Study 1
The Sussman, Dent, and Lichtman (2001) study recruited participants from 18 continuation high schools (CHS's) in California. CHS's are alternative public schools where students are referred, once they are of high school age, due to functional reasons such as behavioral problems or poor academic performance. CHS students are at a greater risk for tobacco addiction and for their addiction to continue into adulthood. The schools were assigned to three conditions: 1) control group, 2) treatment group (Project EX), and 3) treatment group (Project EX with a school-as-community [SAC] component). The SAC component uses the school’s Associated Student Body (ASB), under teacher supervision and support, to organize service, recreational, and job training events that emphasize non-tobacco use behaviors. Through the use of project newsletters the ASB also publishes anti-tobacco use literature. The CrimeSolutions review of this study focused on the differences between both treatment groups combined (Project EX and Project EX with the SAC component) and the control group.
The study used a randomized block design procedure. This procedure involved calculating factor scores derived from archival school demographic information, arranging schools along a single-factor score continuum, and then randomly assigning adjacently scored schools to conditions.
Student participation in cessation clinics was voluntary; individuals willing to participate were given credit and class release time. To be eligible for the study, participants had to have used tobacco within 30 days prior to the first session and had to join the clinic in the first 2 of the 6 weeks (on or before session 4). A total of 335 students were included in the study with 259 smokers participating (139 students at the clinic-only schools; 120 students in the clinic-plus-SAC schools, and 76 students at the control schools). Among the cigarette smokers, 46 percent smoked only cigarettes, 36 percent smoked both cigarettes and cigars, 6 percent used both cigarettes and smokeless tobacco products, and 12 percent used all three types of tobacco. Based on the initial nicotine dependence questionnaire, 25 percent of tobacco users scored in the no or weak signs of addiction range, 58 percent scored in the moderate addiction range, and 17 percent scored in the heavy addiction range.
A total of 64 percent of the sample were male. Of the sample, 47 percent were Latino, 27 percent were white, 8 percent were Asian, 6 percent were African American, and 12 percent were “other.” The mean age was 16.8, with a range from 14 to 19. The demographics of the clinic enrollees did not differ significantly among program conditions.
Clinic participants were measured at baseline (pretest), immediately following the program, and at a 3-month follow-up. At control schools, tobacco-using students volunteered to take the baseline and 3-month follow-up surveys. Self-report measures included tobacco use, behavior and intentions, nicotine dependence, and demographic measures (age, gender, and ethnicity). Reports of nonsmoking were verified by Carbon Monoxide (CO) levels in expired-breath samples, using a cutoff of 9 parts per million. The study authors conducted additional analyses to examine the difference between the Project EX treatment group and the Project EX with the SAC component treatment group in smoking cessation.
