Marianne B. Wildey

The long-term prevention of tobacco use among junior high school students: classroom and telephone interventions.

OBJECTIVES The purpose of this study was to implement and evaluate the effectiveness of a long-term tobacco use prevention program for junior high school students that used college undergraduate change agents and telephone boosters. METHODS A psychosocial intervention combining refusal skills training, contingency management, and other tobacco use prevention methodologies such as telephone and mail boosters was implemented in 11 junior high schools in San Diego County, California. Eleven other junior high schools served as controls. Of the 2668 participants, 57% were White/non-Hispanic, 24% were Hispanic, and 19% were of other racial/ethnic groups. College undergraduates served as change agents for both the classroom and booster interventions, the latter of which was delivered in the third (ninth-grade) year of the program. RESULTS At the end of the third year, the prevalence of tobacco use within the past month was 14.2% among the intervention students and 22.5% among the controls, yielding an odds ratio of 0.71 for analysis at the school level. CONCLUSIONS Both college undergraduate change agents and direct one-to-one telephone interventions appear to provide cost-effective tobacco-related behavior modification.

Fat and sugar levels are high in snacks purchased from student stores in middle schools.

OBJECTIVE Children consume about one third of their daily energy at school, mostly from cafeteria food and bag lunches. Students also shop at student-run stores that generate revenue for extracurricular activities; yet the nutritional value of snacks sold at student stores has not been documented to our knowledge. DESIGN Cross-sectional study of foods sold at student stores in middle schools. SUBJECTS/SETTING Twenty-four San Diego County (Calif) public middle schools, grades 6 through 8 (age 11 to 13), from 9 school districts. The schools represent a diversity of ethnic groups and socioeconomic levels. STATISTICAL ANALYSES PERFORMED Descriptive statistics, Pearson product moment correlations, analysis of variance. RESULTS Snacks averaged 8.7 g fat and 23.0 g sugar. Overall, 88.5% of store inventory was high in fat and/or high in sugar. Sugar candy accounted for one third of store sales. Chocolate candy was highest in fat content: 15.7 g. Fourteen of the 24 schools had stores that sold food and were run by student organizations. Stores were open daily for about 90 minutes; half sold food during lunch. CONCLUSIONS Adolescents need opportunities to supplement main meals; however, student stores in middle schools sell primarily high-fat, high-sugar snacks. Key intervention possibilities include limiting sales of chocolate candy and substituting low-fat varieties of cakes, cookies, chips, and crackers. Competition with cafeterias for sales at lunchtime should be addressed.

Generic Tobacco Use among Four Ethnic Groups in a School Age Population

The prevalence of overall or “generic” tobacco use among Hispanic, white, Black and Asian youths in grades four, seven, ten and twelve was compared in San Diego, California (n = 4980). Significant differences in generic tobacco use between ethnic groups were found in the 4th, 10th and 12th grades, but were greatest in the 10th grade. Only white youths demonstrated a sharp increase in regular tobacco use (once a month or more) between 7th and 10th grade. Overall, the prevalence of regular use was highest among whites (25.8%), followed by Hispanics (19.7%), Blacks (17.6%) and Asians (12.6%). Marijuana, alcohol, and other drug use explained approximately 40 percent of the variance in tobacco use in each ethnic group. Other predictors varied by ethnicity and included socioeconomic status, happiness of student, strictness of parent, adult tobacco use at home, accessibility to marijuana, and gender.

Effect of a retailer intervention on cigarette sales to minors in San Diego County, California

Graduate School of Public Health, San Diego State University, Behavioral and Community Health Studies, 6363 Alvarado Court, Suite 225, San Diego, California 92120, USA K D Keay S I Woodruff M B Wildey E M Kenney Abstract Objective To assess the effectiveness of a retailer educational campaign in re ducing the illegal sale of cigarettes to minors in San Diego County, California, USA. Design A pre-test post-test control group design to study the effects of the programme, including information on sales rates to minors and sales activity. Setting A variety of store types in eth nically diverse communities in San Diego County. Subjects 260 retail outlets. Primary interventions Direct retailer education, mass media, and grass roots work within the community. Main outcome measures Cigarette sales to minors. Results -260 stores were visited by minors, aged 12-17 years, with the intent of purchasing cigarettes. The minors were successful at 69.9% of the stores surveyed. The percentage of stores il legally selling cigarettes to minors was significantly reduced (to 32.2 %) in the 143 stores which had received retailer edu cation one month after the intervention ended. Control stores also showed a slight, nonsignificant, reduction (59.0%). Conclusion An intensive retailer edu cational programme can have a sig nificant effect in reducing the illegal sales rate of cigarettes to minors. (Tobacco Control 1993; 2: 145-151)

Tobacco-refusal skills and tobacco use among high-risk adolescents

Psychosocial tobacco use prevention programs are based on the assumption that refusal skills training will have a suppressive effect on the onset of use by enabling non-using adolescents to refuse offers of cigarettes and smokeless tobacco. The present study investigated this assumption with 389 high-risk junior high-school students involved in a prevention program during their seventh, eighth, and ninth-grade years. Direct behavioral measures of refusal skills were taken by having subjects respond to audiotaped offers of tobacco and then rating the quality of their responses. These ratings were then linked to tobacco use measures obtained at the end of each of the 3 study years. Results showed that the comprehensive prevention program produced a favorable trend in delaying or preventing the onset of tobacco use. However, the refusal skills training, which was carried out throughout the 3-year intervention period, produced significant differences in overall refusal skill quality only at the seventh grade. Moreover, refusal skill quality was not related to overall tobacco use or cigarette use at any grade.

Assessing skills for refusing cigarettes and smokeless tobacco.

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 offerers 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.

Retailer Education to Reduce the Availability of Single Cigarettes

Abstract The practice of selling single cigarettes is a reflection of the shifting demographics of smoking as a habit of lower-income Americans. Buying singles is an affordable way to try smoking and keep smoking. The purpose of this study was to: (1) determine store and retailer characteristics associated with the availability of single cigarettes in a variety of store types in low-income, ethnic communities, and (2) to describe the effectiveness of an intervention to reduce such availability. Information on availability was collected at four store types: supermarkets, independent markets, gas station/convenience stores, and liquor stores in seven communities of San Diego County, California. Singles were observed to be available in 24.8 percent of stores during the 1990 baseline survey, mostly in liquor stores (39.7 percent) and independent markets (31.4 percent). As part of a larger intervention to reduce youth access to tobacco products, 313 retailers received information regarding laws prohibiting sal...