Children’s anti-tobacco effort fails

Published 9:00 pm Tuesday, December 19, 2000

By PAUL RECER

Associated Press

WASHINGTON — It was to be a showcase, world-class demonstration of how to persuade schoolchildren not to smoke.

The $15 million program used the latest smoking prevention theories from the best social scientists. From the third grade on, children attended special classes and were meticulously instructed by trained teachers how to resist tobacco use.

But after 14 years, experts declared Tuesday that the project failed.

More than a fourth of the former Washington state schoolchildren in the study are now regular smokers, about the same rate as those who didn’t receive the special classes, according to a report in the Journal of the National Cancer Institute.

"It simply didn’t work," said Arthur Peterson Jr., the project’s lead researcher. "It was a surprise. It was a disappointment."

Peterson, who heads a cancer prevention program at Fred Hutchinson Cancer Research Center in Seattle, said researchers are now scrambling to find new approaches for controlling tobacco use among the young.

"It is time for researchers to go back to the drawing board," he said.

Peterson said techniques that have worked in some areas include denying youthful access to tobacco by raising taxes and controlling sales, and by countering tobacco company advertising with a heavy, youth-oriented media blitz.

The Fred Hutchinson Cancer Research Center study, involving 8,388 schoolchildren and 640 teachers in 40 school districts, was based on what is called a "social influences" approach.

The experiment included classes designed to arm children with the skills to ignore social pressures to smoke, to teach them about the dangers of smoking and to provide a motivation to remain smoke-free throughout life. The students were taught to resist advertising, peer persuasion and influences at home.

Children were targeted during the critical tobacco decision years — the time in life when smoking habits that may last a lifetime are adopted.

Peterson said this social-influences approach has been the accepted standard among smoking prevention researchers for 25 years.

A curriculum for grades 3 through 10 was drawn up by smoking-prevention experts at the National Cancer Institute, which paid for the research. The educational program met guidelines for school-based anti-tobacco education recommended by the Centers for Disease Control and Prevention.

Teachers in the test schools attended training classes to learn the anti-tobacco education techniques.

The study started in September 1984, and continued until September 1999, with researchers following the progress of the test children as they grew older.

"This study was carefully conceived and meticulously performed, and it achieved a new standard of scientific rigor for prevention research," said Richard Clayton, a University of Kentucky researcher.

Yet it failed.

Surveys of the students in the study found that 24.4 percent of the girls and 26.3 percent of the boys were daily smokers by the 12th grade. That rate of smoking is almost identical to that among students who did not participate in the study, researchers found.

A survey of the students two years after high school found an even higher rate of smoking: 28.42 percent for those in the experimental group vs. 29.07 percent for those not in the program.

A federal survey released last week found 31.4 percent of high school seniors reported smoking at least once in the past month, a decline from the 34.6 percent found in a 1999 survey.

Clayton said the Washington state study shows the school-based social influences philosophy of smoking prevention may be basically flawed, or is at least clearly inadequate.

"It is based on the idea that the smoking decision is a rational one," he said. "It may be that we’ve ignored emotion and put too much emphasis on the rational" when trying to control smoking among the young.

Smoking is responsible for about 400,000 premature deaths in the United States, the CDC says. It is estimated that tobacco costs the nation about $50 billion annually in health care costs. Cigarette smoking has been linked to eight different types of cancer and to heart and lung diseases.

CDC smoking information:

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ttp://www.cdc.gov/health/smoking.htm

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