title: The outcome consequences of defunding the Minnesota youth tobacco-use prevention program.
abstract: OBJECTIVE
  To assess the immediate and intermediate outcome consequences of defunding a successful tobacco use prevention program.
  
  
  METHODS
  A four-survey repeated cross-sectional design is employed. Two surveys were completed while the program was fully operational, one after program dismantling was initiated and another about 6 months after the campaign was completely dismantled. Survey to survey trends for five immediate and six intermediate outcomes are analyzed. Changes in measures are tested employing chi-square estimated using SAS 8.
  
  
  RESULTS
  Each immediate outcome measure declined significantly from the third to the fourth survey except one, and this measure declined from the second to the third survey when it was eliminated. All intermediate outcomes showed significant change from the third or second to the fourth survey. These include two measures of openness to smoking, three attitude/belief scales and one measure of intention to smoke.
  
  
  CONCLUSIONS
  Defunding a successful tobacco-use prevention campaign results in rapid erosion of program messages, parallel increases in susceptibility, a rapid and sharp re-emergence of pro-tobacco attitudes/beliefs and a marked rise in intentions to smoke.
authors.affiliation: Department of Epidemiology and Public Health, Tobacco Research and Evaluation Center, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL 33136, USA. dsly@med.miami.edu
authors.forename: David F
authors.initials: DF
authors.lastname: Sly
authors.forename: Kristoper
authors.initials: K
authors.lastname: Arheart
authors.forename: Noella
authors.initials: N
authors.lastname: Dietz
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Trapido
authors.forename: David
authors.initials: D
authors.lastname: Nelson
authors.forename: Richard
authors.initials: R
authors.lastname: Rodriguez
authors.forename: Jeffery
authors.initials: J
authors.lastname: McKenna
authors.forename: David
authors.initials: D
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005380:Financing, Government; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008910:Minnesota / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention; D040241:Social Marketing; D018709:Statistics, Nonparametric