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Program Profile: Minnesota Smoking Prevention Program

Evidence Rating: Promising - One study Promising - One study

Date: This profile was posted on November 19, 2013

Program Summary

A smoking prevention program for school-aged children that consists of an interactive curriculum of coursework designed to inform students about the harms of tobacco use. The program is rated Promising. The intervention group reported reduced smoking intensity and prevalence compared to the comparison group.

Program Description

Program Goals/Target Population
The Minnesota Smoking Prevention Program (MSPP) is a smoking prevention program designed to promote awareness and knowledge of the harms of tobacco use among school-aged children. The goals of MSPP are to (1) help youths identify the reasons children their age smoke (e.g., peer pressure, advertising, lack of self-confidence); (2) provide resistance tools they can implement; and (3) emphasize the value of social support in resistance through peer leadership activities. Throughout the span of six classroom sessions, the program aims to instill educationally based strategies to abstain from tobacco use. The program was developed for students to work in collaboration with peers to apply learned tactics to not smoke.

Program Activities/Key Personnel
The development of MSPP came about from a larger project titled Minnesota Heart Health Program (MHHP) that was conducted in the North Dakota areas of Fargo and West Fargo, and Moorhead, Minn. The MHHP was designed to improve eating, exercise, and smoking patterns across the entire population of the communities. The MSPP was one component of this effort. The inaugural year of MSPP began in 1984 with sixth graders.

MSPP is comprised of six sessions that last 45–50 minutes in length. Each session was designed to incorporate various educational strategies for preventing tobacco use. The six sessions include:

  1. small group discussions identifying short-term consequences of smoking;
  2. comparing expectations of smoking with actual data and discussing overestimates of prevalence;
  3. learning why adolescents smoke (e.g., an attempt to seem mature);
  4. understanding how culture affects the desire to behave or act;
  5. skills to resist social influences; and
  6. expressing a public commitment to abstain.

Materials for implementation include a facilitator’s manual containing detailed instructions for each session. Additionally, transparencies and handouts are provided to lead each session. Peer leaders participate in a 30-minute training session conducted by the teacher to prepare them for instruction of student groups. The peer leadership guide was written specifically for students, and designed to make their time in MSPP worthwhile.

Evaluation Outcomes

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Study 1
Smoking Intensity and Prevalence
The main outcomes evaluated in the study were smoking intensity and prevalence among students. Perry and colleagues (1992) found that 14.6 percent of the cohort sample from the intervention community that received the Minnesota Smoking Prevention Program (MSPP) reported smoking weekly compared with 24.1 percent of the comparison group, a significant difference. The number of cigarettes smoked per week was also significantly lower in the intervention group compared with the comparison group. In addition, data gathered from the examination of the saliva samples showed a significantly lower presence of thiocyanate in the intervention group compared with the comparison group.

The results from the cross-sectional data supported these results from the cohort data.
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Evaluation Methodology

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Study 1
The evaluation of Minnesota Smoking Prevention Program (MSPP) by Perry and colleagues (1992) used a quasi-experimental design to assess the net effect of combining a behavioral health education program in school with the communitywide Minnesota Heart Health Program (MHHP) on youth living in the intervention community. Seven annual waves of cohort and cross-sectional behavioral measurements were collected.

The cohort design, which followed students for 6 years, surveyed students annually. The study took place in Sioux Falls, S.D., and was matched to the Fargo–Moorhead community for comparison. All sixth graders enrolled in public schools in both communities were invited to participate in a baseline survey in April 1983, and that grade cohort was surveyed annually each April until its graduation from high school in 1989. Students received the intervention over a 5-year period. The study evaluated annual self-reported smoking history and in 1986 included the amount of thiocyanate in saliva samples. The self-report consisted of standardized questions regarding daily smoking, weekly smoking, and smoking history. The saliva samples were obtained from a random sample of approximately half of all classrooms in 1986 (analysis was done on 667 students in the intervention community and 409 students in the comparison communities).

