Program Profile: Model Smoking Prevention Program

This is a smoking prevention program designed to promote awareness and knowledge of the harms of tobacco use among school-aged children. The program is rated Promising. Students in the intervention group had a statistically significant lower likelihood of smoking and smoked fewer average cigarettes per week, compared with students in the control group.

A Promising rating implies that implementing the program may result in the intended outcome(s).

A Promising rating implies that implementing the program may result in the intended outcome(s).

Program Goals/Target Population

The Model Smoking Prevention Program (MSPP), formerly known as the Minnesota Smoking Prevention Program, is a smoking prevention program designed to promote awareness and knowledge of the harms of tobacco use among school-aged children. The goals of MSPP are to 1) help youths identify the reasons why their peers smoke (e.g., peer pressure, advertising, lack of self-confidence); 2) provide resistance tools they can implement; and 3) emphasize the value of social support for resistance through peer leadership activities. Over six classroom sessions, the program provides educationally based strategies to help students abstain from tobacco use. The program was developed to allow students to work in collaboration with their peers to apply these strategies.

Program Activities/Key Personnel

The development of MSPP came about from a larger project titled the Minnesota Heart Health Program (MHHP), which was conducted in Fargo and West Fargo, N.D., and in Moorhead, Minn. The MHHP was designed to improve eating, exercise, and smoking patterns across the entire population of the communities. The MSPP was one component of this effort. The MSPP began in 1984 with sixth graders.

MSPP comprises six sessions that last 45–50 minutes in length. Each session is designed to incorporate various educational strategies for preventing tobacco use. The six sessions include

1. Small group discussions identifying short-term consequences of smoking
2. Comparing expectations of smoking with actual data and discussing overestimates of prevalence
3. Learning why adolescents smoke (e.g., an attempt to seem mature)
4. Understanding how culture affects the desire to behave or act
5. Skills to resist social influences
6. Expressing a public commitment to abstain

Peer leaders participate in a 30-minute training session conducted by the teacher to prepare them for instruction of student groups. The peer leadership guide was written specifically for students, and designed to maximize the value of their experience in MSPP.

Study

The evaluation of the Model Smoking Prevention Program (MSPP) by Perry and colleagues (1992) used a quasi-experimental design to assess the net effect of combining a behavioral health education program in school with the communitywide Minnesota Heart Health Program (MHHP) on youths living in the intervention community. Seven annual waves of cohort and cross-sectional behavioral measurements were collected.

The cohort design, which followed students for 6 years, surveyed students annually. The study took place in Sioux Falls, S.D., and was matched to the Fargo–Moorhead community for comparison. All sixth graders enrolled in public schools in both communities were invited to participate in a baseline survey in April 1983, and that grade cohort was surveyed annually each April until its graduation from high school in 1989. Students received the intervention over a 5-year period. The study evaluated annual self-reported smoking history and, in 1986, included the amount of thiocyanate in saliva samples. The self-report consisted of standardized questions regarding daily smoking, weekly smoking, and smoking history. The saliva samples were obtained from a random sample of approximately half of all classrooms in 1986 (analysis was done on 667 students in the intervention community and 409 students in the comparison communities).

The cross-sectional design consisted of a survey for participants to evaluate smoking intensity and history. Cross-sectional students represented those in the community through the study as well as those not present at baseline or new to the community. The survey took approximately 40 minutes and was completed by students in their health, social science, or English classes. Specialized survey staff were trained to administer the surveys. The prevalence of weekly smoking was used to assess the impact of the intervention, and intensity scores were given to quantify the self-reported measures. Smoking intensity was defined as the number of cigarettes smoked per week by each student, which was then calculated as an average of three self-report questions that related to daily smoking, weekly smoking, and smoking history.

The study examined data using nested cohort and nested cross-sectional designs. In this study, students were observed in classrooms, which were nested within schools, which were nested within the towns assigned to the two treatment conditions. For the cross-sectional analyses, all participants were included. For the cohort analyses, only those who also participated in the baseline survey were included. The study did not provide specific sample sizes or demographics for the intervention and comparison community groups. Subgroup analyses were not conducted.

Materials for implementation include a facilitator’s manual containing detailed instructions for each session. Additionally, transparencies and handouts are provided to lead each session. Peer leaders participate in a 30-minute training session conducted by the teacher to prepare them for instruction of student groups. The peer leadership guide was written specifically for students, and designed to maximize the value of their participation in the Model Smoking Prevention Program (MSPP).

For additional information about the MSPP, including information on implementation, please go to the Hazelden website: http://www.hazelden.org/

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Botvin, Gilbert, Linda Dusenbury, Eli Baker, Susan James-Ortiz, Elizabeth Botvin, and Jon Kerner. 1992. “Smoking Prevention Among Urban Minority Youth: Assessing Effects on Outcome and Mediating Variables.” Health Psychology 11(5):290–99.

Bruvold, William. 1993. “A Meta-Analysis of Adolescent Smoking Prevention Programs.” American Journal of Public Health 83(6):872–80.

Langlois, Marietta, Rick Petosa, and Jeffrey Hallam. 1999. “Why Do Effective Smoking Prevention Programs Work? Student Changes in Social Cognitive Theory Constructs.” Journal of School Health 69(8):325–31.

Murray, David, Marsha Davis-Hearn, Anne Goldman, Phyllis Pirie, and Russell Leupker. 1988. “Four- and Five-Year Follow-up Results from Four Seventh-Grade Smoking Prevention Strategies.” Journal of Behavioral Medicine 11(4):395–405.

Murray, David, Phyllis Pirie, and Russell Luepker. 1988. “Five- and Six-Year Follow-Up Results from Four Seventh-Grade Smoking Prevention Strategies.” Journal of Behavioral Medicine 12(2):207–18. (This study was reviewed but did not meet CrimeSolutions criteria for inclusion in the overall program rating.)

Murray, David, Scott Richards, Russell Luepker, and Anderson Johnson. 1987. “The Prevention of Cigarette Smoking in Children: Two- and Three-Year Follow-up Comparisons of Four Prevention Strategies.” Journal of Behavioral Medicine 10(6): 595–611.

Perry, Cheryl, Joel Killen, Michael Telch, Lee Ann Slinkard, and Brian Danaher. 1980. “Modifying Smoking Behavior of Teenagers: A School-Based Intervention.” American Journal of Public Health (70)7:722–25.