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The Minnesota Smoking Prevention Program (MSPP) is a school-based smoking prevention curriculum for students in grades 4–8 (ages 9–13). The program targets this age group to start primary prevention strategies before the peak years of smoking onset (seventh through ninth grades). The goals of the program are to 1) help youths identify the reasons kids smoke (peer pressure, advertising, lack of self-confidence), 2) provide youths with resistance tools they can really use, and 3) teach youths the value of social support in resistance through peer leadership activities.
MSPP is based on a “social influences” model and addresses social and psychological factors that have been shown to promote the onset of tobacco use, including peer pressure, advertising, and a lack of behavioral skills with which to resist these influences. The program highlights the role of peer influence on when and how youths first try cigarettes. Elected peer leaders conduct about 70 percent of MSPP activities. The roles of community and environment in smoking behavior also are central to the program.
The program consists of six developmentally appropriate classroom sessions. Educational strategies include cooperative learning groups, large-group discussions, interviews, role-playing, media use, writing reports, and setting goals. Each session is 45 to 50 minutes long. In a typical lesson, students may participate in a small peer-led group discussion, analyze mock social situations, identify influences to use tobacco, practice resistance skills, participate in role-plays, create antitobacco advertisements, or make personal public commitments to establish their intention not to use. A facilitator’s manual contains detailed instructions for each session. Transparencies and handouts are included. Peer leaders participate in a 30-minute training session conducted by the teacher. The peer leadership guide is written specifically for these students and is geared to make their experience successful.
The evaluation of MSPP was strongly tied to the activities of a larger project, the Minnesota Heart Health Program (MHHP), which was conducted as part of a larger, communitywide program to prevent heart disease. MHHP involved risk factor screening, mass smoking cessation, community task forces, mass media education, and other strategies. The research was designed to compare two communities—one receiving MSPP and MHHP and one receiving neither—matched for size, socioeconomic characteristics, and distance from program base. In the base year, all sixth graders in schools in both communities were eligible to participate. These students were tracked until they graduated. In all years following base, students not in the original group but in the same current grade level were also eligible to participate. The data thus follows the original cohort, to the extent possible given natural attrition, and represents a cross-section of all students in a given year and grade. The sample included students from 13 elementary schools and 7 high schools.
Data was collected annually during 1983–89, using surveys administered in classrooms by MHHP staff. Tobacco use was assessed through self-reports of smoking behavior/history and saliva tests. A measure of smoking intensity—the number of cigarettes smoked per week by each student—was calculated using self-report data. Other measures included current age, gender, and (after 1987) parental occupation. Saliva tests were used in 1986 only to validate self-report data.
The evaluation results suggest that MSPP has a significant impact on the smoking behaviors of teens. The evaluation demonstrated to a statistically significant degree that smoking rates among students in the intervention community were significantly lower following their participation in the program. At the end of 10th grade, 13.1 percent of students in the intervention community were current smokers, compared with 22.7 percent of students in the control group. At the end of 12th grade, 14.6 percent of intervention community students were weekly smokers compared with 24.1 percent of control group students.
Perry, Cheryl L., Steven H. Kelder, David M. Murray, and Knut–Inge Klepp. 1992. “Communitywide Smoking Prevention: Long-Term Outcomes of the Minnesota Heart Health Program and the Class of 1989 Study.” American Journal of Public Health 82(9):1210–16.
Roxanne Schladweiler
Hazelden Publishing and Educational Services
15251 Pleasant Valley Road
P.O. Box 176
Center City, MN 55012
Phone: (800) 328-9000
Fax: (651) 213-4793
E-mail: rschladweiler@hazelden.org
Web site: http://www.hazelden.org
Edie Julik
Hazelden Informational and Educational Services
11517 22nd Avenue South
Burnsville, MN 55337
Phone: (877) 890-1628
Fax: (612) 890-1732
E-mail: ejulik@hazelden.org
Web site: http://www.hazelden.org
