Current smoking decreased; more students identified as committed nonsmokers
CHICAGO -- Florida's comprehensive youth-led prevention program has helped reduce cigarette smoking among middle and high school students, while increasing their commitment not to smoke, according to an article in the August 9 issue of The Journal of the American Medical Association (JAMA), a theme issue on tobacco.
Ursula E. Bauer, Ph.D., and colleagues with the Florida Department of Health, Tallahassee, Fla., surveyed students from selected middle and high schools to assess changes in cigarette use and intentions following the 1998 implementation of the Florida Pilot Program on Tobacco Control (FPPTC). The program was created as part of the $11.3 billion legal settlement reached between the State of Florida and the tobacco industry in August 1997.
Bauer presented the article here today at a JAMA media briefing on tobacco during the World Conference on Tobacco OR Health.
The FPPTC includes an innovative youth-directed media campaign marketing the "truth" brand and slogan ("Our brand is truth, their brand is lies"); school-based education and training; enforcement of laws restricting tobacco sales to minors; and youth and community activities, featuring Students Working Against Tobacco (SWAT) teams.
To assess the impact of the FPPTC, the researchers asked students in grades 6-8 and 9-12 to answer self-administered questionnaires. Surveys were completed by 22,540 students at 255 schools in 1998; by 20,978 students at 242 schools in 1999; and by 23,745 students at 243 schools in 2000.
The researchers report there were substantive and statistically significant changes in cigarette use and intentions following implementation of the FPPTC. "In 1999 and 2000, fewer Florida public middle school and high school students smoked cigarettes currently than did in 1998," they write. "Among those who never tried cigarettes, a greater percentage of students indicated they will Œdefinitely not' try or use cigarettes in the future," they continue.
Among the findings of the survey:
- Over the two-year period between the first and third surveys, current cigarette use declined by 40 percent (from 18.5 to 11.1 percent) among middle school students, and by 18 percent (from 27.4 to 22.6 percent) among high school students. The decline in current use by middle-schoolers is the result of the absence of initiation into cigarette use among new students moving into the middle school grades (and by older students with higher use rates moving up to high school).
- The prevalence of frequent cigarette use (defined as those who smoked on 20 or more of the previous 30 days) decreased from 5.4 to 2.9 percent from 1998 to 2000 among middle school students, and from 13.5 to 10.4 percent among high school students.
- The percentage of students who were never users of cigarettes increased from 56.4 to 69.3 percent among middle school students, and from 31.9 to 43.1 percent among high school students.
Among students who had never tried cigarettes, the percentage defined as committed nonsmokers increased from 67.4 to 76.9 percent for middle school students, and from 73.7 to 79.3 percent for high school students.
Among those who had tried smoking, the percentage of students who said they would not smoke again increased from 30.4 to 42.0 percent for middle school students, and from 44.4 to 51.0 percent for high school students.
"In 1999 and 2000, Florida middle and high school students were less likely to buy into the allure of tobacco; they have voiced a strong commitment to resist tobacco ..." the researchers write.
"The findings presented here suggest that a statewide comprehensive youth tobacco use prevention program can reduce cigarette use and increase intentions to never use cigarettes (ever or again) among youth," the authors conclude.
"If these gains can be maintained as youths age, then, over time, such a program will result in striking reductions in the prevalence of adult cigarette use and lifetime reductions in morbidity and mortality attributable to cigarette use. A challenge for the FPPTC will be to ensure that the gains achieved among middle school and high school youth are maintained as these youth become young adults."
Media Advisory: To contact Ursula E. Bauer, PhD, call Frank Penela at 850-245-4444, ext. 4112. On Tuesday, August 8, call the Science News Department at 312-464-5374.
(JAMA. 2000; 284:723-728)
For more information about The Journal of the American Medical Association or to obtain a copy of the study, please contact the American Medical Association's Science News Department at 312-464-5374.
Posted by the Center for the Advancement of Health http://www.cfah.org. For information about the Center, call Petrina Chong, pchong@cfah.org 202-387-2829.
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