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TliftuL< YIa1R LO:IGFPUDIFJAI, SrUGY . .''iOCIi,L-. SYCIfC1J1OGICAL DLr cRRElN"r& OT• sntOxlvG IN SCISOOL S, I?ROJ LCr i --- _- ( I ° 11 o1: -mCZ):cr :,:_a perirnr_•i i ta?. "ISi rd-aore r S rul c rs Snokers !;=16 t lp E9qc09c0 I I'IG[,T•F 3. in YhC .Jlal`-'Si5 C.f . ...J'1: l_ -'+,.y;~. c ~~ ,:c31 l 1 a_.~ , _

i 1475 PIl7T S1UDY•';. . ,: R€PORTED SMOKINr g(tlAVlOR; ' FIr)I,RF 1. . PERCENTAGE OF STUDENTS WHO. BEGAN SMOKING (ONE,OR MORE CIGARETTES A MONTH) DURING THE FIRST QUARTER OF THE SEVENTH GRADE, AS'P,EPORiED_ AT THE END OF THE TE RM, ~ TREATII~Ef,iT VS EuPEGIMENITAE GRG P 9 U .. . XZ = 4..r`.- I ~ r..~. rr . ... ~ ..-I. S z95c8.9c0 I

i i 'fIlI21:Fi 1•1'A 1t L(~`;CIT IIIII':.1L STt1f1Y ',u(' I!1i.- I'SY('li(11.1iG1(:,1l.. I11:1'1 I.I,i:'i•fti (li 5M(ih 1?;(" I N SCIIUOI.S I'F.(1JGCT aU' Clltagl' . .•r j'~aj n ~ -U 1 I -w ~............- . . . . ~ InJluencrJ not to S:^ui:r ,.!t I!?f IU:•IIiC Irrli;Z: ~ ~ ... f io oh-.n-c>n:3c:3 iatnr-~,io.a c-mccmitxq inf3uc_.:e cF intnr.e. inn Etrnr7:cs ~ wit'i z. s-v1e G4=61) of tuc'., r.ts ir, the rl j 1 n lta~^n C rc.i ..i c.~ fel la. _ r*^ x - _ _ - t. tas• en-: cf the sc<•ond ve~r o he ~ vc' J 19'17 1 ~ F. ~.9~~+p~ _ Y4V.7[.O 4

WC :ih:7i:1CG .`'fYnU'.i2'^t,_` E.f1iOrt: " buliY(: into sc'f,boo'l Cltirric'u11 shtnt'ciW'ticatcl inocuTutions-aaain:,t-socill-pressures-to-smoke p-rograma -in .Titu of the f'requentlf used' high fear arou.sal,, centerei pregrams „.srhdcls cr,ay well even-be counter-

~;um::rrir,' of' T_sti7ta, . To Be Pt'esented 1'o-~he Unit:ed' Stat : .:~ttate Sub-Comwittez on_"ealth c;rt "ay 25, 1973, Byr Richard Ii "r,vans„ Flt-. D'.. c rofe ssor of' Psy cholog,y ;?'er;onstratiol Center, Houston, Texas and is Principal Investigator , Coilec,c of Medicine Macional Heart 3rrd'Blood V'essel Research and lfaiversity of Houston Rouston, Texas (Dr. iYan.s is also Director otf the Smoking Section of the. 2a,:lor in Schools Pro,;ect) of the MHLt3I-supported Social Psychological Deterrents to Smakin6 Social psychologists have traditionally been engaged in fairly l•asi;: laboratory research drP3ling wi `.h theoretical and' methodolo- gicllissues. During the past several years, however, they have been increasingly challenge.d to develop~ and ev3luate interv_nticns relatiag to significant social problems.such'as mer*.al illness -yedici.ne, rai.•ticularly as it relates.to modi2..y-inZ life styles which, more rweent clNall'ienge for social psychologists has been behavioral preju:iice and discrimination, poverty4 crime, and delinquency. •: contribute to moriiid'ity and mortality. Control of' cigarette smoking, which has been well established as a, crucial "'risk f'actor"' rdiovascular disease and cancer is a particularly significant of behavioral inwestigation. Although trhe previous focus has b-en upon the addicted adult smoker, a more fruitful line o invcs tinat Ion mig,ht be to addreas the more fundamental proplem of' r1etcrring the onset of smoking.' Dealing with children who aree sub- w., - . .fecta": to social pressures to initiate smoking behaviox presents a ~ii°^er..:t se: those encountered asdic:.ed smoker. theoretical and methodological issues than in attempts to aTter the behavior of

