Students: Classroom and Telephone Interventions.
    Supplier No.: 
                     93-4048
    Author: 
                     Elder, J.P.;Wildey, M.;de Moor, C.;Sallis, J.F.;Eckhardt,
                     L.;Edwards, C.;Erickson, A.;Golbeck, A.;Hovell, M.;Johnston,
                     S.;et al.
    Pub. Year: 
                     1993
    Journal Name: 
                     American Journal of Public Health
    Volume: 
                     83
    Issue No.: 
                     9
    Pagination: 
                     1239-1244
    Pub. Date: 
                     September 1993
    Abstract: 
                     This study evaluates the effectiveness of a tobacco use
                     prevention program for junior high school students in San Diego
                     County, California. The Students Helping Others Understand
                     Tobacco (SHOUT) intervention was delivered by college
                     undergraduates over a three-year period. Eleven schools
                     participated in the psychosocial, school-based intervention and
                     11 others served as controls. Following two years of classroom
                     refusal skills and related antitobacco training, subjects
                     received newsletters and personalized booster phone calls as a
                     followup. Students were surveyed four times during the
                     three-year period, ending in the ninth grade. At the final
                     post-test, the student sample (n = 2,668) was composed of
                     nearly equal numbers of males and females, with an average age
                     at baseline of approximately 12 years, including 57 percent
                     white/non-Hispanic, 24 percent Hispanic, and 19 percent
                     composed of other ethnic groups. The intervention included
                     classroom videos, discussions, education on tobacco products,
                     skills-building to resist peer pressure, skits, and other
                     techniques. The third-year program consisted of mail and
                     telephone contacts. At the end of the third year, the prevalence
                     of tobacco use within the past month was 14.2 percent among
                     the intervention students and 22.5 percent among the controls.
                     The authors conclude that the SHOUT intervention model using
                     undergraduate students as change agents and using mail and
                     one-to-one phone call interventions provides cost-effective
                     tobacco-related behavior modification.


                     This article presents the one-year behavioral outcomes from the
                     prevention study of Project Towards No Tobacco Use (Project
                     TNT), a five-year school-based tobacco use prevention and
                     cessation project addressing both cigarette smoking and
                     smokeless tobacco. The project was designed to test the
                     effectiveness of three common components of social influence
                     programs that teach refusal skills, awareness of social
                     misconceptions about tobacco use, and misconceptions about
                     physical consequences. Four different curricula were developed;
                     three were designed to counteract the effects of the each of the
                     three components, and a fourth to counteract the effects of
                     combined social and physical consequences. The four curricula
                     were tested in a five-group randomized block design experiment
                     in 48 schools, from sixth to eighth grades, in 27 school districts
                     in southern California. The control students received routine
                     prevention activities provided by the school. The next day after
                     completion of a 10-day curriculum, data were collected from
                     6,716 seventh grade students, half of them male. Sixty percent
                     of the subjects were white, 27 percent were Hispanic, 7 percent
                     were African American, and 6 percent were Asian or 'Other.'
                     All of the four programs were effective in decreasing the use of
                     cigarettes, except for the curriculum in which refusal skills
                     were taught. All programs were effective in decreasing initial
                     use of smokeless tobacco except the one designed to correct
                     social misperceptions. The combined intervention was most
                     effective in reducing the initial and weekly use of both
                     cigarettes and smokeless tobacco. The authors conclude that
                     different causes of tobacco use need to be counteracted
                     simultaneously because the behavior is determined by multiple
                     causes. Since single programs were also effective in reducing all
                     but weekly tobacco use, any of the components may be
                     worthwhile prevention tools.


