Prevention of cigarette smoking through mass media intervention and school programs.

OBJECTIVES: In this study we tested the ability of mass media interventions to enhance the efficacy of school cigarette smoking prevention programs. METHODS: For 4 years, students in one pair of communities received media interventions and school programs that had common educational objectives. Students in a matched pair of communities received only the school programs. The combined cohort of 5458 students was surveyed at baseline in grades 4, 5, and 6 and was followed up annually for 4 years. RESULTS: Significant reductions in reported smoking, along with consistent effects on targeted mediating variables, were observed for the media-and-school group. For cigarettes per week the reduction was 41% (2.6 vs 4.4); for smoking cigarettes yesterday the reduction was 34% (8.6% vs 13.1%); and for smoking in the past week the reduction was 35% (12.8% vs 19.8%). No effects were observed for substance use behaviors not targeted by the interventions. CONCLUSIONS: These results provide evidence that mass media interventions are effective in preventing cigarette smoking when they are carefully targeted at high-risk youths and share educational objectives with school programs.