An investigation of a personal norm of condom-use responsibility among African American crack cocaine smokers

The purpose of this study was to investigate the unique contribution of a personal norm of condom-use responsibility to the formation of intentions to use male condoms during vaginal sex. Data were collected from 402 male and 157 female heterosexual African American crack cocaine smokers in Houston, Texas, US. Two structural equation models of the intention to use a condom with the last sex partner were estimated. One model included measures of condom-use attitudes, subjective norms and condom-use self-efficacy. A second model included these three measures and a fourth measure of a personal norm of condom-use responsibility. Separate models were estimated for men and women. The addition of a personal norm of condom-use responsibility provided a significantly better fit to the data than did models including only outcome expectations, subjective norms and self-efficacy. Results also showed distinctly different underlying cognitive structures of condom-use intention for men and women. A personal norm of condom-use responsibility had a strong direct effect on men's intentions to use condoms with the last sex partner. Other variables appeared to have no direct effect on men's intentions. Women's intentions were strongly influenced by a personal norm and social subjective norms. Situational self-efficacy and outcome expectations had weaker, yet significant, effects on women's intentions. Given the strong effect of personal norms on men's intentions to use condoms, further research should be undertaken.

Results from a statewide approach to adolescent tobacco use prevention

BACKGROUND

The 1985 Minnesota Legislature established guidelines for school-based tobacco-use prevention programming and provided financial incentives to school districts to encourage them to adopt a broad range of preventive measures. The Minnesota-Wisconsin Adolescent Tobacco-Use Research Project was funded by the National Cancer Institute in 1986 to evaluate the Minnesota initiative through two parallel studies.

METHODS

The Four Group Comparison Study was a prospective study of 48 school "units" which were randomly assigned to one of four conditions in 1987. Baseline observations were taken in the sixth grade in 1987, interventions were delivered in the seventh grade, and follow-up observations were taken in the seventh, eighth, and ninth grades. The Four Group Comparison Study was designed to evaluate the three middle-school interventions that were most widely adopted by Minnesota school districts as a result of the 1985 legislation. The Two State Comparison Study was a serial cross-sectional study of representative districts in Minnesota and Wisconsin. Annual surveys of ninth graders were conducted from 1986-1990. The Two State Comparison Study was designed to determine whether tobacco-use patterns changed in Minnesota relative to Wisconsin following the Minnesota legislation.

RESULTS

The prospective study indicated that none of the interventions was more effective in reducing adolescent tobacco use compared with a randomized control group. The serial cross-sectional study revealed that there was a modest net decline in Minnesota relative to Wisconsin from 1986 to 1990, but that it was within the range of chance variation.

CONCLUSIONS

Taken together, these results indicate that this legislative initiative was insufficient to reduce adolescent tobacco use statewide during the 5-year study period. Together with results from other recent studies, they suggest that even more intensive efforts may be required to effect widespread reductions in adolescent tobacco use.

Five- and six-year follow-up results from four seventh-grade smoking prevention strategies

Seven thousand one hundred twenty-four members of the Classes of 1985 and 1986 who had participated as seventh graders in one of several smoking prevention programs were tracked and surveyed for smoking habits at 5- and 6-year follow-up: participation exceeded 90% in both cohorts. These data indicated that participants who received seventh-grade interventions based on the social influences model had similar smoking patterns compared to participants in other conditions. This finding supports the call for booster sessions after the initial seventh-grade intervention program. Future follow-up studies will assess whether the earlier benefits associated with the social influences model will translate into measurable differences in adult smoking patterns.

A statewide approach to adolescent tobacco-use prevention: the Minnesota-Wisconsin Adolescent Tobacco-Use Research Project

Adolescent smoking rates remain high and the use of smokeless tobacco is increasing, especially among males. Despite this continuing public health problem and the recent development of more effective prevention programs, few adolescents now participate in such programs at school. Recent legislation in Minnesota established guidelines for tobacco-use prevention programming and provides financial incentives to school districts to use more effective methods. The Minnesota-Wisconsin Adolescent Tobacco-Use Research Project has implemented an evaluation design that will provide data on the efficacy of this statewide approach to the prevention of tobacco use among adolescents. This article describes the current state of tobacco-use prevention programming in Minnesota schools, current efforts to improve on that record, and the research design set up to evaluate these strategies.

