Because adults often find it difficult to stop smoking (Glasgow & Bernstein, 1981; Leventhal & Cleary, 1980; Pechacek, 1979), a great deal of attention has been given to programs designed to prevent children from becoming smokers. Most of these efforts have taken place in school settings. This emphasis on smoking prevention is not new, but researchers' tactics are different from those used before 1970.
Early smoking prevention progress typically included one-sided attempts to increase adolescents' knowledge about the dangers of smoking. Reviews have been consistent in concluding that such programs were successful in improving knowledge, less successful in changing attitudes, and ineffective in preventing actual smoking behavior (Evans, Henderson, Hill, & Raines, 1979; Thompson, 1978; Williams, 1971). More recent programs have introduced multicomponent interventions that address a variety of psychosocial factors associated with the development of adolescent smoking. For example, interventions have been designed to counteract peer and media pressure to experiment with cigarettes. Most reviews of the newer smoking prevention programs conclude that they have had sizable effects on smoking behavior (e.g., Botvin & McAlister, 1981; Botvin & Willis, 1985; Coates, Perry, Killen, & Slinkard, 1981; Evans, Smith, & Raines, 1984; Johnson, 1982a; McAlister, Perry, & Maccoby, 1979; Pechacek & McAlister, 1980). The great variety of programs that have been developed may suggest new directions for the prevention of other health and nonhealth hazards as well.
In this chapter we shall describe the various ingredients of these prevention programs.