                         Assessing skills for refusing cigarettes and smokeless
                         tobacco.
    Supplier No.: 
                         91-6534
    Author: 
                         Sallis, J.F.;Elder, J.P.;Wildey, M.B.;de Moor,
                         C.;Young, R.L.;Shulkin, J.J.;Helme, J.M.
    Author Affiliation: 
                         (Auth. Abs.)
    Pub. Year: 
                         1990
    Journal Name: 
                         Journal of Behavioral Medicine
    Pagination: 
                         13(5):489-503
    Pub. Date: 
                         Oct 1990
    Abstract: 
                         Hops and colleagues developed an audiotaped refusals
                         skills test in which students respond to cigarette offers
                         and their responses are scored for content. The present
                         study employed a modified analogue skills test.
                         Modifications included adding a separate subscale for
                         smokeless tobacco, emphasizing repeated offers and
                         group pressure, and rating the quality of responses
                         (good, fair, poor). The test was evaluated in four
                         seventh-grade classrooms (N = 78). Half had participated
                         in a refusals skills training program; the others were
                         controls. Intervention subjects provided more " good:
                         responses and fewer "poor: responses than controls. In a
                         multiple regression, repeated and group offers were
                         associated with the quality of response, while offerer's
                         gender and type of tobacco variables were not
                         associated. In a second regression, experimental
                         condition was associated with quality of the responses,
                         while gender, ethnicity, exposure to tobacco, use of
                         tobacco, and attitudes toward the test were not
                         associated.

Acquisition of smoking refusal skills in junior high school
                        students.
    Supplier No.: 
                        90-5026
    Author: 
                        Katz, R.C.;Robisch, C.M.;Telch, M.J.
    Author
    Affiliation: 
                        (Auth. Abs.)
    Pub. Year: 
                        1989
    Journal Name: 
                        Addictive Behaviors
    Pagination: 
                        14(2):201-4
    Pub. Date: 
                        1989
    Abstract: 
                        This study examined the effects of a smoking prevention
                        program on the acquisition of refusal skills among junior
                        high school students. Two conditions were compared: one
                        in which the subjects participated in a videotaped training
                        program on resisting pressures to smoke, and the other an
                        untreated control group. As predicted, the results showed
                        significant improvement in the skill training group, while
                        the untreated controls showed no change relative to their
                        pretest performance. These findings suggest that smoking
                        prevention programs which focus on resisting social
                        pressures can enhance the young person's ability to say
                        "no" to smoking.

Title: Smokeless Tobacco and Cigarettes: Differential Attitudes and Behavioral
Intentions of Young Adolescents Toward a Hypothetical New Peer.
Supplier No.: 99-0077
Author: Kury, S.P.;Rodrigue, J.R.;Perri, M.G.
Author Affiliation: University of Florida Health Science Center, FL.
Pub. Year: 1998
Journal Name: Journal of Clinical Child Psychology
Volume: 27
Issue No.: 4
Pagination: 415-422
Pub. Date: 1998
Abstract: This journal article describes a study conducted to examine adolescents'
perceptions of cigarette smokers and smokeless tobacco users. Participants were 562
middle school students in rural Florida who viewed one of six videotapes of a
hypothetical peer (actor) who would soon be attending their school. The videotapes
differed only as a function of gender (boy or girl) and tobacco condition (no tobacco,
cigarette, smokeless tobacco). After viewing the videotape, participants completed
two measures designed to assess attitudes and behavioral intentions toward the peer.
Results indicated that the actor in the no-tobacco condition was rated more favorably
than actors in the other two conditions, although the actor in the smokeless-tobacco
condition was rated more favorably than the actor in the cigarette condition; girls
viewed the actor in the smokeless-tobacco condition more favorably than did boys;
and, compared to nonsmokers, adolescents with a cigarette use history provided more
favorable ratings for the actor in the cigarette condition. Taken together, results
suggest that different types of tobacco use may have a different impact on social image
within the young adolescent population.

