Program

Jul 01, 2009

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

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.

Link to program curriculum:

http://tnd.usc.edu/tnt/order.php

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.

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, Cost Is Available, Manual Is Available.

Program
information last updated 07/1/09.

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