Hutchinson Smoking Prevention Project
Condition: Smoking Among Youth
Study type: Interventional
Phase: Phase 3

Summary: 
      The Hutchinson Smoking Prevention Project is a 16-year, group-randomized trial to determine
      the extent to which a school-based (grades 3-10), theory-based, social-influences tobacco use
      prevention intervention can deter youth tobacco use throughout and beyond high school.
    

Detailed description: 
      Cigarette smoking remains the number one cause of preventable premature death in the U.S.,
      annually killing more than 400,000 Americans. Without reversal of adolescent smoking trends,
      five million of today's youth will die prematurely of smoking-related illnesses. The 16-year
      Hutchinson Smoking Prevention Project (HSPP) was conducted in 1984-1999 to (1) address
      challenges of trial design and execution in school-based smoking prevention by developing the
      most rigorous school-based randomized trial possible, and (2) use the trial to answer the
      scientific questions, "To what extent can a theory-based, social-influences smoking
      prevention intervention spanning elementary, middle and high school grades reduce smoking
      among youth at 12th grade and two years post-high-school?"

      The HSPP trial used a group-randomized, matched pair design with the school district as the
      experimental unit. Of 40 participating school districts, 20 were randomly assigned to the
      experimental (intervention) condition and 20 were assigned to the control (no HSPP
      intervention) condition. No restrictions were placed on the health promotion or tobacco use
      prevention activities of the control districts, thus enabling schools to continue whatever
      health curricula were normally offered. Main endpoints were daily smoking at 12th grade and 2
      years after high school (Plus-2). Study participants (N=8,388) were two consecutive third
      grade enrollments in each of the 40 school districts. All third graders were followed to
      endpoint, including those who dropped out of school or otherwise left their school districts.
      The study achieved a 94% follow-up rate at the Plus-2 endpoint.

      The HSPP intervention was a teacher-led, grades 3-10 tobacco use prevention curriculum plus
      unit-specific teacher training. There were 65 classroom lessons in the HSPP curriculum: 9
      lessons in each of grades 3-5, 10 lessons in each of grades 6-7, 8 lessons in grade 8, and 5
      lessons in each of grades 9-10, for a total number of 46.75 hours of classroom instruction
      time in grades 3-10. The HSPP uses an enhanced social influences approach that includes the
      15 NCI-endorsed "essential elements" for school-based tobacco prevention and meets the CDC's
      "best practices" guidelines. The intervention's behavioral components featured skills for
      identifying and resisting social influences to smoke, correcting erroneous normative
      perceptions regarding smoking, promoting tobacco-free norms, and building self-efficacy for
      tobacco-free lifestyle choices. The intervention was developed to be practical for the school
      setting, emphasizing ease of use by teachers, good fit into school routines and with schools'
      existing educational objectives, and incorporation of topics/activities that are interesting,
      engaging and developmentally-appropriate for students.
    

Intervention name(s): Social-influences
Intervention type(s): Behavioral
Intervention description(s): grades 3-10, school-based social influences tobacco use prevention curriculum
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: smoking prevention; tobacco use prevention; adolescent tobacco use; prevention intervention