A profile of teen smokers who volunteered to participate in school-based smoking intervention
Geri Dino 1,2
More details
Hide details
Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, Morgantown, USA
Department of Community Medicine, West Virginia University, Morgantown, USA
Department of Psychology, West Virginia University, Morgantown, USA
Department of Pharmaceutical Systems and Policy, West Virginia University, Morgantown, USA
Submission date: 2008-06-13
Acceptance date: 2008-08-05
Publication date: 2008-07-31
Tobacco Induced Diseases 2008;4(August):6
Although a number of population-based studies have examined the characteristics of teens who attempt to quit smoking, few have identified the characteristics of youth who participate in structured cessation interventions, particularly those with demonstrated effectiveness. The purpose of the present study is to describe the sociodemographic and smoking-related characteristics of teen smokers who participated in the American Lung Association's Not On Tobacco (N-O-T) program, spanning eight years. N-O-T is the most widely used teen smoking cessation program in the nation.

Drawn from multiple statewide N-O-T studies, this investigation examined data from 5,892 teen smokers ages 14–19 who enrolled in N-O-T between 1998–2006. We demonstrate similarities and differences between N-O-T findings and existing data from representative samples of US teen smokers where available and relevant.

N-O-T teens started smoking earlier, were more likely to be poly-tobacco users, were more dependent on nicotine, had made more previous attempts to quit, and were more deeply embedded in smoking contexts than comparative samples of teen smokers. Additionally, N-O-T teens were moderately ready to quit smoking, believed important people in their lives would support their quit efforts, yet had deficits in their confidence with quitting.

This profile of N-O-T teens can guide efforts for targeted recruitment strategies to enhance intervention reach for teen smoking cessation. Findings provide guidance for marketing and recruitment efforts of intensive, school-based cessation interventions among established teen smokers, particularly those who want to quit. Study results may shed light upon who is and is not enrolling in N-O-T.

Centers for Disease Control and Prevention: Youth Risk Behavior Surveillance Survey. MMWR. 2006, 55 (3305): 69.
Centers for Disease Control and Prevention: Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs – United States, 1995 – 1999. MMWR. 2002, 51 (14): 300-3.
Zhu S, Melcer T, Sun J, Rosbrook B, Pierce JP: Smoking cessation with and without assistance: a population-based analysis. Am J Prev Med. 2000, 18 (4): 305-11. 10.1016/S0749-3797(00)00124-0.
Dino G, Horn K, Goldcamp J, Fernandes A, Kalsekar I, Massey C: A 2-year efficacy study of Not On Tobacco in Florida: an overview of program successes in changing teen smoking behavior. Prev Med. 2001, 33 (6): 600-5. 10.1006/pmed.2001.0932.
Tyas S, Pederson L: Psychosocial factors related to adolescent smoking: a critical review of the literature. Tobacco Control. 1998, 7: 409-420.
Vink J, Willemsen G, Boomsma D: The association of current smoking behavior with the smoking behavior of parents, siblings, friends and spouses. Addiction. 2003, 98 (7): 923-931. 10.1046/j.1360-0443.2003.00405.x.
Emmons KM, Wechsler H, Dowdall G, Abraham M: Predictors of Smoking among US College Students. Amer J Public Health. 1998, 88 (1): 104-107.
Niaura R, Abrams DB: Smoking Cessation: Progress, Priorities, and Prospectus. J of Clin Consult Psych. 2002, 70 (3): 494-509. 10.1037/0022-006X.70.3.494.
Audrain-McGovern J, Hughes Halbert C, Rodriguez D, Epstein LH, Tercyak KP: Predictors of Participation in a Smoking Cessation Program among Young Adult Smokers. Cancer Epi Biomarkers Prev. 2007, 16: 617-619. 10.1158/1055-9965.EPI-06-0791.
Kear ME: Psychosocial determinants of cigarette smoking among college students. J Community Health Nurs. 2002, 19 (4): 245-57.
Zhu S: Predictors of smoking cessation in U.S. adolescents. Amer J Prev Med. 1999, 16 (3): 202-207. 10.1016/S0749-3797(98)00157-3.
Ellickson PL, McGuigan KA, Klein DJ: Predictors of Late-Onset Smoking and Cessation Over 10 Years. J Adolescent Health. 2001, 29: 101-108. 10.1016/S1054-139X(00)00199-3.
Sussman S: Effects of sixty-six adolescent tobacco use cessation trials and seventeen prospective studies of self-initiated quitting. Tobacco Induced Diseases. 2002, 1 (1): 35-81.
Sussman S, Dent C: A meta-analysis of teen cigarette smoking cessation. Health Psychology. 2006, 25 (5): 549-57. 10.1037/0278-6133.25.5.549.
Mermelstein R: Teen Smoking Cessation. Tob Control. 2003, 12: i25-10.1136/tc.12.suppl_1.i25.