Title: How Are Social Support Effects Mediated? A Test With Parental Support and
Adolescent Substance Use.
Supplier No.: 97-1358
Author: Wills, T.A.;Cleary, S.D.
Author Affiliation: Ferkauf Graduate School of Psychology, Albert Einstein College
of Medicine, Bronx, NY.
Pub. Year: 1996
Journal Name: Journal of Personality and Social Psychology
Volume: 71
Issue No.: 5
Pagination: 937-952
Pub. Date: November 1996
Abstract: This article describes a study conducted to test how the effect of parental
emotional and instrumental support on substance use in adolescents is mediated. Data
were obtained from a sample of 1,702 adolescents attending six schools from public
school districts in lower Westchester County, New York. They were surveyed at three
points between the seventh and ninth grades. The survey included items on parental
support, negative life events, adolescent substance use, and various psychosocial
scales. Parental support was inversely related to substance use throughout the period
from early to middle adolescence and stress-buffering interactions were found at all
assessment points. Structural modeling analyses indicated the effect of support was
mediated through more behavioral coping and academic competence and less tolerance
for deviance and behavioral undercontrol. These mediators were related to negative life
events and deviant peer influences. Multiple-group analyses suggested buffering effects
occurred because high support reduced the effect of risk factors and increased the
effect of protective factors. Implications for the theory of social support effects and
resilience mechanisms are discussed.

Title: Peer Influences on Adolescent Cigarette Smoking: A Prospective Sibling
Analysis.
Supplier No.: 99-0699
Author: Rose, J.S.;Chassin, L.;Presson, C.C.;Sherman, S.J.
Author Affiliation: Department of Psychology, Indiana University, Bloomington,
Indiana.
Pub. Year: 1999
Journal Name: Merrill-Palmer Quarterly
Volume: 45
Issue No.: 1
Pagination: 62-84
Pub. Date: January 1999
Abstract: This study examined the role of nonshared parent and peer influences as
prospective predictors of adolescent cigarette smoking onset, using a sibling sample
and hierarchical linear modeling to control for shared influences on behavior.
Between 1980 and 1983, all consenting sixth to 12th graders in a midwestern county
school system completed up to four annual surveys. Follow-up surveys were conducted
in 1987 and 1993. Of the 1,474 families identified as having full biological siblings,
874 had at least one adolescent who had smoking data at any two adolescent time
points, was a nonsmoker at baseline, and had complete data on the family- and
individual-level measures at baseline. One sibling was randomly selected from each of
the 874 families in the sibling sample to create a nonsibling sample. Peer influences
were significant predictors of smoking onset when shared influences were controlled,
suggesting that peer group characteristics operate, at least partially, as nonshared
influences. Siblings with a greater number of close friends who smoked were more
likely to begin smoking. Nonshared peer influences were stronger in more-educated
families than in less-educated families. In addition, having greater expectations for
success from friends was related to a decreased likelihood of smoking onset, but this
was true only among siblings from more highly educated families. Of all the potential
prospective parent influences, only parent strictness was significantly related to
smoking onset among siblings in interaction with parent education. Siblings reporting
greater parent control were more likely to begin to smoke in adolescence, but again,
this was true only for siblings from more highly educated families. Results highlight
the potential utility of controlling for shared influences and support the importance of
accounting for the broader social context.

Webster-Stratton, Carolyn. 
Title 
     Advancing videotape parent training: A comparison study. 
Source 
     Journal of Consulting & Clinical Psychology. Vol 62(3), Jun 1994, 583-593.
Abstract 
     This study examines the specific effects of adding a broader based, videotape
     treatment component (ADVANCE) to a basic videotape parent skills training
     program (GDVM). ADVANCE treatment trains parents to cope with
     interpersonal distress through improved communication, problem solving, and
     self-control skills. 78 families with a child diagnosed as oppositional-defiant or
     conduct-disordered were randomly assigned to either GDVM alone or GDVM
     plus ADVANCE. Parent reports of child adjustment and parent distress,
     assessment of child's knowledge of social skills, as well as independent
     observations of mother^ and father-child interactions and communication and of
     problem solving between parents were obtained at pre- and post-GDVM and at
     post-ADVANCE. Both groups significantly improved at short-term follow-up.
     ADVANCE produced additional significant improvements in parents'
     communication, problem-solving skills, and consumer satisfaction, as well as
     children's increased knowledge of prosocial solutions. The clinical significance
     of these findings is discussed.

