Rationale for tobacco cessation interventions for youth.

Tobacco use is the leading cause of preventable death in the United States. Four of every five persons who use tobacco begin before they reach adulthood; more than 3,000 young persons begin smoking each day. In addition, smoking is addictive-three of four teenagers who smoke have made at least one serious, yet unsuccessful, effort to quit. The importance of tobacco use cessation programs for youth is addressed in Healthy People 2000: National Health Promotion and Disease Prevention Objectives and in recently passed legislation related to the Goals 2000 National Education Goals. CDC's Guidelines for School Health Programs to Prevent Tobacco Use and Addiction states that tobacco cessation programs are needed to help young persons who already use tobacco. In 1994, both the Surgeon General's Report, Preventing Tobacco Use among Young People, and the Institute of Medicine's report, Growing Up Tobacco Free, indicated that there were very few effective cessation programs for youth and that more research is needed in this area. This project convened experts to provide recommendations on the design of a tobacco cessation intervention for youth, including helping pregnant teenagers who smoke to stop. This program is based on effective adult cessation programs with modifications relevant to adolescent development. During the first year the major foundational work for this project was accomplished. A database of key contacts and other related interventions in tobacco cessation for youth was developed, a review and analysis of prevalence and trends in adolescent smoking were conducted, and a cooperative agreement with the American Medical Association was established to complete the design, implementation, and evaluation of an effective tobacco cessation program for youth. During the second project year, this program was tested through quasi-experimental research at various school-based health clinics throughout the country. The third year involved follow-up data collection and program modification based on the results. Plans for dissemination of the intervention to youth-serving agencies across the nation will be developed. This is a 3-year project. Copyright 1998 American Health Foundation and Academic Press.