Sin Fumar: Preventing Tobacco Use Among Border Youth
This project aimed 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 in Laredo, Texas. Project investigators teamed with the Laredo Independent School District and Gateway Community Health Center to conduct a quasi-experimental study to evaluate the effects of media and direct peer communication on preventing tobacco use among Hispanics in grades 6-12. Annual surveys measured tobacco use and associated variables in three high schools and four middle schools in the district. A media campaign was implemented alongside intensive peer leadership activities at one high school and two middle schools (chosen randomly). Research evaluated the implementation, processes and effects of the media campaigns, and the hypothesis that media and peer communication is superior to media alone in reducing tobacco use, intentions, and associated factors (assessed by tracking smoking rates and its associated factors) to increase the scientific understanding of how tobacco use can be prevented through media and school programs.
Funding
Texas Higher Education Board 1999-2001Principle Investigators
Amelie G. Ramirez, DrPH IHPR, The University of Texas Health Science Center at San Antonio (at Baylor College of Medicine for this project)Collaborations
Laredo’s Gateway Community Health Center Laredo Independent School DistrictLocation
Laredo, TexasConclusions
After the citywide mass media component and the intervention at the three schools ended, 1,266 students from all six schools completed a follow-up survey in April 2001. About 14% were exposed to all educational materials (in-school activities and TV, radio, print and Internet media) and 76% to at least one. Here are the results:
During the intervention period, the proportion of middle-school student who tried smoking rose 5% and high-school students remained the same. However, if the middle schools had maintained the trends observed before the intervention, the expected increase would have been nearly 15%.
At the high-school level, the proportion of students who recently tried cigarettes increased only slightly in the intervention school (3.5% to 4.7%), but tripled in the non-intervention school (1.8% to 5.7%).
Overall, 3.4% of the students exposed to all program activities tried smoking in the last six months, compared to 5.5% of those who had never heard about the program.
The strongest reduction occurred among students exposed to messages at school and on TV (only 2.3% experimented with smoking in the last six months), while the weakest reduction occurred among students exposed only to messages at school (3.8% tried smoking in the last six months).
Exposure to radio messages alone had no positive effect on their behavior.
Despite the short intervention, an analysis of the intermediate variables suggested future changes in individuals’ behavior. The belief that “smoking helps people relax” was significantly reduced 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’s clear that the strongest impact on one school occurred at the high school, where student actors were selected to participate in TV, radio and billboard ads, underscoring the importance of involving the students in the production of all messages.
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, given that the U.S. CDC recommends that interventions last at least three years to achieve meaningful effect.