Webster-Stratton, Carolyn. 
Title 
     Teaching mothers through videotape modeling to change their children's
     behavior. 
Source 
     Journal of Pediatric Psychology. Vol 7(3), Sep 1982, 279-294.
Abstract 
     35 mothers and their 3-5 yr old children were randomly assigned to treatment
     or waiting-list control groups. The children's baseline behaviors were obtained
     through videotapes of children playing with their mothers. Mothers in the
     experimental group attended 4 weekly 2-hr videotape modeling sessions. At the
     end of treatment, experimental children showed a significant decrease in
     negative affect behaviors and submissive behaviors and a significant increase in
     positive affect behaviors. Also, mothers in the experimental group reported
     significantly fewer and less intense behavior problems than the control group
     mothers. Follow-up assessment 2 mo later indicated that the children's
     behaviors continued to improve. The study was subsequently replicated with
     the control group. Results suggest that education of groups of parents by a
     videotape modeling program has powerful secondary effects in changing
     children's behaviors.

O'Dell, Stan L. et al.
Title 
     Predicting the acquisition of parenting skills via four training models. 
Source 
     Behavior Therapy. Vol 13(2), Mar 1982, 194-208.
Abstract 
     Compared the effectiveness of 4 training methods designed to improve parents'
     reinforcement skills and assessed the relationship between acquisition of skills
     and parent characteristics. 100 parents of children between 2 and 10 yrs were
     assigned to a minimal instructions control group or training via 1 of 4 methods:
     written manual, audiotape, videotaped modeling, or live modeling and
     rehearsal with the parent's child. Outcome was assessed via an in-home
     observation of the S's reinforcement skills with his or her child. All training
     methods were superior to minimal instructions. The audiotaped manual was
     significantly less effective than the written manual or the live modeling with
     rehearsal. Parent demographic characteristics and reading level were related to
     outcome in the control group and in the groups receiving written or live
     modeling with rehearsal training. The videotape training appeared to be more
     consistent in training a wider range of parents.

Frodi, Ann M. Lamb, Michael E. 
Title 
     Child abusers' responses to infant smiles and cries. 
Source 
     Child Development. Vol 51(1), Mar 1980, 238-241.
Abstract 
     14 child abusers and a matched group of nonabusers watched videotapes of
     crying and smiling infants. Their psychophysiological responses were
     monitored throughout the session. After each videotape, the Ss described their
     emotional responses on a 10-item mood adjective checklist. The crying infant
     elicited heart-rate acceleration and increases in skin conductance and diastolic
     blood pressure from both groups, although the abusers experienced greater
     increases in heart rate and reported more aversion and less sympathy. Like
     other parents tested in this paradigm, the nonabusers responded to the smiling
     infant with no change in or declines in physiological activation. The abusers,
     however, responded to the smile and cry stimuli similarly.

Flanagan, Susan. Adams, Henry E. Forehand, Rex. 
Title 
     A comparison of four instructional techniques for teaching
     parents to use time-out. 
Source 
     Behavior Therapy. Vol 10(1), Jan 1979, 94-102.
Abstract 
     48 parents of young children were instructed in a time-out procedure and
     received 1 of 4 instructional techniques: written presentation, lecture
     presentation, videotaped modeling presentation, and role-playing presentation. A
     no-treatment control group was also included. The Ss all had at least 1 child
     between 2 and 7 yrs of age and ranged in family size from 3 to 11 members. All
     treatment groups were superior to the control group on questionnaire-assessed
     knowledge of the time-out procedure but not different among themselves. In
     applying the instructed skill, methods of training varied in efficacy. Audiotape
     analog assessment indicated that all instructed groups performed significantly
     better than the control group and that role playing was superior to the lecture
     presentation group. An examination of the parents' ability to apply time-out in
     the home with their own children indicated that the modeling instruction was
     more effective than the written presentation and the control condition.

