Prevention Science, Vol. 1, No. 4, 2000
Inﬂuence of a Family-Directed Program on Adolescent
Cigarette and Alcohol Cessation
Karl E. Bauman,
Susan T. Ennett,
Vangie A. Foshee,
Tonya S. King,
and Gary G. Koch
Programs to reduce adolescent cigarette or alcohol use by users in general populations have
only recently been evaluated. Moreover, in spite of the substantial inﬂuence families have on
their children, few family-directed programs designed to reduce the prevalence of adolescent
smoking and drinking have been rigorously evaluated. This paper reports the ﬁndings of
research designed to determine whether a family program reduced use of cigarettes or alcohol
by users. The program consisted of a series of booklets mailed to families and follow-up
telephone calls by health educators. A randomized experimental design involved families
with children ages 12–14 throughout the United States. Data were collected by telephone
at baseline and 3 and 12 months after the program was completed. No statistically signiﬁcant
program effects were observed for cessation or decrease in smoking and drinking by users.
KEY WORDS: family program; adolescent; tobacco; alcohol; cessation.
Evaluations of programs aimed at general popu-
lations to reduce the prevalence of cigarette or alco-
hol use in adolescence traditionally have focused on
the prevention of onset (Tobler & Stratton, 1997).
The rationale for emphasis on prevention of onset
rather than on promotion of decreased use or cessa-
tion by users is that (1) most adolescents do not
smoke or drink and therefore population prevalence
is most likely to be reduced by effective programs
that target nonusers and (2) it may be easier to pre-
vent onset than to stop smoking and drinking. How-
ever, there is growing recognition that the drug pre-
vention curriculum used in most schools to prevent
onset is ineffective (Ennett, Tobler, Ringwalt, &
Flewelling, 1994) and that even the most successful
programs do not completely prevent smoking and
drinking onset (Tobler & Stratton, 1997). Therefore,
Department of Health Behavior and Health Education, The Uni-
versity of North Carolina at Chapel Hill.
Department of Biostatistics, School of Public Health, The Univer-
sity of North Carolina at Chapel Hill.
To whom correspondence should be directed at 513 Dogwood
Drive, Chapel Hill, NC 27516. E-mail: firstname.lastname@example.org
1389-4986/00/1200-0227$18.00/1 2000 Society for Prevention Research
programs designed to decrease adolescent use once
it has begun, and evaluation of the programs, have
become of increased interest.
The purpose of this paper is to report the effec-
tiveness of a universal family-directed program for
reducing and eliminating cigarette and alcohol use
by adolescents who were users of those substances
when they began the program.
PRIOR EVALUATIONS OF PROGRAMS
TO REDUCE USE
According to Burton’s (1994) review of tobacco
cessation programs for adolescents, programs that
have been rigorously evaluated had low rates of ces-
sation. Sussman, Lichtman, Ritt, and Pallonen (1999)
also reviewed evaluations of programs designed to
reduce tobacco use by users. They considered many
different types of programs, most of which were eval-
uated with research designs too weak for inferring
program effects. They concluded that cessation pro-
grams appear to have some success but that more
studies with better research designs are needed.