Orleans CT, Arkin EB, Backinger CL, Best A, Crossett L, Grossman D, Husten C, Malarcher A, Marshall T, Maule CO, Thornton A: Youth Tobacco Cessation Collaborative and National Blueprint for Action. Am J Health Behav. 2003, 27 (Suppl 2): S103-S119.
McDonald P, Colwell B, Backinger C, Husten C, Maule C: Better Practices for Youth Tobacco Cessation: Evidence of Review Panel. Am J Health Behav. 2003, 27 (Suppl 2): S144-S158.
Curry S, Sporer K, Mermelstein R, Flay B, Berbaum M, Warnecke B, Johnson T, Mowery P, Parsons J, Harmon L, Hund L, Wells H: A National Survey of Tobacco Cessation Programs for Youths. Am J Public Health. 2007, 97 (1): 171-177. 10.2105/AJPH.2005.065268.
Centers for Disease Control: Use of Cessation Methods Among Smokers Aged 16 – 24 Years – United States, 2003. MMWR. 55 (50): 1351-1354. December 22, 2006.
Horn K, Dino G, Goldcamp J, Kalsekar I, Mody R: The Impact of Not On Tobacco on Teen Smoking Cessation: End-of-Program Evaluation Results, 1998 to 2003. J Adolesc Research. 2005, 20 (6): 640-661. 10.1177/0743558405274891.
Dino G, Horn K, Abdulkari A, Kalsekar I, Branstetter S: Cost-Effectiveness Analysis of the Not On Tobacco Program for Adolescent Smoking Cessation. Prevention Science. 2008, 9 (1): 38-46. 10.1007/s11121-008-0082-0.
Sussman S, Dent CW, Burton D, Stacy AW, Flay BR: Developing school-based tobacco use prevention and cessation programs. 1995, Thousand Oaks, CA: Sage.
Plested CH, Smitham D, Jumper-Thurman P, Oetting E, Edwards R: Readiness for drug use prevention in rural minority communities. Substance Use Misuse. 1999, 34 (4 and 5): 521-544.
Prochaska JO, DiClemente CC: Stages and processes of self-change of smoking: Toward an integrative model. J Consult Clin Psych. 1996, 51: 390-395. 10.1037/0022-006X.51.3.390.
Pomerleau CS, Carton SM, Lutzke JL, Flessland KA, Pomerleau OF: Reliability of the Fagerstrom Tolerance Questionnaire and the Fagerstrom Test for Nicotine Dependence. Addict Beh. 1994, 19 (1): 33-39. 10.1016/0306-4603(94)90049-3.
Fagerstrom KO: Measuring degrees of physical dependence to tobacco smoking with reference to individualization of treatment. Addict Behav. 1978, 3: 235-241. 10.1016/0306-4603(78)90024-2.
Prokhorov A, Hudman K, Stancic N: Adolescent Smoking: Epidemiology and Approaches for Achieving Cessation. Therapy In Practice. Pediatric Drugs. 2003, 5 (1): 1-10.
Wang MQ, Fitzhugh EC, Lee GB, Turner LW, Eddy JM, Westerfield RC: Prospective Social-Psychological Factors of Adolescent Smoking Progression. J Adolesc Health. 1998, 24 (1): 2-9. 10.1016/S1054-139X(98)00080-9.
Curry SJ, Grothaus L, McBride C: Reasons for quitting: intrinsic and extrinsic motivation for smoking cessation in a population-based sample of smokers. Addict Behav. 1997, 22 (6): 727-39. 10.1016/S0306-4603(97)00059-2.
Carey KB, Purnine DM, Maisto S, Carey MP: Assessing Readiness to Change Substance Abuse: A Critical Review of Instruments. Clin Psych: Science and Practice. 1999, 6 (3): 245-10.1093/clipsy/6.3.245.
Biener L, Abrams DB: The Contemplation Ladder: validation of a measure of readiness to consider smoking cessation. Health Psych. 1991, 10 (5): 360-5. 10.1037/0278-6133.10.5.360.
Herzog TA, Blagg CO: Are most precontemplators contemplating smoking cessation? Assessing the validity of the stages of change. Health Psych. 2007, 26 (2): 222-31. 10.1037/0278-6133.26.2.222.
Helping Young Smokers Quit. Accessed August. 2007, [http://www.helpingyoungsmokers...] .
Huerta M, Chodick G, Balicer RD, Davidovitch N, Grotto I: Reliability of self-reported smoking history and age at initial tobacco use. Prev Med. 2005, 646-650. 10.1016/j.ypmed.2005.01.011. 41.
Storr CL, Reboussin BA, Anthony JC: The Fagerstrom test for nicotine dependence: A comparison of standard scoring and latent class analysis approaches. Drug and Alcohol Depend. 2005, 80 (2): 241-250. 10.1016/j.drugalcdep.2004.04.021.
Youth Risk Behavior Surveillance Survey. MMWR. Surveillance Summaries. 2003, 53 (ss02): 1-96.
