Project Towards No Tobacco Use (TNT)

More school-based programs are needed to counteract the continued exposure of children to media and advertising messages that promote the use of tobacco.

Project Towards No Tobacco Use (TNT) is a school-based prevention program designed to delay the initiation and reduce the use of tobacco by middle-school children. Upon completion of the program, students should be able to describe the course of tobacco addiction, the consequences of using tobacco, and the prevalence of tobacco use among peers.

The goal of the program is to: help youth resist tobacco use; demonstrate effective communication, refusal and cognitive coping skills; identify how the media and advertisers influence youth to use tobacco products; identify methods for building self-esteem; and describe strategies for advocating no tobacco use. The program was designed to counteract several different causes of tobacco use simultaneously. This comprehensive approach works well for a wide variety of youth who have different risk factors influencing their tobacco use.

The program includes the following activities:

1. a comprehensive 10-day, classroom-based social influences program that examines media, celebrity, and peer portrayal of tobacco use;
2. training in active listening, effective communication, and general assertiveness development, along with methods for building self-esteem;
3. education on the course of tobacco-related addiction and diseases;training in tobacco-specific cognitive coping skills and assertive refusal techniques;
4. practice in ways to counteract media portrayals of tobacco use, including social activism letter writing to make a public commitment to refrain from tobacco use;
5. use of homework assignments, classroom competition, and a two-lesson booster program; and
6. longitudinal assessment material

Contact persons: Stephen Hauk hauk@usc.edu or Steve Sussman ssussma@hsc.usc.edu

The program consists of 10 core lessons with 2 booster lessons, each 40 to 50 minutes long. The core lessons can be implemented within a 2- or 4-week period. The booster lessons are delivered 1 year after the core lessons in a 2-day sequence, or one booster lesson per week for 2 weeks.

The study participants were White, African-American, Hispanic, and Asian-American youths, ages 10 to 15 years old.

The program can be administered in a classroom setting.

Required resources include two videos, a student workbook, and an implementation manual with introductory and background material.

Forty-eight junior high schools were recruited from 27 southern California school districts and randomly assigned to either program curricula or standard condition. Seventh graders in the program condition received tobacco programming. The school provided students in the control condition routine prevention activities not specific to tobacco use.

Results of the study include the following:

• Initiation of cigarette use was reduced by approximately 26% when 1- and 2-year outcomes were averaged together.
• Initiation of smokeless tobacco use was reduced by approximately 30%.
• Weekly or more frequent cigarette smoking was reduced by approximately 60%.
• Weekly or more frequent smokeless tobacco use was eliminated.