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Tobacco use, especially cigarette smoking, is prevalent among older adolescents. Nationally 36.4% of high-school adolescents smoke cigarettes and 22% of white high school adolescent males use spit (smokeless) tobacco (ST). Tobacco use puts these young people at risk of lung cancer, oral cancer, heart disease and numerous other negative health effects. In the rural community of Lake County, California the prevalence of cigarette smoking and spit tobacco (ST) use among high-school-aged youth is similar to that reported nationally. These adolescents who use tobacco face a number of psychological, physical, and interpersonal issues which may influence tobacco use behaviors, motivation to quit using tobacco, and success in quitting. To address the need for effective intervention strategies in Lake County to help adolescents stop their tobacco use, a collaborative research partnership between experienced researchers at the University of California, San Francisco and community agencies has been formed. The four the primary members of this partnership are: Lake County Office of Education; Sutter Lakeside Community Services, a community-based non-profit organization; and the Lake County Health Services Department Tobacco Control Section Local Lead Agency; and the University of California, San Francisco.
The proposed pilot project will examine factors that may influence tobacco cessation treatment success in adolescent tobacco users and will develop and then pilot test an innovative, community-based tobacco cessation intervention for older adolescents (14-20 years) in one high school in Lake County. The objectives of this proposed pilot project are: (1) To determine the need for separate tobacco cessation interventions based on gender and type of tobacco used by comparing male smokers, female smokers, and male ST users on psychosocial factors and tobacco use characteristics that influence tobacco cessation treatment success. (2) To identify psychosocial factors and intervention components related to successful tobacco cessation among smokers and ST users by conducting a series of gender-specific focus groups with current smokers, former smokers, current ST users, and former ST users. (3) To collaborate with students from the Carle Continuation High School computer technology educational program to develop a computer program for use in the proposed intervention that will morph digital photographs to simulate physical appearance changes related to tobacco use and to the surgical treatment of oral cancer; (5) To develop based on focus group feedback and pilot test for feasibility and acceptability an innovative tobacco cessation intervention with relapse prevention among high school-age adolescents attending one high school in rural Lake County. The intervention will use student peers, a school nurse, and local county educators in its delivery, and will focus on the benefits of quitting as they relate to physical attractiveness, sexual potency, and addiction, and on the development of coping skills and social support mechanisms to facilitate the quitting process.
To discuss study progress and plan research efforts, an Executive Council composed of representatives from each collaborative partner of the study will meet monthly. In addition, to promote communication regarding program development and to gain feedback from already established community advisory boards, appointment of a study representative to the Community Tobacco Education Coalition, the County Maternal Child and Adolescent Health Advisory Board; and the Tobacco Use Prevention Education Advisory Boards at individual high schools in Lake County will be sought. This pilot project will utilize two methods, one-on-one interviews and focus groups, to examine psychosocial factors related to tobacco use and cessation, and to assess feasibility and acceptability of the intervention pilot tested in one high school. Results from this project will provide the foundational work that will allow us to pursue additional funding to conduct a controlled trial to determine the efficacy of the innovative treatment developed among older adolescents (14-20 years) in Lake County. |
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In 1998, 60% of high school students surveyed in Lake County (n=485) had tried smoking and 36% were self-reported regular smokers. To address this problem, a collaborative partnership between staff at Lake County Office of Education, Sutter Lakeside Community Services, the Lake County Health Services Department, and researchers at the University of California, San Francisco was formed to conduct a pilot study with the following specific aims:
(1) To identify psychosocial factors and intervention components related to successful tobacco cessation among smokers.
(2) To collaborate with faculty and students from Carle High School computer technology.educational program to develop a computer program to "morph" digital photographs to simulate physical appearance changes related to tobacco use and/or oral cancer.
(3) To pilot test a tobacco cessation intervention for feasibility and acceptability among high schoolage adolescents attending one high school in rural Lake County.
We gained parental consent and surveyed a sample of 123 high school-aged adolescents (69 Males, 69 Females) to assess factors that influence treatment success in adolescent tobacco users. To refine intervention components, we conducted 20 gender-specific focus groups with current smokers, former smokers, never smokers, and spit tobacco users in the same sample of adolescents. We also pilot tested the proposed intervention program in l high school to assess its feasibility and acceptability. The program consisted of oral cancer screening by a school nurse, who advises all tobacco users to quite and invites them to join a 6-week quit program; facial skin and fingernail care analysis by a skin care specialist from the community who relates facial wrinkles and nail staining to tobacco use, and a computer-based program that simulates physical appearance changes. Our findings indicate that the program is feasible and acceptable; that nicotine addiction needs to be addressed; that adolescent tobacco users might be motivated to make a quit attempt based on tobacco-related adverse effects on physical attractiveness; that all students should be offered the opportunity to participate in the oral and skin care screenings and computer simulations; and that counseling sessions should be gender specific. |
