Hutchinson Study of High School Smoking
Condition: Smoking Cessation
Study type: Interventional
Phase: Phase 3

Summary: 
      The primary goal of the Hutchinson Study of High School Smoking, a group-randomized trial
      conducted by the Fred Hutchinson Cancer Research Center in partnership with 50 Washington
      State high schools, is to develop and evaluate an innovative proactive smoking cessation
      intervention, based upon Motivational Interviewing (MI) and Cognitive Behavioral Skills
      Training (CBST), for its effectiveness in reaching teen smokers and helping them succeed in
      quitting smoking. A positive finding would have significant implications for reducing youth
      smoking and, ultimately, improving the nation's health.
    

Detailed description: 
      Rates of smoking prevalence among US adolescents remain unacceptably high, with 24% of high
      school seniors smoking monthly and 16% smoking daily. Unfortunately, without intervention,
      for the majority of these adolescent smokers, smoking will be a long-term addiction. Recent
      studies have demonstrated that a majority of teen smokers want to quit and try to do so, but
      with little success.

      The Hutchinson Study of High School Smoking is a 2-arm group-randomized trial in adolescent
      smoking cessation, conducted by the Fred Hutchinson Cancer Research Center in partnership
      with 50 Washington State high schools. Twenty-five high schools are randomly assigned to the
      experimental (intervention) condition and 25 are assigned to the control (no intervention)
      condition. The trial uses innovative and rigorous trial design and methodology to address
      recruitment, retention, and other methodological challenges encountered in early adolescent
      cessation trials, to provide a rigorous test of in innovative proactive smoking cessation
      intervention. Participants are 2,151 high school students (all smokers and a sample of
      nonsmokers identified via baseline survey of all enrolled students at the end of their junior
      year).

      The intervention, delivered during the senior year of high school, consists of a series of
      counselor-initiated, individually-tailored telephone counseling calls. Incorporating both
      Motivational Interviewing and Cognitive Behavioral skills training, the counseling telephone
      calls aim to increase smokers' motivation for quitting smoking, build skills for smoking
      cessation, and assist with relapse prevention. For nonsmokers, the telephone calls provide
      positive reinforcement of students' abstinence choices and help build skills for supporting
      peers' efforts to quit smoking. Complementary intervention components include an interactive
      cessation/informational Web site (www.Matchbreaker.org) and school-based promotional
      materials (cessation posters, school newspaper ads).

      Participants are followed to two follow-up times: the first at age 19 (approximately 6 months
      post-high school), and the second at age 25, to assess immediately after high school, and
      again in young adulthood, the intervention's impact on cessation status, number of quit
      attempts, change in readiness to quit and reduction in frequency and level of smoking.

      Concerning effectiveness in reaching teen smokers, 65.3% (691 out of 1058) smokers in the
      intervention condition were successfully recruited, and participated in the telephone
      counseling.

      Concerning effectiveness in helping teen smokers quit smoking, at the first follow-up, the
      intervention increased the percentage who achieved 6-month prolonged smoking abstinence among
      all smokers (21.8% in the experimental condition vs 17.7% in the control condition,
      difference = 4.0%, 95% confidence interval [CI] = -0.2 to 8.1, P = .06) and in particular
      among daily smokers (10.1% vs 5.9%, difference = 4.1%, 95% CI = 0.8 to 7.1, P = .02). There
      was also generally strong evidence of intervention impact for 3-month, 1-month, and 7-day
      abstinence and duration since last cigarette (P = .09, .015, .01, and .03, respectively). The
      intervention effect was strongest among male daily smokers and among female less-than-daily
      smokers.
    

Intervention name(s): MI + CBST
Intervention type(s): Behavioral
Intervention description(s): The HS Study intervention consisted of proactive identification and recruitment of eligible smokers (and selected nonsmokers) within the target population, and a protocol-guided series of counselor-initiated, personally-tailored telephone calls (from 1 to 10, depending on participant's interest) to eligible high school senior smokers and nonsmokers in experimental high schools. The telephone-delivered behavioral intervention integrated Motivational Interviewing and Cognitive Behavioral Skills building. Content and dose were tailored to the individual.
Other intervention name(s): HS Study Intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Adolescent; smoking; smoking cessation; counseling