Smoking cessation efforts directed to teens experience low participation and high dropout rates. A variety of studies suggest that teens regard cost, convenience, and being in control of decision to quit as important issues. This report summarizes information from nine one-hour focus groups conducted during school hours.  The focus groups were used to guide the development of two smoking prevention/cessation strategies: health care clinician advisement (Teen REACH – Pathways to Change) or an interactive computer-telephone method (Teen Quitline).  The participants were 14-16 year-old students (33 in Teen REACH and 40 in Quitline project groups).

The authors outlined common themes and responses to proposed features of each program.  Not surprising, youth indicated that it is their own choice to smoke or quit - denying that peer pressure caused them to start or prevents them from quitting. Motivations for smoking include stress, boredom, to look older, to fit in, friends and/or family smoking, control hunger, social ‘ritual.’ Motives to quit include odor, family members whose smoking led to illness or death, financial cost, reduced physical performance, or a close friend.

Desired features of smoking cessation programs included: 1) straight information about the effects of smoking (e.g., physical performance impact) and what to expect during quit efforts; 2) support from a person who is concerned about the teen, not just smoking behavior; 3) counselors who are former smokers; and 4) confidential, nonjudgmental communications that respect for the teen’s need for independence.  Accepted methods included private, computer-based programs and personal contact by telephone. Generally, they believed that school-based programs do not assure confidentiality and involve lectures or demands. They want counselors, regardless of location or method, relate to teens’ experiences and offer useful quit tips.  

Focus groups or other methods to solicit teens’ input can provide important information for developing and testing components or methods of proposed programs. These findings suggest that regardless of how the smoking cessation program is delivered, it must address real barriers to quitting, respect that the teen believes he makes a conscious decision to quit, and render support confidentially.

(Vuckovic H, Polen M and Hollis J. Prev Med 2003; 37(3):209-218.)

Comment: These youth generally distrusted school-based smoking cessation programs but since only one metropolitan area was represented, this cannot be generalized to other sites.  We should review how school-based programs are publicized and delivered – adults may define “privacy” differently than teen clients.  -- J.O.