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Smoking prevention for ethnically diverse adolescents: 2-year outcomes of a multicultural, school-based smoking prevention curriculum in Southern California.

C Anderson Johnson, Ph.D.
Director, Institute for Health Promotion and Disease Prevention Research
University of Southern California

Effective school-based curricula are needed to prevent smoking
among ethnically diverse adolescents. This study evaluated a multicultural
smoking prevention curriculum in ethnically diverse Southern California
middle schools. Methods: Students in 24 middle schools (N = 3157 sixth
graders) received the multicultural curriculum, a similar curriculum without
references to cultural issues, or a control condition. Odds ratios for
experimentation with smoking over a 2-year period were calculated. Results:
The multicultural program was associated with a lower risk of smoking
between sixth and eighth grade, relative to the control group. Program
effects varied according to the ethnic composition of the schools. In
schools with predominantly Hispanic populations, the multicultural
curriculum was more effective than the control, but the standard curriculum
was not. In schools with predominantly Asian or multicultural populations,
the standard curriculum was more effective than the control, but the
multicultural curriculum was not. Analyses stratified by ethnicity within
the schools revealed that the multicultural curriculum was effective among
Hispanic students within predominantly Hispanic schools, but not among
Hispanic students within predominantly Asian/multicultural schools.
Conclusions: Smoking prevention for adolescents in culturally diverse school
contexts is a challenge. In this study, a multicultural curriculum was most
effective among Hispanic students in predominantly Hispanic schools. Further
research is needed to determine the best ways to prevent smoking in
predominantly Asian and multicultural schools.