Durrett, Deborah D. Kelly, Patricia A. 
Title 
     Can you really talk with your child? A parental training program in
     communication skills toward the improvement of parent-child interaction. 
Source 
     Group Psychotherapy & Psychodrama. Vol 27(1-4), 1974, 98-109.
Abstract 
     Conducted an experimental research program in which 5 families completed the
     6 21/2-hr training sessions, and 5 families served as controls. The sessions used
     modeling, written manuals, videotape feedback of previous family interaction,
     focused videotape feedback of current parent-parent interactions, and behavior
     rehearsals. Interviews and the Child-Parent Relationship Questionnaire were
     used to evaluate the program's effectiveness. Results indicate that the training
     group children demonstrated a greater increase in total talk time and number of
     responses during parent-child interaction, as well as a greater degree of attitude
     improvement toward the parent-child relationship.

Bloom, Lisa A. Hursh, Daniel. Wienke, Wilfred D. Wolf, Ronald K. 
Title 
     The effects of computer assisted data
     collection on students' behavior. 
Source 
     Behavioral Assessment. Vol 14(2), Sum 1992, 173-190.
Abstract 
     Examined whether teachers would effect greater and more rapid change in
     student behavior (SB) using computer-assisted or traditional
     paper-and-pencil methods of data collection (DC) and whether teachers would
     continue collecting data after having recorded data using a computer. A
     multiple-baseline, across-behaviors design with changing conditions was
     employed and replicated across SBs of 5 students (aged 7-23 yrs) with
     behavior disorders in 3 self-contained classrooms. The initiation of teacher DC
     resulted in greater and more rapid change in SB in the desired direction when
     compared with baseline conditions. The method of DC did not produce
     differential effects on SB. A checklist surveying teachers' DC habits before,
     during, at the end, and 2 mo after the study shows that teachers preferred the
     computer and had changed their DC habits to begin collecting and graphing
     data on a daily basis

Burnett, Kent F. Magel, Patricia E. Harrington, Susan. Taylor, C. Barr. 
Title 
     Computer-assisted
     behavioral health counseling for high school students. 
Source 
     Journal of Counseling Psychology. Vol 36(1), Jan 1989, 63-67.
Abstract 
     Computer-assisted behavioral health counseling for high school students (n =
     45) was compared with an educational intervention in which health tip sheets
     were distributed (n = 17) and with an assessment-only condition (n = 15). In
     addition, overweight subjects in the computer-assisted counseling condition
     received computer-generated feedback designed to encourage weight reduction.
     At the conclusion of the 12-week study period, subjects in the
     computer-assisted counseling condition reported significant reductions in
     saturated fat and cholesterol consumption and significant increases in fiber and
     complex carbohydrate consumption. Subjects in the two control conditions also
     reported dietary improvement but to a lesser degree. Overweight subjects in the
     computer-assisted counseling condition lost a mean of 6.5 lb compared with a
     mean weight loss of 1.25 lb for the assessment-only subjects and mean weight
     gain of 2.75 lb for subjects in the health tips conditions.

Dijkstra, Arie. De Vries, Hein. Roijackers, Jolanda. 
Title 
     Targeting smokers with low readiness to change with tailored and nontailored
     self-help materials. 
Source 
     Preventive Medicine: an International Devoted to Practice & Theory. Vol
     28(2), Feb 1999, 203-211.
Abstract 
     In a large randomized field trial, with 843 Ss (mean age 41.7 yrs), 2 different
     computer-generated tailored smoking cessation self-help interventions
     (multiple tailoring and single tailoring) and 1 standardized smoking cessation
     self-help guide were compared with a no-information control group and with
     each other. The contents of the tailored interventions were adapted to
     individuals' self-reported stage of change, outcome expectations, self-efficacy
     levels, and smoking behavior. The primary outcome measure was forward
     stage transition. The standardized self-help guide had no effect. Among
     smokers who were not planning to quit within the next 5 yrs the
     multiple-tailored intervention was more effective than the single-tailored
     intervention. This pattern was supported by the cognitive changes caused by the
     interventions. Among smokers who were planning to quit within the next 5 yrs
     but not within the next 6 mo, none of the self-help materials had any effect.
     The present results show that the standardized self-help guide was not effective
     among smokers with low readiness to change. However, computer-generated
     tailored interventions seem a promising means of communicating information
     on smoking and smoking cessation to these smokers.

