Teaching teens to see through pro-tobacco messages in the media may be better at preventing youth smoking than just saying no, according to new research.
More kids who began the study at least open to the possibility of starting to smoke changed their minds after a media literacy course, compared to kids in a traditional anti-smoking class, researchers found.
"Standard school-based smoking-prevention programs are just not as successful as we would like," Dr. Brian Primack said.
Primack, the study's lead author and director of the Program for Research on Media and Health at the University of Pittsburgh School of Medicine, said clean air laws and large anti-smoking campaigns have led to an overall drop in smoking in the U.S.
"But when it comes down to (youth) educational programs, it just hasn't worked as well as we hoped," he added.
For the new study, he and his colleagues recruited 796 ninth-grade students from three Pittsburgh high schools to either take a traditional anti-smoking class or the media literacy program.
The traditional program deals a lot with resisting social influences, such as peers and parents who smoke, according to Primack.
The media literacy program, on the other hand, is intended to teach adolescents to analyze and evaluate the messages they're encountering in popular culture.
Primack said research has found that the amount of smoking seen in movies and media is a good predictor of whether people will smoke.
"That's why people said if the media is so influential, maybe media literacy at least theoretically could be a good avenue for intervention," he said.
Primack noted, however, that the two classes share common themes. "They're not completely 100 percent opposite," he said.
At the start of the study, students were given survey questions and asked to respond on a scale from "strongly agree" to "strongly disagree."
In response to a question about their intention smoke, 236 students did not firmly disagree - which the researchers interpreted as the teens being susceptible to starting to smoke.
Almost a quarter of those susceptible students who were assigned to the media literacy class said they had changed their mind about smoking by the end of the program and were firmly against starting. That compared to about 16 percent among those taking the traditional anti-smoking class.
Statistically, however, the difference between those groups could have been due to chance, the researchers note in the Journal of School Health.
At the end of the study, students in the media literacy program were more likely than those in the traditional class to perceive smoking as unpopular. They were also more likely to say they liked the program and to pay attention in the classes.
"In general, facilitators like doing this type of education more as well," Primack said.
Cari McCarty, a research associate professor at the University of Washington and Seattle Children's Hospital who has developed prevention programs for kids, said the new study is a promising start.
McCarty, who was not involved in the new study, also said there are a lot of advantages to a media literacy approach, such as the program allowing adolescents to come to conclusions on their own about what the media is trying to tell them.
"I think we need more and bigger studies to be more definitive in terms of outcomes of the study," she said.
Primack said he and his team want to look at long-term outcomes for the adolescents in the programs.
"We need to see if this type of program sticks with people," he said, adding that they would also like to examine whether media literacy is useful at tackling other health behaviors.
McCarty agreed. She said smoking often goes hand in hand with antisocial behavior and addressing them both would be an advantage.
"I guess I'm recommending a big-picture approach, because getting too streamlined can lose other important aspects of the problem," she said.