© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 16, 1268,
August 15, 2001
© 2001 Oxford University Press
CORRESPONDENCE |
Re: Hutchinson Smoking Prevention Project: Long-Term Randomized Trial in School-Based Tobacco Use Prevention—Results on Smoking
Correspondence to: Harry A. Bliss, M.D., Maine Medical Center, 22 Bramhall St., Portland, ME 04102 (e-mail: blissh{at}mmc.org).
Peterson et al. (1) recently reported a randomized controlled trial of a social-influences approach to smoking prevention administered in schools annually from grades 3 to 10. They found no evidence of reduced smoking prevalence, either at grade 12 or 2 years after high school. This result is in contrast to that of Botvin et al. (2), who in a previous randomized school-based trial of an intervention that was administered intensively in grades 7–9 and that also aimed at teaching skills for resisting social influences to use tobacco and other substances, found a statistically significant reduction in smoking at high school graduation. Peterson et al. noted but did not discuss the difference in outcome between their study and the study by Botvin et al. and, in fact, they concluded that, "consistent with previous trials," their negative results showed that a school-based social-influences approach is ineffective in deterring smoking.
What could account for this difference in results? Although Peterson et al. offered no explanation, Clayton et al. (3), in their accompanying editorial, implied that the higher attrition rate, 39% in Botvin et al. versus 7% in Peterson et al., made the results of Botvin et al. problematic. However, Botvin et al. had used statistical techniques that revealed no differential effects related to attrition in the study groups. Clayton et al. provided no other specific criticisms of Botvin et al., concluding, like Peterson et al., that the social-influences approach does not work.
An alternative explanation for the difference, however, might be that the instructional materials and techniques of Botvin et al. were more effective than those of Peterson et al. in preventing smoking. No easy method of testing this possibility offers itself, but I believe we should not yet discard the social-influences approach to prevention of smoking initiation in youth.
REFERENCES
1
Peterson AV Jr, Kealey KA, Mann SL, Marek PM, Sarason IG. Hutchinson Smoking Prevention Project: long-term randomized trial in school-based tobacco use prevention—results on smoking. J Natl Cancer Inst 2000;92:1979–91.
2
Botvin GJ, Baker E, Dusenbury L, Botvin EM, Diaz T. Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. JAMA 1995;273:1106–12.
3
Clayton RR, Scutchfield FD, Wyatt SW. Hutchinson smoking prevention project: a new gold standard in prevention science requires new transdisciplinary thinking [editorial]. J Natl Cancer Inst 2000;92:1964–5.
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