Three-month follow-up data was collected (n=
244.) The results initially indicated approximately 20%
versus 10% smoking cessation, and 44% versus 0%
smokeless tobacco cessation, for clinic participants versus
wait-list controls at three months post-clinic. Quit
rates were then corrected by controlling for those who
dropped out after the first clinic session (intent-to-treat
analysis; i.e., assumption that drop-outs did not quit
tobacco use) and use of biochemical validation to adjust
for over-reporting of abstinence (saliva cotinine data
was collected and analyzed). After these corrections,
the data revealed no difference in clinic versus wait-list
smoking cessation rate (about 7% cessation in each
group). However, 13% smokeless tobacco use cessation
was observed in the clinics and none was observed
among the wait-list controls [7]. Also, school-wide
trends for non-participants at program schools or control
schools were in a direction showing an overall increase
in tobacco use.
Through subsequent work, a five-session clinic
was refined from the Project TNT clinic programs.
Some clinic material was added (e.g., anger management)
or combined (addiction and psychosocial dependency
quit strategies), and nongeneralizable, relatively
expensive program elements such as TNT key
chains and calendars were eliminated. The final product
of this process was the Project TNT comprehensive
adolescent tobacco use cessation guide, a five-session
combined curriculum, including both psychosocial and
chemical dependency oriented aspects.
This combined program became the foundation
for building a motivation-enhanced curriculum known
as Project EX. Project TNT includes most standard tobacco
cessation material, including information on reasons
for using tobacco, physiological effects of tobacco
use, nicotine withdrawal symptoms and strategies for
managing them, psychological coping such as anger
management and relaxation, avoiding weight gain, relapse
prevention strategies, and maintenance of cessation
through health promotion (e.g., exercise and dietary
change).