Strecher, Victor J. 
Title 
     Computer-tailored smoking
     cessation materials: A review and discussion. 
Source 
     Patient Education & Counseling. Vol 36(2), Feb 1999, 107-117.
Abstract 
     Reviews and discusses the differences between general, targeted, and
     computer-tailored smoking cessation materials, and examines the
     impact of tailored vs the general or targeted modalities. 10 randomized
     trials of tailored materials indicate a significant impact of these
     materials in a majority of the studies. Very few patterns, in terms of
     the characteristics associated with the tailored materials, subject
     recruitment, subject characteristics, or follow-up procedures were
     found when comparing positive vs negative trials. The 2 trials that
     combined tailored materials with nicotine replacement therapy found a
     strong impact on smoking cessation; studies that examine the
     combined effects of tailored behavioral and pharmacological
     interventions are suggested. Most studies that included
     precontemplators found a significant positive impact of materials
     tailored to this group. It is concluded that these findings suggest
     important new avenues for reaching smokers. ((c) 1999
     APA/PsycINFO, all rights reserved)

Redding, Colleen A. Prochaska, James O. Pallonen, Unto E.
     Rossi, Joseph S. Velicer, Wayne F. Rossi, Susan R. Greene,
     Geoffrey W. Meier, Kathryn S. Evers, Kerry E. Plummer, Brett
     A. Maddock, Jason E. 
Title 
     Transtheoretical individualized multimedia expert systems
     targeting
     adolescents' health behaviors. 
Source 
     Cognitive & Behavioral Practice. Vol 6(2), Spr 1999, 144-153.
Abstract 
     Describes a transtheoretical model and computer-based
     technology for standardized assessment and individualized
     theory-based intervention delivery. Two different studies
     utilizing multimedia expert systems technology for assessing
     and intervening with adolescents targeting several health
     behaviors are illustrated. One study includes high school
     students and targets smoking cessation or prevention, sun
     protection, and dietary fat reduction. The other study includes
     urban adolescent female clients recruited in family planning
     clinics and targets condom adoption and either smoking
     cessation or prevention. The advantages and disadvantages of
     expert systems technology are reviewed. Multimedia expert
     system technology has the potential to enhance health promotion
     and adherence by integrating the strongest components from
     both clinical and public health models of intervention.

Schneider, Sid J. Walter, Robert. O'Donnell, Richard. 
Title 
     Computerized communication as a medium for behavioral
     smoking cessation treatment: Controlled
     evaluation. 
Source 
     Computers in Human Behavior. Vol 6(2), 1990, 141-151.
Abstract 
     An interactive, behavioral smoking cessation program was
     offered on a computer network to 1,158 participants. The
     program tailored treatment to each S's smoking history,
     progress toward quitting smoking, and responses to questions
     posed by the computer system. Ss were randomly assigned to
     4 groups in a 2 by 2 design: Half received the full program
     (FP), while half received a less-detailed control version. Half
     the Ss also had access to an ongoing, computer-stored forum
     on stopping smoking. Ss who received the FP were more
     likely to stay in the program, and there was a trend toward
     higher abstinence rates in the FP. Ss who received neither the
     forum nor the full version had particularly low abstinence
     rates.