Social, personality and environmental determinants of smoking in young Finnish men

The study was based on 471 males, aged 19 to 20 years, who started their compulsory military service in three military bases in Southwest, Southeast and Northern Finland in February 1982. Of these subjects 48% smoked regularly and had smoked in the past three weeks. The correlation between the reported number of cigarettes smoked a day and serum thiocyanate was 0.60. Seventy-four per cent of the subjects whose best friend smoked, were current smokers compared with 24% of the others. Proportion of smokers was higher in urban areas than in rural areas. Among the 14 explanatory variables in the multivariate logistic analysis, family members' and friends' smoking, the place of residence, strenuousness of leisure-time physical activities, number of friends, rebelliousness, intelligence test score, and general pessimism were most strongly associated with the likelihood of being a current smoker. The model explained 87% of the smoking variance.

Four-year follow-up results of the smoking prevention program in the North Karelia Youth Project

The North Karelia Youth Project was a 2-year intervention study aimed at preventing cardiovascular diseases risk factors among 13-year-old adolescents at the project's start. It was carried out during the years 1978 to 1980 in the county of North Karelia, Finland. The smoking prevention portion of the program was aimed at teaching children skills necessary to handle the social and psychological pressures associated with starting to smoke. During the 2-year program, 10 sessions were carried out in two schools by the project team and by specially trained peer leaders. In about half of the remaining 22 schools in North Karelia, a five-session program was carried out voluntarily by the teachers. After the program, 20% of the children in the two schools where the direct intervention was carried out reported smoking at least once a month. The same rate also was observed in two matched schools representative of the rest of the schools in North Karelia. In two other matched control schools in another county, 30% of the pupils reported to be smokers by the same criteria. Two years after the program (4 years after the beginning of the program), the reported smoking rates in the different school groups were 27, 26, and 37%, respectively. The results of this pilot study indicate that it is possible to reduce smoking onset by this kind of innovative program and that the beneficial effect can last several years.

Occupational and worksite norms and attitudes about smoking cessation

The relationship of worksite and occupational norms about smoking to workers' attitudes toward smoking cessation was studied in a defined population. From smokers identified in a self-administered questionnaire circulated to all employees of 10 worksites in suburban Minneapolis, 447 smokers were randomly selected and interviewed. Attitudes and social norms about smoking cessation were compared by occupation and worksite using analysis of covariance, controlling for age, sex, and education. Similarly, the relationships of social norms to attitudes were examined using multiple regression analysis. Interest in quitting smoking, confidence in the ability to quit, and coworker support of prior quit attempts were equally pervasive among workers from blue collar and white collar occupations. Yet substantial differences between worksites in attitudes and norms about smoking cessation suggest the importance of the unique social milieu of individual worksites. Of particular importance is the impact of coworker discouragement of prior quit attempts, which varied across worksites and was directly related to confidence in the ability to quit and the desire to seek formal help in future quit attempts. These findings point to the relevance of intervention programs aimed at changing worksite norms about smoking and smoking cessation.

Effect of two years of educational intervention on adolescent smoking (the North Karelia Youth Project)

A two-year educational intervention programme was carried out to try to prevent the onset of smoking among 13-15-year-olds in the county of North Karelia in eastern Finland. The aim of the programme was to teach the children skills to resist social pressures towards smoking. Older students (peer leaders) were trained to conduct the programme, which was directly managed in two schools and voluntarily implemented by the staff of about half of the remaining 23 schools in the county. Both types of intervention were associated with a significant reduction in self-reported onset rates of smoking. It is concluded that this type of innovative approach, based on modern psychosocial principles, is needed to control the smoking epidemic among adolescents.