(image: DANYA International, Inc. logo, HHS and NIH logos)

• Founded in 1996 by Dr. Jeffrey Hoffman
• Guiding values: Integrity, Quality, and Creativity
• A customer-focused, technology-enabled company
• Offices in Silver Spring, MD, and Atlanta, GA
• Extensive experience with SBIRs and product development

(image: photos of Danya products)

• Need for Prevention
  • Purpose of Study
  • National Education Guideline Recommendations
• Components of StartSMART Program
  • Curriculum
  • Session Descriptions
  • Student Advertisements
• Outcome Evaluation
  • Eligibility Requirements
  • Methods
  • Preliminary Results
  • Limitations
• Next Steps

• Tobacco use remains the leading cause of premature death in the United States
• New data suggests that progress is slowing down
• Rate of decline in 30-day smoking rates is slowing
• Exposure to and effectiveness of anti-smoking ads is decreasing
• State funding down

• StartSMART program acts as a mechanism to reduce tobacco use among youth 11 to 13 years of age by engaging the involvement of students, teachers, administrators, and parents.
• The program allows students to observe anti-tobacco messages, learn the skills to both identify and resist tobacco use, and participate in delivering prevention messages to their peers.

1. Develop and enforce a school policy on tobacco use
2. Provide health education about short- and long-term consequences of tobacco use
3. Provide tobacco prevention programs across all school years (K-12)
4. Provide program-specific training for teachers
5. Involve parents and families to support school programs
6. Support cessation efforts for both youth and staff
7. Evaluate prevention programs

• The Facilitator's Curriculum
• The Youth Workbook
• Prevention Video
• Training Package:
  • Facilitator's Training Video
  • One-Day Training Option
  • Teacher's Training Notes
• Parent Support
• Booster Sessions
• Support Web site

(image: StartSMART logo)

• Session 1: Influence of Big Tobacco
• Session 2: Environmental Influences of Smoking
• Session 3: Smoking Misperceptions
• Session 4: Short- and Long-Term Consequences of Smoking
• Session 5: Resisting Tobacco Use
• Session 6: What's Your Idea?
• Session 7: Time, Talent, Tools
• Session 8: Lights, Camera, Action

(image: cover of StartSMART Youth Workbook)

• Identify anti-tobacco and pro-tobacco messages
• Homework activity
• Family involvement

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Glamour, sophistication
Humor, fun
Lies, trickery
Celebrity, stardom

(image: Session 1 worksheet)

• Deconstruct the ad
• Examples of pro-tobacco advertisements
• Tobacco industry's role

(image: Session 1 worksheet)

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• Recap of session's main points
• Confirm that students understand concepts
• Repeats at end of every session

(image: Session 1 worksheet)

• Why do people continue to smoke even though they know it's unhealthy to do so?
• Video Game Example

(image: drawing of kid playing video game)

Interactive Game (recap of the first four sessions):

• Wordshark
• Scientist
• Actor
• Artist

(image: game cards of people mentioned above)

(image: storyboards)

(image: StartSMART materials)

• Saving your child —The impact of a smoking mother on her asthmatic son's health.
• Winded — What happens when two boys, one smoker and one nonsmoker, challenge each other to a race?
• It's all about choice — A young person's decision whether to spend his money on cigarettes or other goods.
• Why smoking, why not? — Peer influence on teenage girls and the results of their decisions.
• We told him so! — The effect of a teenage boy's decision to smoke.
• Who do you want to be? — Two girls, one homely, sickly, and smoking, the other healthy, popular, and smoke-free, sit uncomfortably beside each other on a park bench.
• Fun times gone bad — A slumber party quickly takes a turn for the worse after the partiers become ill from smoking.
• Don't be a stupid girl — A womanizing lad tries to entice a group of girls to smoke, but is left hanging after the girls realize it's not their cup of tea.
• They know — A simple yet chilling message on the true intentions of the tobacco industry.
• It's not worth it — A boy will do everything to please his new love — everything, that is, except to buy her a pack of cigarettes.
• No thanks — Hip teens instruct viewers to say "No thanks" to peers and the entertainment industry who try to coax them into smoking.

(image: photo of someone sleeping outdoors)

(image: video)

(image: video)

• Randomized control trial (189 enrolled)
• Seven schools recruited from Washington, D.C., area
• Data collected at four points in the evaluation: baseline, 8 weeks, and follow-up at 1 month and 6 months
• Treatment group attended 8-session program

• Enrolled in 6th or 7th grade
• Cannot be participating in other tobacco prevention or cessation programs
• Able and willing to attend all sessions
• Able and willing to provide physiological measures (saliva, breath)

• Knowledge
• Stages of change:
  • Non-smokers
  • Smokers
• Susceptibility and intentions
• Attitudes toward smoking
• Physiological measures

Participants

• 15 female middle school students (subsample)
• Mean age: 12.3 ± 0.5 years
• 73% Caucasian
• 33% reported having at least one parent currently smoking
• None of the children reported trying cigarettes
• None of the children reported having siblings or friends who smoked cigarettes

• None of the students reported trying smoking
• Youth improved their scores on the knowledge questionnaire from 8.5 to 9.9 correct answers out of 13 (p < .05)
• The improvement was largely due to 27%-40% more students getting questions right about how cigarette companies advertise, limitations on counter-marketing ads, and the effects of nicotine (questions 4, 6, and 10; p < .05)

• Participants in the StartSMART group reported that activities were helpful (average rating of activities: 3.0)
• The only activity that was not rated above the midpoint was homework, which was rated at 2.2 on a 5-point scale, with 1 being "not very helpful or not fun" and 5 being "very helpful or a lot of fun"
• Of the other activities, the treasure hunt and developing a counter-marketing ad were reported as being the most helpful

(image: bar graph titled "Preliminary Results, Importance of StartSMART Exercises")

(image: bar graph titled "Preliminary Results, Importance of StartSMART Exercises")

• Recruitment
• Small subsample
• Biochemical verification not evaluated

• Complete outcome evaluation
• Facilitator training
• Booster sessions
• Parent support
• Support Web site

• Henry Wong, Ph.D. — Principal Investigator
• Susanna Nemes, Ph.D. — Co-Principal Investigator
• Jeffrey Hoffman, Ph.D. — Corporate Monitor
• Sharon Zack, MS — Project Director
• Kelly Munly, MS — Co-Project Director
• Jenn Weil — Senior Research Associate
• Jennifer Jones — Research Associate
• Jeff Owczarazk — Graphic Designer
• Emily Glaeser — Technology Project Director
• Suzanne Willis — Editor
• Kathleen Cooke — Quality Assurance

(image: StartSMART logo)