Roger H. Secker-Walker

Prevention of cigarette smoking through mass media intervention and school programs.

OBJECTIVES In this study we tested the ability of mass media interventions to enhance the efficacy of school cigarette smoking prevention programs. METHODS For 4 years, students in one pair of communities received media interventions and school programs that had common educational objectives. Students in a matched pair of communities received only the school programs. The combined cohort of 5458 students was surveyed at baseline in grades 4, 5, and 6 and was followed up annually for 4 years. RESULTS Significant reductions in reported smoking, along with consistent effects on targeted mediating variables, were observed for the media-and-school group. For cigarettes per week the reduction was 41% (2.6 vs 4.4); for smoking cigarettes yesterday the reduction was 34% (8.6% vs 13.1%); and for smoking in the past week the reduction was 35% (12.8% vs 19.8%). No effects were observed for substance use behaviors not targeted by the interventions. CONCLUSIONS These results provide evidence that mass media interventions are effective in preventing cigarette smoking when they are carefully targeted at high-risk youths and share educational objectives with school programs.

Using Mass Media to Prevent Cigarette Smoking Among Adolescent Girls

This article describes the development of a mass media smoking prevention intervention targeted primarily toward adolescent girls at increased risk for smoking and assesses its outcomes. A cohort of 5,458 students was surveyed at baseline in Grades 4-6 and annually for 4 years. Through diagnostic and formative research, media messages were created to appeal especially to girls. Students beginning in Grades 5-7 received the 4-year media intervention and a school program in two communities, while students in two matched communities received the school program alone. Media targeting techniques resulted in high levels of message appeal and exposure consistent with effects on mediating variables and 40% lower weekly smoking at Grades 8-10 for girls receiving the media and school interventions compared to school alone. Smoking behavior effects were maintained at Grades 10-12. These results indicate that mass media interventions targeting specific audience segments can reduce substance use behavior for those segments.

A mass media programme to prevent smoking among adolescents: costs and cost effectiveness.

OBJECTIVE: To examine costs and cost-effectiveness ratios of a four-year mass media programme previously shown to prevent the onset of smoking among adolescents. DESIGN: A matched control design. SETTING: Two cities in Montana, one in New York and one in Vermont, USA. SUBJECTS: Students in grades 10-12 (ages 15-18). INTERVENTION: A four-year mass media campaign to prevent the onset of smoking. MAIN OUTCOME MEASURES: Cost per student potentially exposed to the mass media campaign; cost per student smoker potentially averted; and cost per life-year gained. Cost estimates were also made for a similar campaign that would be broadcast nationally in the United States. RESULTS: In 1996 dollars, the cost of developing and broadcasting the mass media campaign was

Exhaled carbon monoxide and urinary cotinine as measures of smoking in pregnancy

759,436, and the cost per student potentially exposed to the campaign (n = 18,600) was

Factors influencing quality of life in breast cancer survivors

41. The cost per student smoker averted (n = 1023) was

Smoking in pregnancy, exhaled carbon monoxide, and birth weight

754 (95% confidence interval (CI) =

Cigarette Smoking Prevention Effects of Mass Media and School Interventions Targeted to Gender and Age Groups

531-

Food Preferences Predict Eating Behavior of Very Young Mohawk Children

1296). The cost per life-year gained discounted at 3% over the life expectancy for young adult smokers was

Stages of change in smoking during pregnancy in low-income women.

696 (95% CI =

Proactive telephone peer support to help pregnant women stop smoking

445-