Project Title: Sin Fumar: Preventing Tobacco Use Among Border Youth
Abstract:
The goals of this project were to prevent tobacco use among Hispanic youth, educate youth and communities about tobacco use prevention and increase scientific understanding of how tobacco use can be prevented through media and school programs. Baylor College of Medicine, in conjunction with Laredo-Gateway Community Health Center and the Laredo Independent School District planned to execute a quasi-experimental study to evaluate the effects of media and direct peer communication for tobacco use prevention among Hispanic youth in Laredo. Annual surveys measured tobacco use and associated variables in 3 high schools and 4 middle schools in the Laredo Independent School District. A citywide campaign for tobacco use prevention was carried out, along with intensive peer leadership activities that were organized in 1 high school and 2 middle schools (randomly chosen). Research evaluated the implementation, processes and effects of the media campaigns and tested the hypothesis that media, plus peer communication is superior to media communication alone. The main measurable objective of this work was to reduce tobacco use, tobacco use intentions, and factors associated with tobacco use among youth involved in the prevention activities of the study, assessed through the tracking and comparison of smoking rates, and its associated factors. The proposed work fit with other programs in our research portfolio because the communication and research methods that were employed are extensions of our continuing work in cancer prevention and control.
PI:
- Amelie G. Ramirez, DrPH, Associate Professor of Medicine and Deputy Director of the Chronic Disease Prevention and Control Research Center at Baylor College of Medicine
Co-PI's:
- Kipling Gallion, MA, Associate Professor of Medicine in Cancer Education at the Chronic Disease Prevention and Control Research Center at Baylor College of Medicine
- Luis F. Velez, MD, Assistant Professor of Medicine in Cancer Education at the Chronic Disease Prevention and Control Research Center at Baylor College of Medicine
Funding Institution:
Texas Higher Education Board
Funding Period:
2 yrs. – 1999-2001
Location/Service Area:
Laredo, TX
Collaborators/Co-sponsors:
- Laredo-Gateway Community Health Center
- Laredo Independent School District
Goals:
To prevent tobacco use among Hispanic youth through a theory-based educational campaign using mass media and school-based programs
Objectives
- Reduce tobacco use among young people, specifically Hispanics, involved in and reached by media and peer-led tobacco prevention activity in Laredo
- Educate the Laredo community, specifically the youth, about tobacco use prevention through implementation of the proposed media and peer leadership activities
- Increase scientific understanding of how tobacco use can be prevented through media and school programs based on data collected for the purpose of evaluation
Results:
Once the mass media component (entire population) and the intensive intervention (1 high school and 2 middle schools) ended, a follow-up survey was conducted in April 2001 to assess changes from the baseline survey, with a total of 1,266 students participating in the follow-up. Fourteen percent of the students in the 6 schools surveyed were exposed to all program activities (in-school activities, TV, radio, print media and Internet), and 76% were exposed to at least one of them.
During the intervention period, a 5% increase was observed in the proportion of students in each middle school grade who tried smoking, with no increase in the high school grades. However, if the middle schools had maintained the trends observed at baseline (i.e., if no intervention had been implemented), as students mature from one grade to the next, the expected increase would have been around 15% for each grade. Also, a small, unexpected positive effect on smoking was observed, particularly at the high school level, where the proportion of students who recently tried cigarettes increased only slightly in the intervention school (from 3.5% to 4.7%), but tripled in the non-intervention school (from 1.8% to 5.7%). Overall, 3.4% of the students exposed to all program activities tried smoking during the last 6 months, compared to 5.5% of those who had never heard about the program. The strongest reduction was achieved among those students who were exposed to messages both at school and on television (only 2.3% experimented with smoking in the last 6 months). The weakest reduction was achieved among students who were exposed to messages only at school; among these, 3.8% tried smoking in the last 6 months. Exposure to radio messages alone seemed to have no positive effect on their behavior. These analyses suggest that the combination of television and in-school peer networking messages produces the best outcome. Despite the modest impact achieved, these results exceeded the expectations of the research team, since the Centers for Disease Control and Prevention recommend that interventions last at least 3 years to achieve any meaningful effect.
The analysis of the intermediate variables suggesting future changes in the individual’s behavior, showed an impact on some beliefs, despite the short intervention. The greatest overall reduction was seen in such beliefs as “smoking is something stupid to do” (5%), “smoking smells and tastes bad” (3%), and “you can get addicted to smoking” (2.2%). The belief that “smoking helps people relax” showed a significant reduction in the intensive-intervention high school (9.8%) and one of the intervention middle schools (8.7%), but not in the overall group of schools.
It is clear that the strongest impact on an individual school was reached at the high school where student actors were selected to participate in television, radio and billboard ads, underscoring the importance of involving the students in the production of all messages.
Potential Impact:
The project will potentially lead to a reduction in tobacco use among youth, especially Hispanics. It will also likely lead to further scientific understanding of how tobacco use can be prevented through media and school programs.
Publications:
Two publications are currently being developed.
