follow-up. This was true whether the
analyses included all subjects or only
those who remained smokers. No intervention
effect on the number of cigarettes
smoked or smoking days was
seen at 12 months (Table 4).
Intervention Effect on Potential
Mediators of Quitting
The intervention did not have any clear
impact on students’ expectations regarding
the positive and negative outcomes
they associated with quitting (Table
5). Knowledge scores showed no
significant changes over time and between
conditions (data not shown).
Scores on confidence to quit improved
more in the intervention group at 3
months (difference in adjusted mean
change: 0.11 [95% CI: 0.02– 0.21]; P.02)
but not at 12 months (0.08 [95% CI:
0.01– 0.18]; P .10). The number of
quit attempts was significantly higher
for the intervention group at 3 months
(mean: 2.2 [SD: 2.2] vs 1.7 [SD: 2.1]; P
.003) but not at 12 months (2.1 [SD: 2.9]
vs 2.1 [SD: 2.9]; P .9). Of those who
made a quit attempt, the length of time
they were able to refrain from smoking
was significantly longer among students
in the intervention group at 3-month
follow-up (20.8 days [SD: 23.0] vs 15.8
days [SD: 19.5]; P.05) and at 12-month
follow-up (58.4 days [SD: 76.9] vs 47.8
days [SD: 68.3]; P .001). Additional
analyses identified no gender differences
in predictors of cessation
outcomes.
Only 2% to 3% of students reported use
of prescription medications while trying
to quit smoking, and this did not differ
according to condition at either time
point. More students used nicotine replacement
therapies, and this was
somewhat higher in the control group at
3 months (12.6% vs 8.8%; P.07) and at
12 months (19.0% vs 13.7%; P.04). Use
of pharmacologic adjuncts did not differ
according to gender.
Treatment Fidelity and Acceptability
School nurses reported that 70% of
students attended 4 or more visits
with no differences according to gender
or group. The time spent with the
nurse was similar for female and male
students within each group and was
consistent with the expected time commitment
(for the counseling intervention,
30 minutes for each of sessions
1 and 2 and 15 minutes for each of sessions
3 and 4; for the attention-control
condition,10 minutes each session).
Fidelity to the counseling intervention
protocol was generally high. During
the first visit, the majority of intervention
steps were completed 95% or
more of the time. During subsequent
visits, the rates of completion were
more variable, but still generally high
for the majority of the intervention
steps. School nurses were able to
work the delivery of the intervention
into their daily routine without added
expense; therefore there were no
costs associated with the nurses delivering
the intervention.
The majority of students who received
the counseling intervention reported the