WHY BREATHE LA : EXECUTIVE SUMMARY: 4-U-N-I

•    Most lung disease is preventable, yet is now the third leading cause of death; there is no comprehensive youth empowerment initiative related to eliminating lung disease
•    No programs exist to bring smoking cessation programs and services to the 14-21-year-old age group, some seeking to fulfill or avoid fines for being caught smoking on campus
•    Parents reluctant/refusing to send teens to programs designed for and attended by adults
National statistics:
•    90 percent of all adult smokers begin while in their teens, or earlier, and two-thirds become regular, daily smokers before they reach 19
•    20.4 percent of high school students are current smokers by the time they leave school
•    20 percent of all high school students (9-12 grades) are current smokers
•    Roughly one-third of all youth smokers will die prematurely from smoke-caused disease
CA statistics:
•    14.0% of CA adults were smokers in 2005; CA 2nd in the nation for the most smokers
•    CA youth smoking rate is 15.4%
•    596,000 CA kids alive today will die from smoking
•    CA smoking-caused health costs were 9.14 billion in 2004
A one-percentage point increase in CA smoking rates for adults and youth would mean:
•    271,600 more adult smokers
•    22,100 more high school smokers
•    72,000 more smoking deaths
•    30,000 more youth growing up to die from smoking
•    5,600 more smoking affected births
•    $4,221.70 increase in health care costs per person
Conversely, a one-percentage point decrease would reduce numbers by listed amounts.

BREATHE California of Los Angeles County (BREATHE LA) seeks to address the teen smoking cessation gap by founding 4-U-N-I. 4-U-N-I is a student-led, BREATHE LA-supported, teens-helping-teens quit smoking program designed to inspire, support, and assist youth in Los Angeles high schools.
•    4-U-N-I leads L.A. County efforts to reach the 2010 National Quit Goals for Youth
•    4-U-N-I champions multi-cultural youth as the voice for prevention of teen tobacco use, and as mentors supporting teen cessation, resulting in a tobacco-free youth population
•    4-U-N-I is the springboard for youth empowerment programs that will engage a new generation of leaders in the prevention of tobacco use

•    bridge the teen smoking cessation gap by building formally recognized clubs on high school campuses and increasing the number of participating campuses annually
•    build a diverse membership by strategically communicating with racially, ethnically and culturally diverse prospective participants
•    train and collaborate with these students to build student and parent knowledge about the dangers of cigarette smoking, second hand smoke, and the tobacco industry
•    train teens as “quit mentors,” and have them generate and provide quit information and quit-smoking media messages for peers and parents
•    implement a technology-based intervention: Text-to-Quit
•    train a subset of participants in social science research skills
•    conduct a scientifically rigorous evaluation to improve project implementation and to generate outcome data
•    assess the overall merit of 4-U-N-I by measuring change in teen knowledge and attitudes about tobacco use, self-reported tobacco use, parent/ teen communication about tobacco use and the rate of quit attempts among both teens and parents

•    Year 1 2009-2010: Train 8-12 Quit Mentors
    -Quit Mentors will work once a month with 4-5 peers or parents to quit smoking
    -100-120 successes
•    Year 2 2010-2011: Train 12-15 Quit Mentors
    -Quit Mentors will work once a month with 7-10 peers or parents to quit smoking
    -150-200 successes
The outcome evaluation will be accomplished in Year 1 utilizing a two-group pre- and post-test quasi-experimental evaluation design including 10th and 11th grade students at two intervention and two “wait list” comparison high schools. To the extent possible, schools will be selected to match student demographics in intervention/comparison pairs. In Year 2, 11th and 12th grade students at all four of these high schools will comprise the intervention condition (at two levels of project maturity) and at least two new “wait list” schools will be recruited into the comparison condition. Evaluators will track individuals over the two-year project duration.
•    Grow 4-U-N-I clubs at a rate of three per calendar school year
The Program Coordinator and 4-U-N-I students will maintain “outreach diaries,” recording their activities and the results they produce. Evaluators (collaborating with student evaluation research assistants) will survey vice principals/activity counselors and associated student body presidents in (Year 1-30/Year 2-45) high schools located in target zip code areas to assess response to the recruitment process and 4-U-N-I outreach materials.
•    Recruit clubs on diverse campuses and represent diversity in the club
Student membership rosters recording basic demographic information will be produced and maintained by volunteer student evaluation research assistants. The demographics of club membership will be compared to campus student demographics to direct targeted outreach activities. Students will be encouraged to work with evaluators to specify means (e.g. event exit interviews, “random encounter” brief student surveys) to assess population response to appeals.
•    Demonstrate a statistical comparison between student pre- and post-tests
Data will support comparisons of 4-U-N-I club members to the general student body, as well as comparisons between gender and racial/ethnic student subgroups. Evaluators will work with student evaluation research assistants and collaborating teachers to develop formative evaluation processes such as key informant interviews and focused group discussions to assess student and parent response to fact sheets, quit kit materials and PSAs.