title: Using the internet to assist smoking prevention and cessation in schools: a randomized, controlled trial.
abstract: OBJECTIVE
  To evaluate the impact of a classroom-based, Web-assisted tobacco intervention addressing smoking prevention and cessation with adolescents.
  
  
  METHODS
  A two-group randomized control trial with 1,402 male and female students in grades 9 through 11 from 14 secondary schools in Toronto, Canada. Participants were randomly assigned to a tailored Web-assisted tobacco intervention or an interactive control condition task conducted during a single classroom session with e-mail follow-up. The cornerstone of the intervention was a five-stage interactive Web site called the Smoking Zine (http://www.smokingzine.org) integrated into a program that included a paper-based journal, a small group form of motivational interviewing, and tailored e-mails.
  
  
  METHODS
  Resistance to smoking, behavioral intentions to smoke, and cigarette use were assessed at baseline, postintervention, and three- and six-month follow-up. Multilevel logistic growth modeling was used to assess the effect of the intervention on change over time.
  
  
  RESULTS
  The integrated Smoking Zine program helped smokers significantly reduce the likelihood of having high intentions to smoke and increased their likelihood of high resistance to continued cigarette use at 6 months. The intervention also significantly reduced the likelihood of heavy cigarette use adoption by nonsmokers during the study period.
  
  
  CONCLUSIONS
  The Smoking Zine intervention provided cessation motivation for smokers most resistant to quitting at baseline and prevented nonsmoking adolescents from becoming heavy smokers at 6 months. By providing an accessible and attractive method of engaging young people in smoking prevention and cessation, this interactive and integrated program provides a novel vehicle for school- and population-level health promotion.
authors.affiliation: Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada M5T 3M7. cameron.norman@utoronto.ca
authors.forename: Cameron D
authors.initials: CD
authors.lastname: Norman
authors.forename: Oonagh
authors.initials: O
authors.lastname: Maley
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Li
authors.forename: Harvey A
authors.initials: HA
authors.lastname: Skinner
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D015995:Prevalence; D016730:Program Development; D012572:School Health Services / Q000706:statistics & numerical data*; D012574:Schools; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data*; D000074606:Smoking Prevention