Project Overview +

The purpose of this project is to develop and enhance an effective and easily diffused Internet-based smoking prevention and cessation intervention for adolescents in a large school-based trial. Decreasing smoking rates among adolescents has the long-term impact of lowering the morbidity and mortality rates associated with lung cancer and other tobacco-related illnesses.

Aims +

Aim 1: continue to strengthen and improve the existing web-based expert system intervention for adolescent smoking prevention and cessation by implementing the intervention among a large Michigan middle-school-aged population.

Aim 2: evaluate the effectiveness of the intervention compared to the non-intervention condition.

Secondary aims:

  1. compare the effectiveness of the intervention by gender and race.
  2. perform a process-to-outcome analysis to increase our understanding about differences between induced and secular smoking behavior changes in adolescents.
  3. collect data about feasibility, usability, and acceptability of the intervention.

Participants +

21 middle schools (11 intervention, 10 usual care)

Intervention +

The intervention is a computer-based self-contained expert system (ES), that gives the appearance of human-like reasoning for problems ordinarily requiring experts.

The user interface of the intervention is based on feedback from professional graphic artists, students, and health educators, and observations observed during intervention sessions.

The intervention is designed to teach cognitive and behavioral strategies on how to avoid becoming a smoker or how to quit smoking.

The intervention includes web based designs that appeal to teens, as well as the experiences of middle school students with smoking.

The web-based intervention can track each student's individual session-to-session changes in their attitudes, opinions, and behaviors related to cigarette smoking. The intervention also offers ipsative feedback to multi-session users. Ipsative feedback compares users' responses and progress from their most recent sessions to increase the level of individualization of the intervention.

Findings +

Data analyses show that the Internet-based intervention is feasible and it can follow-up a substantial proportion of its subjects. Furthermore, preliminary data reveal that the weekly smoking prevalence was low among 6th and 7th graders in our mid-school year baseline survey. Our follow-up data collected at the beginning of the follow school year show that the onset of new smoking remained low in our study cohort of over 1,000 adolescents. Furthermore, indicators assessing students' readiness to try smoking confirm these findings.

Conclusion +

Our data suggest that middle school students are an appropriate target group for smoking prevention interventions since only a small minority of the students has yet acquired the smoking habit, which can be very addictive. These data also indicate that the main focus of future interventions should be directed to measures that teach young adolescents skills to resist smoking.

Prevention Smoking in Jr. High School

10/01/2000 - 09/30/2001


Michigan Department of Community Health

Principal Investigator:

Unto E. Pallonen, PhD


Victor J. Strecher, PhD, MPH