Finally, recently published findings from the Hutchinson Smoking Prevention Project (HSPP; Peterson, Kealey, Mann, Marek, & Sarason, 2000) add a cautionary note to our optimism about school-based smoking prevention programs that focus on social influences. In the HSPP, 40 school districts, in small- to medium-sized communities in rural and suburban areas of the state of Washington, were randomly assigned to a social influences prevention program or usual curriculum control. The authors state that the distributions of gender, percent minority, percent in single-parent families, and percent of parents who graduated from high school among study participants were similar to those distributions among all children in the U.S. The intervention began in the third grade and continued through the tenth grade, with teacher-led sessions designed to focus on skills for identifying social influences to smoke, skills for resisting these influences, and correction of exaggerated normative perceptions about smoking. Other goals included motivating students to desire to be smoke free, promoting self-confidence in refusal skills, and enlisting positive family influences. In high school, the program distributed self-help tobacco cessation materials to students, and newsletters regarding tobacco resources and current events to teachers.

Although there was wide variation in smoking patterns among the studied school districts, Peterson and colleagues (2000) found no substantial difference in smoking prevalence between the control and experimental conditions, either at 12th grade or two years after high school. This trial was quite large and quite rigorous. Further studies should evaluate which components of the LST program appear to be exerting a positive influence on adolescent smoking; it may be that differences between the LST and HSPP interventions-such as specific program content, delivery, target population, or starting age-may account for the discrepancy in success. The HSPP trial does, however, highlight the importance of continuing to seek novel and expanded intervention strategies as we implement and evaluate those, like LST and Project TNT, that have met with success to date.