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Kentucky Adolescent Tobacco Prevention Project

Ages 11-14

Rating: Level 3


The Kentucky Adolescent Tobacco Prevention Project is a school-based curriculum for high-risk middle school students who live in tobacco-producing areas. The six-session program uses trained peer leaders to assist with skills training. Students learn

  • How to recognize types of peer pressure
  • Refusal skills
  • Assertiveness skills
  • How to recognize and counter advertising appeals

In the program, students pledge not to use tobacco, and they learn about the negative consequences of using tobacco, including immediate physical consequences. The program includes three booster sessions to reinforce earlier-taught concepts. The basic curriculum is delivered in seventh grade. Three booster sessions are delivered in eighth grade.


The evaluation investigated the efficacy of a social-influences tobacco-prevention program in delaying adoption of tobacco use among adolescents residing in a high-tobacco-production area. The study involved a randomized community design with random allocation of entire schools to study conditions, along with a nested experimental design in which students within schools were followed over time to assess the effect of the intervention. The sample included 19 schools in 14 counties, which annually produce an average of 7.7 million pounds of tobacco. A total of 3,588 seventh grade students with a mean age of 12.4 years were included in the baseline analysis. Of these students, 50.8 percent were girls, 92.0 percent were white, 5.6 percent were African-American. Data analysis included the 3,072 students present for all three surveys.

Students in 10 schools received the educational intervention in the springs of seventh and eighth grade. Students in nine schools received health education as usual. Measurements of tobacco use (both smokeless and cigarettes) and other variables were collected in the autumns of seventh, eighth, and ninth grades. Data collection was conducted through class-administered surveys and privately administered tests for carbon monoxide in expired air.


The study found that minimal intervention with a high-risk group achieved modest effects. Specifically, when compared with the control group, smoking rates in the treatment group were lower for 30-day, 7-day, and 24-hour smoking. The intervention particularly affected those involved in raising tobacco. For instance, the differences between the treatment and control group for those involved in raising tobacco were 29 percent (30 days), 25 percent (7 days), and 30 percent (24 hours), while the differences between the treatment and control group for those not involved in tobacco raising were lower at 23 percent (30 days), 21 percent (7 days), and 23 percent (24 hours). However, the intervention did not appear to affect the use of smokeless tobacco by male students.

Risk Factors


  • Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use


  • Family history of the problem behavior/Parent criminality
  • Family management problems/Poor parental supervision and/or monitoring


  • Peer alcohol, tobacco, and/or other drug use

Protective Factors


  • Positive / Resilient temperament


  • Effective parenting


  • Clear social norms / Policies with sanctions for violations and rewards for compliance


  • Involvement with positive peer group activities


  • SAMHSA: Model Programs


Noland, Melody Powers. 1996. “Tobacco Prevention in Tobacco-Raising Areas: Lessons From the Lions Den.” Journal of School Health 66(7):266–68.

Noland, Melody Powers, Richard J. Kryscio, John Hinkle, Richard S. Riggs, Linda H. Linville, Viki Y. Ford, and Thomas C. Tucker. 1996. “Relationship of Personal Tobacco-Raising, Parental Smoking, and Other Factors to Tobacco Use Among Adolescents Living in a Tobacco-Producing Region.” Addictive Behaviors 21(3):349–61.

Noland, Melody Powers, Richard J. Kryscio, Richard S. Riggs, Linda H. Linville, Viki Y. Ford, and Thomas C. Tucker. 1998. “The Effectiveness of a Tobacco Prevention Program With Adolescents Living in a Tobacco-Producing Region.” American Journal of Public Health 88(12):1862–65.


Melody Powers Noland, Ph.D., CHES
202 Seaton Building
Department of Kinesiology and Health Promotion
University of Kentucky College of Education
Lexington, KY 40506–0219
Phone: (859) 257-5826
Fax: (859) 323-1090