Williams CL. Perry CL. Farbakhsh K. Veblen-Mortenson S. 
Institution 
     Division of Epidemiology, School of Public Health, University of
     Minnesota,
     Minneapolis 55454, USA. 
Title 
     Project Northland: comprehensive alcohol use prevention for young
     adolescents, their parents, schools, peers
     and communities.
Source 
     Journal of Studies on Alcohol - Supplement. 13:112-24, 1999 Mar.
Abstract 
     OBJECTIVE: Project Northland is an ongoing prevention trial with the
     objective of reducing underage drinking and related problems. Phase I
     focused on early adolescence and this study describes the multiple
     interventions, highlighting its parent components. METHOD: A cohort
     design was used with sixth graders from 24 school districts (N = 2,35 1:
     97% of the eligible population: 51.3% boys), randomly assigned to
     intervention or reference condition. Phase I ended in eighth grade (N =
     1,901: 81% retention rate). Both demand and supply reduction guided the
     interventions. This study examined Project Northland's impact using
     MMPI-A scales assessing clinical problems related to adolescents' alcohol
     and other drug use (Alcohol/Drug Problems Proneness scale;
     Alcohol/Drug Problems Acknowledgement scale), as well as MMPI-A
     scales related to school functioning (Adolescent-School Problems Content
     scale: Adolescent-Low Aspirations Content scale) and family functioning
     (Adolescent-Family Problems Content scale). RESULTS: Results
     showed significant reductions on the MMPI-A Proneness scale for those
     exposed to the interventions. The greatest program effects were among
     baseline nonusers of alcohol. CONCLUSIONS: Results suggest that the
     impact of Project Northland is not only on specifically targeted alcohol
     and drug use behaviors and their predictive factors, but also on
     intra-individual and familial factors generally considered precursors of
     more extensive problem behaviors and more resistant to change.
     Furthermore, the engaging home-based sixth-grade intervention, the Slick
     Tracy Home Team Program, is a promising population-based prevention
     approach that may generalize to other serious problems within a young
     person's family.

Allison KW. Crawford I. Leone PE. Trickett E. Perez-Febles A. Burton
     LM. Le Blanc R. 
Institution 
     Department of Psychology, Virginia Commonwealth University,
     Richmond
     23284-2018, USA. 
Title 
     Adolescent substance use: preliminary examinations of school and
     neighborhood
     context.
Source 
     American Journal of Community Psychology. 27(2):111-41, 1999 Apr.
Abstract 
     In considering the influences of microsystems on adolescent substance
     use, familial and peer contexts have received the most extensive attention
     in the research literature. School and neighborhood settings, however, are
     other developmental contexts that may exert specific influences on
     adolescent substance use. In many instances, school settings are
     organized to provide educational services to students who share similar
     educational abilities and behavioral repertoires. The resulting
     segregation of students into these settings may result in different school
     norms for substance use. Similarly, neighborhood resources, including
     models for substance use and drug sales involvement, may play an
     important role in adolescent substance use. We briefly review literature
     examining contextual influences on adolescent substance use, and present
     results from two preliminary studies examining the contribution of school
     and neighborhood context to adolescent substance use. In the first
     investigation, we examine the impact of familial, peer, and school
     contexts on adolescent substance use. Respondents were 283 students
     (ages 13 to 18) from regular and special education classrooms in six
     schools. Although peer and parental contexts were important predictors
     of substance use, school norms for drug use accounted for variance in
     adolescent use beyond that explained by peer and parental norms. Data
     from a second study of 114 adolescents (mean age = 15) examines
     neighborhood contributions to adolescent substance use. In this sample,
     neighborhood indices did not contribute to our understanding of
     adolescent substance use. Implications for prevention are presented.

Klicpera C. Gasteiger Klicpera B. Schabmann A. 
Institution 
     Abteilung fur angewandte und klinische Psychologie, Psychologisches
     Institut
     der Universitat Wien. 
Title 
     [To what extent do school and class-specific factors contribute to
     aggression
     in schools?]. [German]
Source 
     Zeitschrift fur Kinder- und Jugendpsychiatrie. 23(4):243-54, 1995 Dec.
Abstract 
     In a representative study conducted in Vienna and Lower Austria,
     14-year-old students from one class each in 79 different schools (N =
     1594) answered a questionnaire about their experiences at school, the
     main focus being on aggressive acts that occurred at school. In a parallel
     investigation, the students' teachers (N = 554) completed a similar
     questionnaire. The reports on the frequency of aggressive behavior
     differed widely among the classes. A comparison of classes with different
     levels of aggressive behavior showed that solidarity within the classroom
     and the relationship between teachers and students were closely
     associated with the frequency of aggressive behavior. In classrooms with
     frequent aggressive acts there was a negative attitude towards outsiders
     and the students were less inclined to intervene in an unfair fight.
     Furthermore, they were more critical of discussions with their teachers.
     Even after so