Curtailing Tobacco Use Among Youth: Evaluation of Project 4-Health

This article reports the development and evaluation of Project 4-Health, a theory-driven, research-based program to prevent tobacco use among youth enrolled in 4-H clubs throughout California. Additional goals were to involve youth in discouraging others ’ tobacco use and to develop youth leadership for tobacco control. To assess program effectiveness, 72 clubs were matched and randomly assigned to the program or control con-dition. Of 1,853 eligible club members, 88.6 % completed the pretest. Of these, 79.5 % completed a posttest 4 months after conclusion of program delivery, and 77.6 % completed a second posttest 2 years later. Short-term effects were found on 7 of 24 outcome measures, indicating changes in knowledge, attitudes, and behavioral intention, but not in social influence variables or behaviors. No long-term effects were observed. Discussion considers how the challenges of designing, delivering, and evaluating the intervention influenced results and implications for preventing tobacco use through community-based youth groups. This article describes the development, implementation, and evaluation of Project 4-Health, a theory-driven, research-based educational program aimed at preventing and reducing tobacco use among 4-H community club members. This 5-year project was the nation’s first randomized field trial aimed at preventing and reducing smokeless tobacco (ST) use among youth. Following 1 year of exploratory fieldwork, the prevention an