2003 NOV 24 - (NewsRx.com & NewsRx.net) -- Mobilizing young people to help their fellow students say no to smoking can bolster existing tobacco education and prevention projects in schools, according to a study of 25 Arizona elementary and middle schools.
'Peer-helping programs capitalize on natural channels of influence and are a relatively low-cost path to prevention,' said lead study author John Sciacca, MPH, PhD, professor of health promotion at Northern Arizona University in Flagstaff.
The study appeared in the American Journal of Health Education.
In addition to peer pressure, other factors can lead young people to smoke, the researchers note. Parents play a role, too.
'Nevertheless,' Sciacca said, 'peer influence is one of the important influences on a youth's decision to use tobacco.' He added that tobacco use usually begins at an early age and kids frequently turn to other kids for information.
'Unstructured, informal peer influence and education are taking place on a daily basis,' Sciacca said. 'Much of it likely results in misinformation or even harmful advice.'
To learn what happens when peer influence is channeled into fending off tobacco use, Sciacca and colleagues from the University of Arizona and Arizona State University organized the project using a program called Champs Have and Model Positive Peer Skills (CHAMPS).
'CHAMPS is a leadership model to train and empower students to become a positive force in preventing tobacco use,' Sciacca explained.
Only 19 of the original schools implemented the program in the 1998-1999 school year as planned. But the other six schools agreed to let students answer the same questionnaire used in the CHAMPS program. These schools thus provided a comparison group against which to measure program results. The CHAMPS program wasn't the sole approach to tobacco control in the state. Other tobacco prevention strategies were in effect in Arizona at the time, including a statewide mass media campaign.
School principals, teachers, parents, counselors, nurses and community representatives trained as CHAMPS leaders. They then selected student peer helpers.
'Ideal candidates were those to whom other students listened and who exhibited strong leadership skills,' Sciacca said.
Teams of 8-12 student leaders then organized specific activities to encourage tobacco prevention. They used everything from classroom lessons to skits and crossword puzzles in their efforts to focus on tobacco advertising and what tobacco can do to the body.
After 1412 students completed surveys at the beginning and end of the school year, Sciacca and colleagues found that students who had been through the CHAMPS program were significantly less likely to have smoked. The change in smoking rates among the comparison group students was not significant, Sciacca said. The CHAMPS students also correctly answered more questions about the harmful effects of tobacco use.
Over the same time, the percentage of students in the comparison schools who said they would smoke a cigarette if one of their best friends offered it increased significantly from 0.6% to 4.6%, but that figure increased only slightly (1.3% to 2.0%) in the 19 CHAMPS schools.
'The CHAMPS intervention - as an important component of a school-based tobacco prevention program - appears to have helped students to decide not to smoke as well as to have provided students with the perceived abilities to refuse cigarettes offered by a close friend,' Sciacca said. 'Efforts to increase students' perceived ability to resist peer pressure to smoke may be important in reducing smoking among youths.'
Support for this study came from the Arizona Department of Health Services, Tobacco Education and Prevention Program.
This article was prepared by Health & Medicine Week editors from staff and other reports.
