Date of Award


Degree Name

Doctor of Philosophy


Interdisciplinary Health Sciences


Joe Tomaka

Second Advisor

Sharon Davis


Despite reductions in overall smoking rates, data show that adolescents continue to smoke at higher rates than adults and that adolescents living in the Texas-Mexico border area are more likely than their counterparts living elsewhere in Texas to smoke. While adult smoking in the Paso del Norte Region has decreased significantly over the past decade, area youth smoking rates exceed both state and national averages. Recent estimates report cigarette smoking among El Paso youth in the past month to be slightly more than 28% as compared with 21% among Texas youth participating in the 2009 statewide Youth Risk Behavior Survey and 19% among U.S. youth in the same survey. Sociodemographic factors such as income, low community educational attainment, ethnicity, and social context have been shown to contribute to smoking initiation and prevalence among adolescents. In addition to prioritizing groups that may be at high risk of smoking, the CDC's Best Practices for Tobacco Control Programs (2007) suggests several strategies to help eliminate tobacco-related health disparities nationwide. These include identifying populations with disparities related to smoking, partnering to enhance intervention reach and resources, and developing and implementing culturally relevant approaches to smoking prevention and cessation. Accordingly, the purpose of this research project was to develop and evaluate an innovative intervention for youth who may be at high risk of smoking because of sociodemographic factors. Specifically, the research examined whether existing behavioral technology that has been used successfully to reduce alcohol consumption in youth and adults, Personalized Normative Feedback (PNF), can be adapted to similarly affect smoking behavior. PNF refers to a brief intervention process that includes assessment of individual use patterns and direct comparisons of such behaviors to normative data. In the current project, PNF techniques were featured in a brief intervention program that prioritized smoking and non-smoking youth who may be at high risk for continued or future smoking. The primary hypotheses were that participants receiving the PNF intervention would report decreased susceptibility to smoking, lowered estimates of descriptive norms favoring smoking (social norms), and increased negative attitudes towards smoking relative to baseline and in comparison with participants exposed to a nutrition program similar in format and duration but that did not address smoking in any way. Results indicated that although intervention participants reported decreased susceptibility and lowered social norms relative to controls, these changes were not statistically reliable. Regarding changes in attitudes, participants in both groups reported increases in negative attitudes towards smoking which were statistically reliable, and were highest among youth who reported current smoking. Significant differences in smoking prevalence, norms, attitudes, and susceptibility were found by study site and by smoking status, suggesting the need for tailored prevention intervention approaches at the community level. Implications for future research and prevention intervention programs are discussed, as are limitations and strengths of the use of PNF to reduce smoking susceptibility among youth who may be at high risk of smoking because of contextual and sociodemographic factors.




Received from ProQuest

File Size

146 pages

File Format


Rights Holder

Holly Mata