Kari J. Harris - US grants

Tobacco use is responsible for 30 percent of all cancer deaths. Although the overall prevalence of adult cigarette smoking is declining in the US, the prevalence among young adults is increasing, especially among college students where an estimated 28 percent smoke. Career development: Activities include training in cancer prevention and control, advanced biostatistics, advanced epidemiology, nicotine addiction, and medical ethics. Research Program: The goals of the research program are to better understand the smoking behaviors of college students and to identify and test the feasibility of an intervention. The plan involves three studies that address six research questions. Studies will be conducted in collaboration with the Student Health Center and Wellness Center at University of Missouri- Columbia (MU). Study 1 details the natural history of smoking in college students. Measures adapted from existing assessments will be administered to 3,500 students in introductory classes at MU. Students will construct identifiers, which will be used to maintain confidentiality and to match students' responses to a follow-up survey administered in study year 4, when the cohort will be in their senior year. Study 1 will provide information on the progression and correlates of smoking in college students, many of whom may smoke occasionally as freshman but progress to daily smoking while in college. Study 2 consists of conducting three single-gender focus groups and follow-up interviews among each of two distinct groups, occasional (less than 5 cigarettes per day) and regular to heavy (at least 10 cigarettes per day) smokers. The goals of these twelve groups are to identify: a) interest in quitting and/or managing smoking, b) barriers to behavior change, c) strategies used to quit and/or manage smoking, and, d) intervention preferences across levels of smoking. Study 3 is a pilot study examining the feasibility and efficacy of a counseling intervention based on Motivational Interviewing and booster e-mail messages. Students will be randomized to either a tailored (n=40) or standard control (n=40) arm. Trained counselors will tailor two 15-minute sessions and three electronic mail messages based on students' interest in reducing or quitting. Primary outcomes include progression to regular smoking, cigarette consumption, and quit rates over two years. The research plan uses exploratory, descriptive, and intervention research to address tobacco use an understudied population, college students. Each study stands on its own, but is designed to build on the findings of the prior study. The proposed experiences will provide Dr. Harris with the skills to develop and launch a fully independent career in cancer prevention and control.

[unreadable] DESCRIPTION (provided by applicant): Tobacco use is responsible for 30% of all cancer deaths. Although the overall prevalence of adult cigarette smoking is declining in the US, the rate among college students has increased, and recent estimates suggest the prevalence may be as high as 33%. The primary aim of this study is to assess the efficacy of a motivational interviewing counseling intervention focused on smoking (Tx) versus an attention control condition focused on fruits and vegetables (C) for smoking cessation among members of college Greek (fraternity and sorority) organizations. Since few college students who smoke do so every day, students reporting a wide range of tobacco smoking (i.e., out of the past 30 days, smoking cigarettes from 1 to 30 days) will be recruited through their Greek organizations to participate in a health intervention. Students will be encouraged to participate regardless of their interest in quitting. This study will use a group-randomized design with two arms. Over two months, students in the Tx and C arms will receive 4 individual sessions using motivational interviewing counseling. Students in both Tx and C will receive quit tip sheets developed specifically for college students in this study. Randomization will occur at the level of fraternity and sorority to minimize potential contamination and to maximize recruitment and retention of participants. We project that 24 Greek groups with 20 eligible smokers in each will be required to detect the proposed treatment effect. To increase inclusiveness we will also enroll students from historically black Greek letter organizations, who will form two extra clusters each with about 10 smokers for a total of 26 clusters comprised of 500 college smokers. The primary hypothesis is that, at 6 months from randomization, smokers receiving motivational interviewing focused on smoking (Tx) will have significantly higher 30-day point prevalence abstinence (defined as no cigarettes in the past 30 days) than smokers receiving a attention controlled condition (C). We will also test the effect of the intervention on short term (7-day) and long-term (90-day) abstinence, on cigarette reduction, and on movement along the stages of change. At the conclusion of the intervention, we will conduct focus groups stratified by smoking status to identify factors that contributed to the intervention success or failure. Ultimately, we envision that the intervention, if efficacious, could be used as a pre-packaged intervention disseminated through the Greek community, residential housing, and student health/counseling centers. [unreadable] [unreadable]