a sa?cial rsychologist ac.id r-~:=sing , himself increasiagly to. ;_ problems of the p:revention and control of czrdiavascular : tliscase particularly a~t the moment, swoking, it would appear meµ thlt an important direction im which we might go .is L~ ,; ino^_uLation strategies--which, involve training, children to resi ti:e:social pressures to begin smoking or advance toward frequent,,. addictive smoking. Our, cuirrent findings in our NH'LB'I-supporte.3 investigation :,ut-r,,est that fear arou!sal may, be ineffective in anti-smoking, mes- ; Zge:. to cY:ildren. By the time they reach the seventh g,rade, even t~~h~~o~~ugh~ virtually all chlil~dr~e~n~, believe smoking is~~ dangerous, many begin s~:.oking anyway. Our in-depth, intervi.e*.rs with a large popuL3tion, of sevenith graders,, suggest that, individually or col- leetivell,; peer pressures, models of'smoking .parents, and the mass a:edi :(e.g. , cigarette comipany.advertisinig,)' ma;; override the belicf of children that smoking is dangerous. P,'ecenit explorations of this problem at Stanforl and! Miinniesotacorroborate our fi,ndings., Further:nore, we now have some evidence that in a.ddition t depending too heavily on fear as a deterrent to smoking, anti- smokinq messages in schooTss faTl.into a"timie perspective" trap. Th1t i n,, they foculs, too much on the firture dangers of smoking. . ~.~ Children arp more likely to focus on the present. Smoking;control mescq;,es sliould emphasize more immediate effects of smokin;,on the chi'1d ~.r teczafier. 6fe are using an inoculation-against-piressures-toi-sm:oke strategy ('seemingly quite effec'tive first in a ten:-w~eek pilot

anitT now tlI ruug,kr the seco•:: .:-:ar of a tkiree-yeur lon3,ituciinal sOrtLy which wi11 f"o.l'Iow s tudents Lhrough the seven.th,, e.ig,hth, - . . andninth gracles) predicatea on the following theoretical not'ion: -social-pr essure5-to-smoke• jurrior.. high school years,,: they willl s+urilents can be "nuirsed"' throuFh the particularly.vulnera1bl fortified suffi.:iently so that the heavy, addictive smoking which is g,enerally first found as students progress into high school, will less likely occur. By then,, students may be more independent, and may be less likely to respond to these social i:r•os-,rutre:3~ to bc.g,i_n sr,zo~cing. We would encourage the development of programs which use f~'iilms and related reinforcers (Posters, etc. ) and feature scenes of' the students themselves demonstr3ting, how they say II pressures to smuke rather tteain authority f'ig,ure adults presenting, hieh fear aroussl me:ssages. Such e.n approach alsc may be poten- .`tially a maximally cost effective strategy to dieter smoiting. 'Zhis is in contraat -to small-group face-to-face training which - has the d'isadivantage of not being readily exportable to other locaies, varies considerably in how skillfully it is executed,, and cannot be too easily standarized for evaluation purposes. To amplify our methods and results,; first a ten-week invcs,`.igati!on wcls completed witir 7510 male and female studen~~s. . . Rates of onset of smoking, in'the full treatment, the feedback, entering se,:entll grade. ~ ~ an.-1 the test.inr,only groups were significantly lower than the ~ onset rates in the pretest-single posttest control groups (See rigure.1).

Titl.we resLtlGs sug€est. thnfs such :,,terventionis may pirove more usr.ful in !iPterrin,g smoking among j'unior high students than'merely instructing the:a ial the loing,-termdang,ers of smoking. A longitudinal studly initially involving approsimate.l'y 41,500 stud•.iits is presently undlerway tracking, these students throu•g,h ti;n sevcnth ,, eighth, and nitrti: gradies. Through its second year, preliminary data analysis suggests a s3gnif'icantt impact of the 1nterventions. (See Figure 2). The saliva speci:tezs of._a r3zdom sample 'of forty-f'ive (,45 ) seventh, g,raa'e students in the studyy were analyzed for nicotiine content by a^rass spectrometric techniqite dieveloped by Dr. Evan . Horning, Baylor College of Medicine. Students were reoxesenta- ., _ .tive oE nonsmoking, "experimental". smo:king„ and "regular" smoking sub-g,roups within our larger stu!diy directed' at preventing,. the onset of addictive smoking i.ni adolescenits. Results of the ~ anatysis showed that nonsmok:ers had less nicotine than "experimen- l.- and...regr.tlar'" smokers with 3.5'3,, 5.07, and l4:g6 ppm of' nicotine in the saliva of t_`te average sublject from each of' these respecti:ve..,' g,rouas. E:r_rs though low levels of' nicotine were observ:ed in non- smokers, the presence of any nicotine represents the effects o "second-iiand smoke" -- influence of others who slmoke. (With - ~. • this mean of 3.5.3, nicotine levels of up, to 10 ppm were observedi i'n lt4ais group.), See Tablie 3. This may be one of the most extensive demonstrations of how "passive smoking," or."'second- handi smoke` does, indeed, effect thle nonsmoking adolescent.