A National Survey of Tobacco Cessation Programs for Youths

Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA.
American Journal of Public Health (Impact Factor: 4.55). 02/2007; 97(1):171-7. DOI: 10.2105/AJPH.2005.065268
Source: PubMed


We collected data on a national sample of existing community-based tobacco cessation programs for youths to understand their prevalence and overall characteristics.
We employed a 2-stage sampling design with US counties as the first-stage probability sampling units. We then used snowball sampling in selected counties to identify administrators of tobacco cessation programs for youths. We collected data on cessation programs when programs were identified.
We profiled 591 programs in 408 counties. Programs were more numerous in urban counties; fewer programs were found in low-income counties. State-level measures of smoking prevalence and tobacco control expenditures were not associated with program availability. Most programs were multisession, school-based group programs serving 50 or fewer youths per year. Program content included cognitive-behavioral components found in adult programs along with content specific to adolescence. The median annual budget was 2000 dollars. Few programs (9%) reported only mandatory enrollment, 35% reported mixed mandatory and voluntary enrollment, and 56% reported only voluntary enrollment.
There is considerable homogeneity among community-based tobacco cessation programs for youths. Programs are least prevalent in the types of communities for which national data show increases in youths' smoking prevalence.

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    • "This structure supports the implementation of a centralized dissemination model. It is currently the most used teen smoking cessation program in the nation (34) and has been incorporated into the WV Division of Tobacco Prevention comprehensive tobacco control efforts since 2000. However, even within the ALA’s national training infrastructure, lack of an evidence-based dissemination model impedes efficient and effective program monitoring, implementation, accessibility, and sustainability. "
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    • "At the end of treatment, 143 of the total sample of 1,167 adolescent smokers reported not currently smoking cigarettes (12.3%); 78 of the 402 adolescents with a TTFC after 30 min of waking were identified as being quit (19.4%) versus 65 of the 700 adolescents with a TTFC within 30 min of waking (8.5%). Due to data imputation using the BOCF approach, the efficacy results of N-O-T were somewhat lower than the typical 15%– 30% success rates for the program (Cahill et al., 2010; Curry et al., 2007; Grimshaw & Stanton, 2006; Horn et al., 2005), with 13.9% of those receiving N-O-T reporting that they had quit versus 10% of those receiving the BI. As demonstrated in Table 2, logistic regression examining the effect of TTFC on quit status suggests that when controlling for treatment group, age, gender, motivation, confidence, and baseline cigarettes/day, those who smoked their first cigarette of the day after 30 min of waking were approximately twice as likely of being quit at end of treatment versus those reporting smoking within 30 min of waking. "
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    ABSTRACT: This study examined the relationship between the time to the first cigarette (TTFC) of the morning with quit status among adolescent smokers at the completion of a school-based smoking cessation program. Among those who did not quit, the relationship of TTFC with changes in cigarettes/day (CPD) was also examined. A total of 1,167 adolescent smokers (1,024 nonquitters and 143 quitters) from 4 states participating in efficacy and effectiveness studies of the Not-On-Tobacco (N-O-T) cessation program were assessed prior to entry into the program and again 3 months later, at the end of treatment. Linear and logistic regression analyses determined the influence of treatment condition, age, gender, motivation to quit, confidence in quitting ability, baseline CPD, and TTFC on quit status and end-of-treatment CPD. Adolescents with a TTFC of >30min of waking were twice as likely to quit at end of treatment. Additionally, among those who did not quit at end of treatment (n = 700 for TTFC ≤30min and n = 324 for TTFC for >30min), those with a TTFC within 30min of waking smoked a greater number of CPD. The relationships of TTFC with both of these outcomes remained when controlling for all other predictor variables. Identifying adolescent smokers who smoke their first cigarette of the day within the first 30min of waking prior to a quit attempt may help to classify those individuals as having a greater risk for cessation failure. Thus, TTFC may be a behavioral indicator of nicotine dependence in adolescents.
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