DESCRIPTION: (Applicant's Description) Adolescent smokers are at high risk
for future tobacco-related morbidity and mortality. Results of our trials
in adolescent smokers using nicotine patch therapy indicate that
pharmacologic intervention is not sufficient. Behavioral treatments
tailored to adolescents offer the possibility of more effective
intervention. An interactive, in home, computer-based system, CHESS
(Comprehensive Health Enhancement Support System) has demonstrated positive
health outcomes in a number of adult populations. In this proposal, an
Internet-based CHESS module will be developed and evaluated for in home use
for adolescent smoking cessation. We chose to study the efficacy of CHESS
for adolescent smokers because it offers a number of advantages over
traditional smoking cessation programs, including peer-based social support
and other content which will be based on the needs identified by
adolescents. It also has the potential for widespread dissemination through
the Internet. The primary study aims are: 1) to assess the needs of
adolescent cigarette smokers through a comprehensive needs assessment of
adolescent current and former smokers ages 11 to 17; 2) to develop the
content, design and subsequently construct a CHESS module for smoking
cessation based on the needs identified by adolescents; and 3) to evaluate
in a randomized trial the efficacy of providing in home computers with the
CHESS module compared to brief office intervention on the week 24 smoking
abstinence rates in 252 adolescent cigarette smokers ages 11 to 17. The
primary hypothesis to be tested is that CHESS will increase the 6 month
smoking abstinence rates in adolescent cigarette smokers compared to brief
The project will have three phases. The first phase will consist of a needs
assessment using focus groups and surveys of 612 adolescent current and
former smokers ages 11 to 17. The second phase will be to develop and
construct an Internet-based CHESS module for adolescent smoking cessation.
In the third phase, 252 adolescent smokers ages 11 to 17 years will be
provided with brief office intervention for 4 weeks (n=126) or CHESS for 24
weeks (n=126) in a randomized, two-group design. The assessments will occur
at weeks 0,4, 8,12, 16,20,24,36, and 52. The primary outcome will be the
point-prevalence smoking abstinence rates at week 24 verified with expired
air carbon monoxide. Adolescents will be recruited for participation in the
study from four geographically and ethnically diverse locations. The study
will be conducted by the Mayo Clinic, Rochester, MN and the University of
Wisconsin, Madison, WI.
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