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Motivation-enhanced teenage tobacco use cessation

Institution: University of Southern California
Investigator(s): Steven Sussman, Ph.D.
Award Cycle: 1997 (Cycle 6) Grant #: 6RT-0182 Award: $750,248
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Research Project Awards

Initial Award Abstract
No known published research has docu-mented reasonably effective quit-tobacco clinics among adolescents in general, and high risk youth, in particular. Quit rates among adolescents in clinic programs average about half that of adults (about 13%). Almost no research exists regarding quitting tobacco use among youth in higher risk settings. Subjects in the present project will consist of students from schools specializing in the education of high risk youth, known as "continuation" high schools in California. By developing a workable quit program for this school-based population, we hope to overcome some of the limitations of current adolescent quit-tobacco approaches.

The overall objectives of the proposed research are to (a) improve knowledge about the quitting process by developing a motivation strategy repertoire to encourage adolescents to stop using tobacco now rather than waiting until the future (an intrapersonal approach), (b) develop a clinic program which incorporates the intrapersonal motivational component, (c) develop a school-as-community component which applies directly to quitting tobacco use, as an interpersonal motivation approach, and (d) do a field experiment which contrasts motivation-enhanced clinic-only and motivation-enhanced clinic plus school-as-community programs in a continuation high school context involving 20 continuation high schools. General prevalence of tobacco use will be assessed at these 20 continuation high schools, and at 18 other continuation high schools engaged in another ongoing project, to calculate the level of self-initiated quitting.

Final Report
Please summarize, in language understandable to an educated lay person, the objectives of this project, significant findings which have resulted from the work to date, and the implications of the findings for reducing the human and economic costs of tobacco-related disease in California. Print the abstract in the box. We had two main objectives in mind when we began this project. First, we wanted to know if we could use scientific program development methods to create a teen school-based tobacco use cessation clinic program that would be well-received by high risk teens during implementation. Second, we wanted to know if we could test rigorously teen tobacco use cessation programming in the school-based clinic context. The resulting clinic program was named "Project EX." Project EX is an 8-session teen school-based clinic tobacco use cessation program that involves the inclusion of enjoyable, motivating activities (games, talk show, and alternative medicine-type) to try to enhance quit rates among youth. This clinic program was tested in a 3-group experimental design: clinic only, clinic plus a school-ascommunity component, and standard care control. Eighteen continuation high schools (CHS; alternative high schools in California) were randomly assigned to the three conditions. Three hundred and thirty five smokers participated in the study, making this the largest controlled teen smoking cessation field trial conducted to date. Seventeen percent of the smokers enrolled in the clinics had reports of having quit smoking for at least the last 30 days at 3 month follow-up (five months after the program quit day), compared to only 8% of the control condition smokers over than same time period. No differences were found between the two program conditions. The resulting Project EX clinic program appears to be an effective means of tobacco use cessation among teens, doubling quit rates.

Self-initiated quitting among adolescent smokers
Periodical: Preventive Medicine Index Medicus:
Authors: Sussman S, Dent CW, Severson H, Burton D, Flay B ART
Yr: 1998 Vol: 27 Nbr: Abs: Pg: A19-A28

Reasons for quitting and smoking temptation among adolescent smokers: Gender differences
Periodical: Substance Use and Misuse Index Medicus:
Authors: Sussman S, Dent CW, Nezami E, Stacy AW, Burton D, Flay BR ART
Yr: 1998 Vol: 33 Nbr: 14 Abs: Pg: 2703-2720

Effects of thirty-four adolescent tobacco use cessation and prevention trials on regular users of tobacco products
Periodical: Substance Use and Misuse Index Medicus:
Authors: Sussman S, Lichtman K, Ritt A, Pallonen U ART
Yr: 1999 Vol: 34 Nbr: 11 Abs: Pg: 1469-1504

Perceived invulnerability and cigarette smoking among adolescents
Periodical: Addictive Behaviors Index Medicus:
Authors: Milam JE, Sussman S, Ritt-olsen A, Dent CW ART
Yr: 2000 Vol: 25 Nbr: 1 Abs: Pg: 171-180

Developing treatment for nicotine addicted youth - issues and challenges
Periodical: Journal of Child and Adolescent Substance Abuse Index Medicus:
Authors: Henningfield JE, Michaelides T, Sussman S ART
Yr: 2000 Vol: Nbr: Abs: Pg:

Motivation in tobacco use cessation research
Periodical: Substance Use and Misuse Index Medicus:
Authors: Nezami E, Sussman S, Pentz MA ART
Yr: 0 Vol: Nbr: Abs: Pg:

Smoking cessation among persons in recovery
Periodical: Substance Use and Misuse Index Medicus:
Authors: Sussman S ART
Yr: 2000 Vol: Nbr: Abs: Pg: