DESCRIPTION: (Applicant's Description) Over 3 million adolescents smoke
cigarettes, with 3,000 starting each day. Most will continue to smoke, and
an estimated 5 million people ages 0-17 in 1995 will ultimately die from a
smoking-related disease. Although research efforts have focused on methods
for preventing adolescent smoking, there are little data available on how to
help the one-third of adolescents who smoke. Effective cessation
interventions are key to reducing smoking prevalence in this population.
Both clinician- and self-help interventions are particularly appropriate to
this population, as they allow for targeting large and geographically
diverse populations, while maintaining confidential contact that is
developmentally important to this age group. The proposed study will
examine the effectiveness of a health care provider-based intervention with
self help adjuncts for adolescent smokers ages 14-18. Ninety pediatric and
adolescent practices will be recruited in a 6 county area, with 20
adolescents/practice for a total of 1800 subjects. Practices will be
blocked on key variables and randomized to: 1) Intervention - physician,
nurse practitioner, and physician assistant training in smoking intervention
(following NCI and AHCPR guidelines), and self-help adjuncts (self-help
manual, hotline, proactive calls, Internet resources) or 2) Usual care.
Interventions and practice level implementation will be guided by focus
group feedback in year 1. Subjects will be followed by telephone at 3 and
12 months for determination of smoking status, use of self-help resources,
and other smoking/health variables. Health care providers will be surveyed
pre- and post training and at 12 month follow-up to regarding self-reported
smoking screening and intervention with adolescents; adolescent subjects
will also be queried regarding receipt of these services. This study will
provide evidence for effective smoking cessation interventions for
adolescents, and will assist in planning future intervention efforts with
this population.
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- The DCCPS Team.