Learning Objective #1: Understand how to implement and evaluate a comprehensive, innovative, and technologically advanced school-based spit tobacco program for children, families, and communities in rural Appalachia

Learning Objective #2: Discuss the implications and evidence-based outcomes of an Appalachian-sensitive spit tobacco prevention and cessation program for middle-school students and their families

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In Appalachian communities, spit tobacco is widely used. In Ohio, an astounding 19% of high school boys use spit tobacco on a regular basis as compared to the national average of 14% as reported by the CDC (Campaign for Tobacco-Free Kids,2000). In addition, the CDC recommended that 'school-based programs' be a part of "evidenced-based" best practices for a comprehensive tobacco control program. Thus, it was critical to develop an effective , school-based spit tobacco prevention program that addressed Appaplachian cultural issues that targeted young kids BEFORE they initiated tobacco use. Therefore, our target population was 1,000 middle-school students (grades 5 through 8)and their families in three school districts in Belmont County, Ohio. After an extensive review of current spit tobacco programs that exist, we developed and implemented in each school, a new, 5 week (45 minutes each session) spit tobacco prevention program. The program included fun and games; role play; models; experiments; two brief videos; weekly prizes and an interactive CD-ROM (developed specifically for our program) that the students took home and watched with their parent(s). Pretest and post-test data were collected using the 'Ohio Youth Spit Tobacco Survey' (revised 2004) which measured risky behaviors, attitudes, and knowledge related to spit tobacco. Pilot study data (n=176) revealed that 8th grade students who had a 'negative attitude' toward spit tobacco use tended to use less spit tobacco (p=.002), use less spit tobacco on school property(p< .001), and tended to smoke cigars and cigarellos less (p<.0001). Qualitative and program evaluation data was also collected.