Centers for Disease Control and Prevention: Cigarette Use Among High School Students – United States, 1991–2003. J Am Osteopath Assoc. 2004, 104 (8): 328-331.
Dino GA, Horn KA, Goldcamp J, Maniar SD, Fernandes A, Massey CJ: Statewide demonstration of not on tobacco: a gender-sensitive teen smoking cessation program. J Sch Nurs. 2001, 17 (2): 90-7.
Klesges LM, Johnson KC, Somes G, Zbikowski S, Robinson L: Use of Nicotine Replacement Therapy in Adolescent Smokers and Nonsmokers. Arch Pediatr Adolesc Med. 2003, 517-522. 10.1001/archpedi.157.6.517. 157.
Rojas K, Killen JD, Haydel F, Robinson T: Nicotine Dependence Among Adolescent Smokers. Arch Pediatr Adolesc Med. 1998, 152: 151-156.
Sargent JD, Mott LA, Stevens M: Predictors of smoking cessation in adolescents. Archives of Pediatrics Adolesc Med. 1998, 152: 388-393.
Horn K, Fernandes A, Dino G, Massey C, Kalsekar I: Adolescent Nicotine Dependence and Smoking Cessation Outcomes. Addictive Behaviors. 2003, 28: 769-776. 10.1016/S0306-4603(02)00229-0.
McDonald C: Intentions to quit smoking in substance-abusing teens exposed to a tobacco program. J Substance Abuse Treatment. 2000, 18 (3): 291-308. 10.1016/S0740-5472(99)00067-7.
Biglan A, Duncan TE, Ary DV, Smolkowski K: Peer and parental influences on adolescent tobacco use. Journal of Behav Med. 1995, 315-330. 10.1007/BF01857657. 18.
Distefan JM, Gilpin EA, Choi WS, Pierce JP: Parental influences predict adolescent smoking in the United States, 1989–1993. J Adolesc Health. 1998, 466-474. 10.1016/S1054-139X(98)00013-5. 22.
Tyas SL, Peterson LL: Psychosocial factors related to adolescent smoking: a critical review of the literature. Tob Control. 1998, 7 (4): 409-420.
Willemsen MC, De Zwart WM: The effectiveness of policy and health education strategies for reducing adolescent smoking: a review of the evidence. J Adolesc. 1999, 22 (5): 587-99. 10.1006/jado.1999.0254.
Patton G, Coffey C, Carlin J, Sawyer S, Wakefield M: Teen Smokers Reach Their Mid Twenties. J Adolesc Health. 2006, 39 (2): 214-220. 10.1016/j.jadohealth.2005.11.027.
Backinger CL, Michaels CN, Jefferson AM, Fagan P, Hurd AL, Grana R: Factors associated with recruitment and retention of youth into smoking cessation intervention studies – a review of the literature. Health Educ Res. 2008, 23 (2): 359-68. 10.1093/her/cym053. Epub 2007 Sep 19.
Grimshaw GSA: Tobacco Cessation Interventions for Young People. Cochrane Database of Systematic Reviews. 2006, 4.
Using a Media Campaign to Increase Engagement With a Mobile-Based Youth Smoking Cessation Program
Amy Sanders, Cendrine Robinson, Shani C. Taylor, Samantha D. Post, Jeffrey Goldfarb, Rui Shi, Yvonne M. Hunt, Erik M. Augustson
American Journal of Health Promotion
Potential effects of active parental consent: Enrolling teen smokers into a school-based cessation program
Kimberly A. Horn, Steven A. Branstetter, Geri A. Dino, Traci D. Jarrett, Cindy Tworek, Jianjun Zhang
Nicotine & Tobacco Research
Are you in or out? Recruitment of adolescent smokers into a behavioral smoking cessation intervention
Johannes Thrul, Mark Stemmler, Michaela Goecke, Anneke Bühler
Addictive Behaviors
Best Practices Guidelines for Nurse Practitioners Regarding Smoking Cessation in American Indian and Alaskan Native Youth
Esmeralda C. Ubina, Sharon L. Van Sell, Carol Arnold, Stephanie Woods
Family & Community Health
School-level disadvantage and failed cessation treatment among adolescent smokers
Kimberly Horn, Maliha Ali, Tiffany Gray, Andrew Anesetti-Rothermel, Steve Branstetter
Tobacco Prevention & Cessation
Beyond Reach and Effectiveness
Andrew Anesetti-Rothermel, N. Noerachmanto, Kimberly Horn, Geri Dino
Health Promotion Practice
Evidence-Based Review and Discussion Points
Kimberly Horn, Geri Dino, Candice Hamilton, N. Noerachmanto, Jianjun Zhang
American Journal of Critical Care
Nationwide experiences with youth-targeted smoking and nicotine product cessation
Sofie Rasmussen, Charlotta Pisinger
Tobacco Prevention & Cessation
Journals System - logo
Scroll to top