Critique 

University of Vermont - Smoking Prevention Program

The following assessment of program strengths and weaknesses has been abstracted from reviews by the Task Force on Program Selection of The Health Project. Where weaknesses are postulated, it must be taken into account that the review Task Force is very critical, that no programs are perfect, that the Award Winning programs have been selected from over 300 candidate programs and represent the very best, that the materials reviewed may have been incomplete, that suggested deficiencies may have resulted from incomplete understanding of the program by the reviewers or that any problems may have been corrected since the time of review.

Evaluation: The University of Vermont's Smoking Prevention Through Mass Media & School Programs effort targets public school students in lower-income areas with community-wide mass media messages supported with a National Cancer Institute grant and with 50 percent matching pro bono time by local radio stations. The program changes each year to match students developmental needs and includes long term follow-up. Substantial reductions in smoking versus community norms have been realized with related savings in heart disease, chronic pulmonary disease and lung cancer based on published forecasts. Several states are now considering similar programs.

Excellent longitudinal study to evaluate the impact of community-wide mass media messages to support school-based smoking prevention programs. The study design with comparison groups, including focus group research to tailor high-risk specific messages and follow-up two years after intervention, was excellent. Study showed results of 5 percent difference in smoking prevalence between the two groups, with 1,064 fewer smokers if the same proportional reduction in smoking onset occurred. Cost-benefit and cost-effectiveness analyses show significant impact. Program cost at $28 per participant is low. This is one of the finest community programs evaluated by the Health Project. The program has been operating since 1985. Cost saved for every dollar invested were $11 in avoiding heart disease, $37 in avoiding pulmonary disease and $8 in avoiding lung cancer as imputed by the reduced number of smokers.

There is limited description of the actual multi-media materials used. Issues of smokeless tobacco were not addressed. Cost-savings were noted to be projections. Program evaluation is based upon self report and there is no evidence that the two communities (Montana/New York State) are comparable. Long-term impact not assessed. Several reviewers did not note any weaknesses.