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Media Literacy to Prevent Adolescent Smoking

This study has been completed.
Robert Wood Johnson Foundation
Information provided by (Responsible Party):
Brian Primack, University of Pittsburgh Identifier:
First received: November 8, 2006
Last updated: July 24, 2017
Last verified: July 2017
The purpose of this project is to determine if a 3-session anti-smoking media literacy based intervention is more effective that a standard 3-session anti-smoking media literacy intervention at changing students' intention to smoke, actual smoking behavior, attitudes and norms regarding smoking, and level of media literacy.

Condition Intervention
Smoking Status Behavioral: Control Behavioral: Media Literacy

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Prevention
Official Title: Media Literacy to Prevent Adolescent Smoking

Resource links provided by NLM:

Further study details as provided by Brian Primack, University of Pittsburgh:

Primary Outcome Measures:
  • Susceptibility to smoking (Pierce, 1996) [ Time Frame: Immediate, Delayed ]
  • Current smoking (last 30 days) [ Time Frame: Delayed (one year) ]
  • Smoking media literacy [ Time Frame: Immediate, delayed (one year) ]

Secondary Outcome Measures:
  • Attitudes toward smoking [ Time Frame: Immediate, delayed (one year) ]
  • Subjective normative beliefs involving smoking [ Time Frame: Immediate, delayed (one year) ]
  • Implementation fidelity [ Time Frame: Immediate ]
  • Feasibility/acceptability of program [ Time Frame: Immediate, delayed (one year) ]

Enrollment: 1211
Study Start Date: October 2006
Study Completion Date: June 2009
Primary Completion Date: June 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Control
Students receive standard anti-tobacco education
Behavioral: Control
Standard anti-tobacco programming
Experimental: Media Literacy
Students receive media literacy based anti-smoking education
Behavioral: Media Literacy
Anti-smoking media literacy curriculum intervention

Detailed Description:

Cigarette smoking is the top cause of preventable death and disease in the U.S., and about 90% of those who die from smoking begin as adolescents. Because smoking-related mass media messages (such as episodes of smoking in films and advertisements) significantly increase adolescent smoking, media literacy, defined as analysis and evaluation of mass media messages, presents a promising new framework for development of innovative school-based tobacco control programs. Media literacy may be more effective than standard tobacco education among the populations that are at greatest risk for smoking, such as African-Americans and the socio-economically disadvantaged, and national organizations have called for use of media literacy to reduce smoking. However, anti-smoking media literacy programs have been neither widely implemented nor well-evaluated.

The aims of this project are to determine if a theory-driven, school-based, 3-session anti-smoking media literacy curriculum delivered to 9th grade students can affect clinically relevant factors mediating adolescent smoking according to the widely accepted Theory of Reasoned Action: intention to smoke, smoking behavior, attitude toward smoking, and norms involving smoking. It is hypothesized that, compared with those exposed to a currently accepted school-based smoking prevention program, students exposed to the media literacy program will develop more negative attitudes toward smoking, a more negative sense of smoking norms, less intention to smoke, and less smoking. We also expect that the curriculum will improve smoking media literacy scores as measured by a reliable, valid scale.

Over two years, eight high schools will be recruited to randomize all 9th grade health classrooms to receive either the 3-session media literacy anti-smoking curriculum or a currently accepted anti-smoking program of equivalent length. This recruitment will occur via two prominent community organizations responsible for anti-tobacco programming in 50 local school districts. Experienced health educators will be trained in implementation of both experimental and control curricula. Outcome measures, demographic data, and other important covariates will be collected by a questionnaire given three times: at baseline, immediately post-intervention, and after one year. Questionnaire items are reliable, valid, and pilot-tested. Process evaluation will be conducted to assess implementation fidelity, to confirm or refute the findings of the quantitative assessment, to help explain outcome data, to refine the intervention, and to inform future replications of the curriculum.

Given the substantial nationwide morbidity and mortality due to tobacco use, the role of mass media messages in adolescent initiation of smoking, and the potential power of media literacy as an agent for health behavior change, it is essential to study the utility of media literacy in altering smoking behaviors and antecedents in this age group. If media literacy programs are successful in buffering the impact of mass media on adolescent smoking, similar interventions can be developed to prevent other harmful behaviors related to mass media messages.


Ages Eligible for Study:   13 Years to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • High school student enrolled in health class at participating schools
  • Must be able to use computer interface for submission of data

Exclusion Criteria:

  • Child does not wish to participate
  • Parent does not wish child to participate
  • Less than 13 or more than 18 years old
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Please refer to this study by its identifier: NCT00398190

United States, Pennsylvania
McKeesport High School
McKeesport, Pennsylvania, United States, 15132
Carrick High School
Pittsburgh, Pennsylvania, United States, 15210
Schenley High School
Pittsburgh, Pennsylvania, United States, 15213
Sponsors and Collaborators
University of Pittsburgh
Robert Wood Johnson Foundation
Principal Investigator: Brian A Primack, MD, EdM University of Pittsburgh