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Smoking among children and adolescents has tremendous public health importance. Onset and development of smoking occurs primarily in adolescence, and because tobacco is highly addictive, regular use in adolescence develops into nicotine dependency. Smoking among adolescents is likely to continue into the adult years, increasing the risk of numerous long-term negative health consequences. Yet, even after three decades of efforts to prevent smoking among children, large numbers of young people continue to smoke. Further, although a large percent of adolescent smokers express an interest in quitting, few are successful.
Unfortunately, adolescent smokers are difficult to recruit and retain in smoking cessation interventions, and even more discouraging, cognitive-behaviorally oriented cessation interventions that have been effective with adults, when tried with adolescents in school clinics and classrooms, have not shown much promise. Many believe that advances in health promotion among young people, including motivating interest in smoking cessation, will focus on innovative and appropriate use of emerging technologies such as computerized communication.
Last year, a virtual reality chat room approach was pilot tested and evaluated in terms of feasibility (e.g., use and acceptability) and immediate effectiveness (e.g., changes in self-efficacy, intentions, and self-reported quit rates) with high-risk teen smokers recruited from six alternative high schools. A smoking cessation counselor trained in motivational interviewing techniques interacted with teen smokers in a real-time on-line virtual reality world. Results were very promising.
In preparation for a proposal to test the chat room approach in a rigorous experimental design, over the next 18 months we are conducting efforts in four areas: (a) establishing strong connections with individual schools that would participate in further study, (b) developing an educational website-based intervention that would be an appropriate comparison with the virtual chat room cessation intervention, (c) refining the virtual world chat room intervention, and (d) refining the evaluation measures.
The virtual world chat room approach for teen smoking cessation has both public health potential and practical appeal. Virtual reality chat rooms can provide a technology appealing to adolescent boys and girls that is both convenient and “naturalistic” in that it involves real-time communication. The computer-based cessation program can overcome many of the traditional barriers of school-based cessation programs, and offer a potentially effective intervention for a population that may be especially resistant to quitting smoking and for whom other strategies have not proven very effective or practical. |
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Smoking among children and adolescents has tremendous public health importance. Onset and development of smoking occurs primarily in adolescence, and because tobacco is highly addictive, regular use in adolescence develops into nicotine dependency. Smoking among adolescents is likely to continue into the adult years, increasing the risk of numerous long-term negative health consequences. Yet, even after three decades of efforts to prevent smoking among children, large numbers of young people continue to smoke. Further, although a large percent of adolescent smokers express an interest in quitting, few are successful.
Unfortunately, adolescent smokers are difficult to recruit and retain in smoking cessation interventions, and cognitive-behaviorally oriented cessation interventions that have been effective with adults, when tried with adolescents in school clinics and classrooms, have not shown much promise. Many believe that advances in health promotion among young people, including motivating interest in smoking cessation, will focus on innovative and appropriate use of emerging technologies such as computerized communication.
Previously, a virtual reality chat room approach was pilot-tested and evaluated in terms of feasibility (e.g., use and acceptability) and immediate effectiveness (e.g., changes in self-efficacy, intentions, and self-reported quit rates) with high-risk teen smokers recruited from six alternative high schools. A smoking cessation counselor trained in motivational interviewing techniques interacted with teen smokers in a real-time on-line virtual reality world. Results from this pilot work were very promising.
In preparation for testing the chat room approach in a rigorous experimental design, over the past 18 months we conducted efforts in four areas: (a) established strong connections with individual schools to participate in further study, (b) developed an educational website-based intervention that would be an appropriate comparison with the virtual chat room cessation intervention, (c) refined the virtual world chat room intervention, and (d) refined the evaluation measures and procedures.
As a result of this work, twelve high schools in San Diego County have agreed to participate in a full research study to test the virtual world for teen smoking cessation. All schools are prepared to recruit students, allocate computer time and space, and assist with cohort maintenance. A web site has been developed that will allow study participants to log on to take surveys on line, access the virtual world, and access the educational comparison web sites. The virtual world has been refined to be more tobacco-specific, and several features have been added. The tobacco use survey measures were refined, incorporating standard measures from national and statewide surveys. A test-retest assessment of the reliability of the measures, as well as testing the web-enabled data collection system, was conducted. |
