Peers can reduce tobacco use among younger smokers

Published in the Journal of Community Health, the study also showed that the most effective tools in the intervention were informational conversations about the consequences of smoking and a "quit kit" of behavior-replacement activities.

The intervention can be an important tool in outreach aimed at preventing regular tobacco use in an age group heavily targeted by industry marketing, according to the authors.

"Almost all smokers first tried using tobacco by age 26," said senior author Elisa Tong, an internal medicine physician at UC Davis Health. "If we can find ways to encourage them to stop smoking before their addictive behaviors become hard wired, we have a much better chance of getting ahead of the enticing methods tobacco companies constantly devise to reinforce lifelong use of their products."

Outreach led by a 'Street Team':

Nearly 30 high school and college students known as the "Street Team" provided the five- to ten-minute intervention, which included one-on-one education, motivational messages, the quit kits and referrals to quit-smoking resources. Team members were recruited and trained by the Sacramento Taking Action Against Nicotine Dependence (STAND) project of Breathe California Sacramento Region, which also developed the outreach protocol.

Over a four-year period, the team delivered the intervention to 279 younger smokers at a booth set up at about 30 street fairs, concerts, mall activities, Second Saturday Art Walks and other Sacramento region community events. Follow-up calls were made to 76 participants three times within six months to collect information and determine whether or not the intervention worked.

Results showed that the quit rate for people who participated in the intervention was 12.5 percent at six months, which is very promising, according to Tong, given that only about 5 percent of smokers are typically able to quit on their own.

Powerful tools for reducing smoking:

A majority of participants -- 70 percent -- reported that the quit kit of giveaways packaged in a water bottle aided their cessation efforts, especially tobacco alternatives they could place in their mouths or hold in their hands such as gum, trail mix, toothpicks, honey sticks and stress balls. Discussions with the Street Team were also helpful, especially those focused on quit-smoking strategies, the costs of smoking and the health harms of tobacco.

"Tobacco-cessation efforts aimed at newer smokers often don't work, likely because they are based on what works for longer-term smokers versus younger smokers who identify as social smokers," said study co-author Kimberly Bankston-Lee, senior program director of STAND.

"One of the key differences with our approach was the comfort factor. Younger smokers were able to interact with people their own age in locations where they all typically hang out."

Another important value of the program was the leadership skills gained by those who participated on the Street Team.

"It's no exaggeration that being a member of the Street Team was life changing," said Sarah Hellesen, who was in high school when she started volunteering with the project. Today, she is a UC Davis graduate working for the university's Tobacco Control Evaluation Center.

"My experience was the foundation for my career in public health, and it introduced me to some of the best and most passionate people in the field of tobacco control," she added.

Refining and sharing the intervention:

The researchers will next test the effectiveness of the intervention at specific sites like community college campuses, utilizing delivery teams from those sites as well.

"Our goals are to find the most powerful ways to engage and empower Sacramento youth to live tobacco-free lives, and then share those tools with the rest of California and the U.S.," Tong said.