The cross-sectional design consisted of a survey for participants to evaluate smoking intensity and history. Cross-sectional students represented those in the community through the study as well as those not present at baseline or new to the community. The survey took approximately 40 minutes and was completed by students in their health, social science, or English classes. Specialized survey staff were trained to administer the surveys. The prevalence of weekly smoking was used to assess the impact of the intervention and intensity scores were given to quantify the self-reported measures. Smoking intensity was defined as the number of cigarettes smoked per week by each student, which was then calculated as an average of three self-report questions which related to daily smoking, weekly smoking, and smoking history.

The study examined data using nested cohort and nested cross-sectional designs. In this study, students were observed in classrooms, which were nested within schools, which were nested within the towns assigned to the two treatment conditions. For the cross-sectional analyses, all participants were included. For the cohort analyses, only those who also participated in the baseline survey were included. The study did not provide specific sample sizes or demographics for the intervention and comparison community groups.
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There is no cost information available for this program.
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Implementation Information

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For additional information about the Minnesota Smoking Prevention Program (MSPP), including information on implementation, please visit the Hazelden Web site.
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Perry, Cheryl, Steven Kelder, David Murray, and Klepp Knut–Inge. 1992. “Communitywide Smoking Prevention: Long-Term Outcomes of the Minnesota Heart Health Program and the Class of 1989 Study.” American Journal of Public Health 82(9):1210–16.
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Additional References

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These sources were used in the development of the program profile:

Botvin, Gilbert, Linda Dusenbury, Eli Baker, Susan James-Ortiz, Elizabeth Botvin, and Jon Kerner. 1992. “Smoking Prevention Among Urban Minority Youth: Assessing Effects on Outcome and Mediating Variables.” Health Psychology 11(5):290–299.

Bruvold, William. 1993. “A Meta-Analysis of Adolescent Smoking Prevention Programs.” American Journal of Public Health 83(6):872–880.

Langlois, Marietta, Rick Petosa, and Jeffrey Hallam. 1999. “Why Do Effective Smoking Prevention Programs Work? Student Changes in Social Cognitive Theory Constructs.” Journal of School Health 69(8):325–331.

Murray, David, Marsha Davis-Hearn, Anne Goldman, Phyllis Pirie, and Russell Leupker. 1988. “Four- and Five-Year Follow-up Results from Four Seventh-Grade Smoking Prevention Strategies.” Journal of Behavioral Medicine 11(4):395–405.

Murray, David, Phyllis Pirie, and Russell Luepker. 1988. “Five- and Six-Year Follow-Up Results from Four Seventh-Grade Smoking Prevention Strategies.” Journal of Behavioral Medicine 12(2):207–18. (This study was reviewed but did not meet criteria for inclusion in the overall program rating.)

Murray, David, Scott Richards, Russell Luepker, and Anderson Johnson. 1987. “The Prevention of Cigarette Smoking in Children: Two- and Three-Year Follow-up Comparisons of Four Prevention Strategies.” Journal of Behavioral Medicine 10(6): 595–611.

Perry, Cheryl, Joel Killen, Michael Telch, Lee Ann Slinkard, and Brian Danaher. 1980. “Modifying Smoking Behavior of Teenagers: A School-Based Intervention.” American Journal of Public Health (70)7:722–725.
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Program Snapshot

Age: 9 - 13

Gender: Both

Race/Ethnicity: Black, American Indians/Alaska Native, Asian/Pacific Islander, Hispanic, White

Geography: Rural, Suburban, Urban, Tribal

Setting (Delivery): School

Program Type: School/Classroom Environment, Alcohol and Drug Prevention

Current Program Status: Active

Listed by Other Directories: Model Programs Guide

Kris Van Hoof-Haines
Executive Director Content Innovations Management
Hazelden Publishing and Educational Services
15251 Pleasant Valley Road, P.O. Box 176
Center City MN 55012
Phone: 800.328.9000 ext: 4331

Training and TA Provider:
Kaylene McElfresh
Special Projects and Training Manager
Hazelden Informational and Educational Services
15251 Pleasant Valley Road, P.O. Box 176
Center City MN 55012
Phone: 800.328.9000 ext: 4324