PROJECT TOWARDS NO TOBACCO USE (PROJECT TNT)

 

OVERVIEW

Project Towards No Tobacco Use is a school-based, informational social-influence program designed to deter high school students from using tobacco. Schools were randomly assigned to one of five conditions: control, informational social influence, normative social influence, physical consequences, and combined. Program impacts have been found on trial and weekly use of cigarettes for the informational social influence, physical consequences, and combined conditions compared with the control condition. Students in the normative social influence, physical consequences, and combined conditions were significantly less likely to try smokeless tobacco than those in the control group.

 

The program materials cost $45 for the teacher’s manual and student workbook and $18.95 for a set of 5 workbooks.  The two- and three-day trainings have additional costs.

 

DESCRIPTION OF PROGRAM

Target Population: High school students

The Project Towards No Tobacco Use came in ten lessons delivered over ten consecutive school days.

 

The control condition received information in the standard format of assemblies on long-term effects of smoking. Messages were mainly “just say no.”

 

The informational social influence condition attempts to counteract the attitudes and behaviors that peers advocate that may be favorable to tobacco use, but are not overt. For example, favorable attitudes may come from viewing advertisements that depict a beautiful person smoking with many friends.

 

The other three program conditions were physical consequences (teaching misperceptions of such consequences), combined, and normative social influence (teaching awareness of such influence, all described in Sussman et al (1993a). In the physical consequences curriculum, students learn stages of experimentation with tobacco leading to disease (first trial, tolerance and enjoyment, addiction, health problems, disease), learn about diseases related to tobacco use, learn the financial costs of tobacco use, “practice horrific imagery,” and learn about the life of a smokeless tobacco user named Sean Marsee.

 

The combined curriculum combines the information and normative social influence conditions into one curriculum. In the normative social influence condition, students learn about peer pressure and acceptance, learn that refusing tobacco from a friend may not be as threatening of a situation as it first appears, learn assertiveness, learn decision-making (know the problem, know alternatives, think the problem through), learn how to say “no,” and learn techniques to escape from situations involving tobacco.

 

According to SAMSHA (PDF), the following costs are associated with Project TNT:

Teacher’s Manual: $45

Student Workbooks: $18.95 for set of five

Stand Up for Yourself video: $79.95

Use Social Images video: $40

Posttest, hard copy: $2.50

Posttest, electronic copy : Free on CSAP/Towards No Tobacco Use Web site

Project Papers: $2.50 each

 

 

EVALUATION(S) OF PROGRAM

Sussman, S., Dent, C.W., Stacy, A.W., Sun, P., Craig, S., Simon, T.R., Burton, D. & Flay, B.R. (1993b). Project towards no tobacco use: 1-year behavior outcomes. American Journal of Public Health, 83(9), 1245-1250.

 

Evaluated Population: The one-year follow-up data contained 7,052 students. At posttest, data were collected from 6,716 seventh-graders. Of these seventh-graders, 60% were white, 27% were Hispanic, and 7% were black.

 

Approach: Forty-eight junior high schools were randomly assigned to one of five conditions. Eight schools were each assigned to the four program conditions. Sixteen schools were assigned to the control curriculum.

 

Data collected included demographic and behavioral questionnaires and biological samples. The behavioral outcomes were “Have you ever tried cigarettes” and “Have you ever tried smokeless tobacco,” and then questions were included asking how often each were used.

 

Results: The informational social influence, physical consequences, and combined conditions significantly differed from the control condition for trial and weekly use of cigarettes. The informational social influence, physical consequences, and combined conditions did not significantly differ from one another on this outcome.

 

Students in the normative social influence, physical consequences, and combined conditions were significantly less likely to try smokeless tobacco than those in the control group. The normative social influence, physical consequences, and combined conditions did not significantly differ from one another on this outcome.

 

Dent, C.W., Sussman, S., Stacy, A.W., Craig, S., Burton, D., & Flay, B.R. (1995). Two-year behavior outcomes of project towards no tobacco use. Journal of Consulting and Clinical Psychology, 63(4), 676-677.

 

Evaluated Population: This sample was the same as the Sussman, Dent, Stacy, and colleagues (1993b), but followed to a second year. At year two, 7,219 of the students, now in ninth grade, completed questionnaires.

 

Approach: The baseline sample was assigned the same as the Sussman, Dent, Stacy, and colleagues’ study (1993b). The same outcomes were measured as the 1993 study.

 

Results: These outcomes were from the two-year follow-up survey. This study found that the increase in tobacco use was significantly different in the four intervention groups compared with the control group. The increase in the four intervention groups was smaller than the increase in the control group. The four intervention groups were not significantly different from each other. For weekly cigarette use, the combined intervention had a significantly smaller increase than the control group. The rest of the conditions were not significantly different from the control group. For both trial smokeless tobacco and weekly smokeless tobacco use, the physical consequences intervention was significantly different from the control condition. The other conditions were not significantly different from the control condition.

 

SOURCES FOR MORE INFORMATION

 

Link to program curriculum: http://tnd.usc.edu/tnt/order.php

 

 

References

Dent, C.W., Sussman, S., Stacy, A.W., Craig, S., Burton, D., & Flay, B.R. (1995). Two-year behavior outcomes of project towards no tobacco use. Journal of Consulting and Clinical Psychology, 63(4), 676-677.

 

Sussman, S., Dent, C. W., Stacy, A. W., Hodgson, C. S., Burton, D., & Flay, B. R. (1993a). Project Towards No Tobacco Use: Implementation, process and post-test knowledge evaluation. Health Education Research: Theory and Practice, 8(1), 109-123.

 

Sussman, S., Dent, C.W., Stacy, A.W., Sun, P., Craig, S., Simon, T.R., Burton, D. & Flay, B.R. (1993b). Project towards no tobacco use: 1-year behavior outcomes. American Journal of Public Health, 83(9), 1245-1250.

 

Program also discussed in the following Child Trends publication(s):

 

Hatcher, J. L. & Scarpa, J. (2001). Background for community-level work on physical health and safety in adolescence: Reviewing the literature on contributing factors. Washington, DC, Child Trends.

Hatcher, J. L. & Scarpa, J. (2002). Encouraging teens to adopt a safe, healthy lifestyle: A foundation for improving future adult behaviors (Research brief). Washington , DC : Child Trends.

 

Program categorized in this guide according to the following:

 

Evaluated participant ages: 13-14

 

Program components: school-based

 

Measured outcomes: physical health; behavioral problems, social/emotional

 

KEYWORDS: Adolescence (12-17), Young Adulthood, Young Adults, Substance Use, Alcohol Use, Illicit Drugs, High-Risk, High School, School-based, White or Caucasian, Hispanic or Latino, Black or African-American, Community, Urban, Tobacco Use, Physical Health; Behavioral Problems, Social/Emotional Development.

 

 

Program information last updated 07/1/09.