Community-Based Smoking Prevention in Military Schools


Name: Paul Lewis

Rank: MAJ, USA

Organization: The Geneva Foundation

Performance Site: Brooke Army Medical Center, Fort Sam Houston, TX; Lackland Air Force Base, TX; Randolph High School, TX; Fort Hood, TX

Year Published: 1999

Abstract Status: Final


This study was intended to measure tobacco use prevalence in a military adolescent population and determine if a prevention curriculum could alter it. This study used a prospective intervention-based, two group, quasi-experimental longitudinal design to compare a tobacco-specific curriculum to a standard health curriculum over a 3-year period. A sample of 767 Army- and Air Force-affiliated adolescents was measured at least once. A core group of 26 was sampled twice in the fifth grade, twice in the sixth grade, and once in the seventh grade using a modified Youth Health Survey with scales for physical activity, self-esteem, tobacco use (self and significant others, with a tobacco knowledge subscale), and a total of 90 multiple-choice questions. The treatment group received six tobacco knowledge and prevention classes. The comparison group received general health and wellness classes. The survey tool was administered before and after these classes in years one and two. In year three, no classes were taught but the tool was administered once. Tobacco prevalence was analyzed using frequency calculations. A Friedman ANOVA was used to determine if a significant number shifted between tobacco-use categories in either group and a one-way, within-subject ANOVA to measure knowledge retention in the treatment group. Tobacco use predictors were determined by discriminant analysis. The prevalence of ever smoking was 6.3%, and in the core group 3.8%, significantly less than nationally (31.3%) or in Texas (17.6%). No significant shift occurred between tobacco-use categories. High levels of physical activity and high self-esteem were correlated with a lower incidence of tobacco use. The knowledge scores suggest that adolescents mastered tobacco information the first year and retained it over the 3 years; thus education in this population might decrease future tobacco use. Nursing is well placed to formulate an educational plan for tobacco avoidance.


Final report is available on NTRL: