Wednesday, October 13, 1999
Houston, Texas
Volume 65, Issue 37

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About the Cougar

UH's smoking cessation program shows success By 

Ken Fountain
News Reporter 

When it comes to smoking, everyone has heard the arguments against it.

Tobacco use can lead to a host of often fatal diseases, including lung cancer, heart disease, and emphysema. Moreover, nicotine, one of the principal substances in tobacco, is highly addictive -- even more so than heroin, some experts say.

The risks have been publicized for decades, but thousands of people take up smoking yearly , and many are teenagers.

In Texas, 31 percent of middle school students and 43 percent of high school students use tobacco products regularly, the Texas Youth Tobacco Survey said.

Those numbers led the Texas Senate to pass legislation in 1998 that made selling tobacco products to people under the age of 18 illegal. When a law-enforcement official sees such a transaction, the merchant making the sale can face a fine of up to $250 and the customer is required to attend a tobacco awareness program.

But the law had one major oversight, said Dennis Smith, associate professor and chairman of the health and human performance department at UH: No statewide tobacco awareness programs existed at the time.

In 1996, however, Smith and Texas A&M's Brian Colwell had developed a pilot study through a multi-year, $500,000 grant from the Texas Cancer Council for the Adolescent Tobacco Use Cessation Program, or ATCP.

After the Senate passed its legislation, Smith and Colwell adapted their study to meet the state's criteria for a tobacco awareness program. It remains the only such program approved by the state.

ATCP's first phase is an eight-hour course based on cognitive and behavioral learning theory that highlights the social and financial costs, as well as the short-term health risks, of smoking. The program also offers participants opportunities to practice reducing tobacco use.

During the eight-hour counseling program, which is held over a two-week period, participants talk about their own tobacco use -- the reasons they started and what effect it has had on their lives. Counselors give them information about the physical, social, and monetary effects of smoking.

The counselors encourage participants to stop smoking for a short period, then to come back and discuss what the experience was like. Most of them report "it was a lot more difficult than they thought," Smith said.

In a trial between January and August 1998, 1,500 teenagers participated in the program at 186 certified ATCP sites across the state. The classes were conducted by 31 adults already certified in counseling adolescents who also received ATCP training.

In three- to six-month follow-ups, Smith said he was surprised to learn that between 30 and 40 percent of the participants had quit smoking. Moreover, participants said they felt more knowledgeable and skilled at techniques for quitting.

Smith said the figures show that ATCP and similar programs have "tremendous value."

After the trial, the program was expanded through a $100,000 grant from the Texas Department of Health that was divided between UH and A&M. New facilitators were trained to bring the total to 280 serving 300 communities across the state. Between September 1998 and September 1999, 4,559 teenagers in Texas participated in ATCP.

Smith said that a second component of the program, involving four eight-hour classes taught during a six-week period, has been designed for long-term cessation support. However, that portion of the program does not meet the mandates of the Senate legislation and may not be practical in light of the success of the first phase, he said.

Smith said most people aren't interested in secondary prevention, or helping those who have already quit smoking to not start again. "It's a ho-hum issue until (smoking) becomes a problem," he said.

Many adults' lack of concern about teen smoking may be a reason Smith and his colleagues have had trouble obtaining funding to continue the program, he said.

Though last year's $17 billion settlement between tobacco companies and state governments was supposed to provide funding for cessation programs, the ATCP has not been part of that payout, Smith said.

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