Intervention in Early Grades May Reduce Risk of Smoking During Teen Years
Embargoed for Release: Thursday October 1, 1998 4 PM EST
Contact: Lisbeth Pettengill (410)-955-6878 or [email protected]
The Prevention Research Center, Johns Hopkins School of Public Health, have shown that carefully designed interventions, if introduced into first and second grade classrooms, may reduce the risk of children, especially boys, becoming smokers when they get to be teenagers. The report appeared in the October issue of the American Journal of Public Health.
The classroom interventions were designed to help curb early aggressive and disruptive behaviors, known to be predictors of drug use in later years. Lead author Sheppard Kellam, MD, professor, Mental Hygiene, Johns Hopkins School of Public Health said, "We hypothesized that exposing first and second graders to interventions aimed at reducing aggressive and disruptive behavior would also lessen their risk of smoking as teens." The study underscored the fact that activities aimed at preventing children from growing up to be smokers needn't be linked to tobacco or delayed until children are old enough to start smoking.
Working closely with the Baltimore City Public School system, the investigators tracked three groups of children from primary school into their teen years, comparing those in the control group, who had not participated in two behavior-management "games" during first or second grade, with those who had played the games. In one group of teens, 60 percent of the boys in the control group had used tobacco at least once, compared to 45 percent of the boys who had played the games as first or second graders. In a second group of teenagers, 50 percent of the control males had used tobacco by follow-up, compared to only 25 percent of the boys who had taken part in the games.
In contrast to the boys, girls did not seem to benefit from the intervention. Aggressive and disruptive behaviors in elementary school are not strong indications that a girl will start to smoke as a teenager.
The two behavior management strategies devised by the researchers were designed to be economical in money and time and to reduce the teacher's burden rather than increase it: ï In the Good Behavior Game (GBG), the teacher assigns all students to one of three teams, balancing the teams for gender and levels of aggressive behavior. Forbidden behaviors such as fighting and shouting out of turn are carefully defined and posted. If one child misbehaves, his or her whole team loses points. ï The Mastery Learning (ML) intervention enriches the reading curriculum of the entire class by using small teaching groups and raising children's expectations for success.
Both the GBG and the ML intervention were associated with lowered tobacco use during the teen years, but only the declines associated with the GBG were statistically significant. The lesser effect of ML on later smoking behavior, however, served to show that GBG's marked beneficial impact on the children was not merely a byproduct of the children receiving extra attention from the teacher.
The researchers said that their results lend support for a general prevention strategy: first identify an early negative behavior known to predict a second negative behavior later on; design a classroom behavior management strategy that lessens the first behavior; then follow the children into their teen years to observe whether participants in the early intervention have a lower incidence of the second behavior than non-participants.
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This work was supported primarily by grants from the National Institute of Mental Health and the National Institute on Drug Abuse.
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