Relations of Coping Effort, Coping Strategies

Subst Use Misuse Downloaded from informahealthcare.com by University of Southern California on 07/28/10 For personal use only.

The International Journal of the Addictions, 28(7), 599-612, 1993

Relations of Coping Effort, Coping Strategies, Perceived Stress, and Cigarette Smoking among Adolescents Steve Sussman,'9*Bonnie R. Brannon? Clyde W. Dent,' William B. Hansen? C. Anderson Johnson,' and Brian R. Flay4

'Institute for Health Promotion and Disease Prevention Research, University of Southern

California,Los Angeles, California *Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington Department of Public Health Sciences, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina Prevention Research Center, School of Public Health, University of Illinois at Chicago, Chicago, Illinois

ABSTRACT Coping strategies may influence adolescent smoking behavior because they provide alternative behavioral and cognitive outlets which facilitate or inhibit smoking, or because they are expressions of general coping effort to smoke or not smoke. The present investigation examined three possibilities regarding how coping strategies versus coping effort compare as predictors of adolescent smolung: (1) general coping effort to not smoke may be a better predictor of adolescent smoking behaviors than are specific coping strategies; (2) coping strategies may *To whom correspondence should be addressed at IPR/USC, LOO0 S. Fremont Ave., Suite 641, Aihambra, California 9 1803- 1358. 599

Copyright 01993 by Marcel Dekker, Inc.

SUSSMAN ET AL.


600

be relatively better predictors of smoking behaviors; or (3) these two constructs may be relatively better predictors of different parameters of smoking behavior. Analytic strategies included calculation of a series of multiple regression models, involving (a) 11 coping strategies previously studied in adolescent smoking research, (b) a new simple measure of coping effort to not smoke, and (c) perceived stress, as concurrent predictors of four smoking-related items. Of the 11 coping strategies, partying, relaxation, seeking spiritual guidance, and getting revenge were related to at least one of the four cigarette smoking items. Only coping effort was directly related to recent smoking behavior, whereas only the coping strategies were related to cumulative smoking. Both types of items predicted refusal self-efficacy and intention to smoke in the future. Apparently, these two types of items show unique as well as common predictive variance. These results suggest that coping strategies are related to cumulative smoking for reasons other than motivation to not smoke.

Key words. Coping effort

INTRODUCTION Coping may be defined as attitudes and behaviors designed to control taxing external and intrapsychic life demands. Certain coping strategies may facilitate or inhibit cigarette smoking as an outcome. As study of coping among adolescents may help increase understanding of the etiology of cigarette smoking and relevant preventive measures, Wills (1986) investigated the differential use of coping strategies both as main effect predictors of cigarette smoking and other drug use and in interaction with perceived stress. In his study, both concurrent and prospective analyses indicated that (1) perceived stress was positively related to cigarette smoking and alcohol use, (2) certain coping strategies (adult support, behavioral coping, and relaxation) were negatively related to cigarette smoking, (3) certain coping strategies (peer support, distraction coping, entertainment, and aggressive coping) were positively related to cigarette smoking, and (4) certain coping x stress interactions predicted smoking (cognitive coping and aggression). Wills suggested that a coping strategies conceptualization may have implications for theories of deviancy, aggression, and substance misuse. Aggression and distraction coping (e.g., partying) may serve as means of alleviating negative affect in those who are relatively likely to use cigarettes or alcohol, whereas seeking adult or spiritual support, problem solving, and use of relaxation may serve as a means of alleviating negative affect in those who are less likely to misuse different substances.


COPING EFFORT AND CIGARETTE SMOKING

601

A measure of coping that Wills did not study, but which might be a good predictor of cigarette smoking or other drug use, is “coping effort.” Coping effort refers to the amount of “work” that a person is willing to do to accomplish an outcome, regardless of specific strategies used or feelings of selfefficacy to accomplish the objective. Zubin and Spring (1977) described this variable in the context of preventing relapse in schizophrenics. The harder a schizophrenic is willing to try to not relapse, the greater the likelihood of success. In the present context, coping effort refers to a self-report regarding how hard an adolescent will try to not smoke cigarettes. In contrasting coping effort to not smoke with coping strategies as predictors of adolescent cigarette smoking-type items, at least three possibilities emerge. First, coping effort may reflect a generalized disposition to select coping strategies that promote or suppress the likelihood of smoking. Adolescents who are trying hard to not smoke may tend to select coping strategies to decrease the likelihood of smoking, whereas adolescents who are nor trying hard to not smoke may tend to select coping strategies which facilitate the likelihood of smoking. Thus, coping effort may be more strongly related to smoking behavior than might any individual coping strategy. On the other hand, many coping disposition constructs (e.g., the tendency to avoid or seek out threatening information) have been found to be poor predictors of both coping strategies and problem behavior, perhaps because they do not account for situational influences (Cohen and Lazarus, 1979). Similarly, a measure of coping effort to not smoke would seem to refer to tendencies of an individual across a variety of situations in which smoking may be involved. Thus, perhaps coping strategies are better predictors of smoking than coping effort. A third possibility is that coping effort to not smoke may be a relatively good predictor of some parameters of smoking behavior but not others. Coping effort may be best conceptualized as a motivational variable. Motivation may provide the energy for a commitment to a course of behavior; however, motivation probably is not sufficient to bring about a lasting course of behavior since it does not provide specific cognitive and behavioral means to do so (Marlatt, 1985). Thus, coping effort may be sufficient to bring about a course of behavior for a certain time, but one’s behavior could become altered through certain situational or intrapsychic influences. For example, while a youth may try hard not to smoke, if this youth goes to parties as a primary coping strategy used to assuage perceived stress, he or she eventually may succumb to temptation or social pressures to smoke present in party situations. In other words, a tendency to “party” when a teenager has a problem may not predict recent smoking, given that the youth is trying to not smoke, but it is likely to predict smoking over many occasions (e.g., lifetime smoking). Thus, coping effort

SUSSMAN ET AL.

602


may predict recent smoking better than do certain coping strategies, and coping strategies may predict lifetime smoking better than does coping effort to not smoke. The present study examined the relations of coping strategies, coping effort, and perceived stress with four cigarette-smohng-related items. This study also engaged in tests of potential redundancy between coping strategies, perceive stress, and coping effort as predictors of cigarette smoking.

METHOD Subjects Subjects were 125 7th grade students who were administered self-report questionnaires in the fall of 1985 at two schools in the Monrovia School District in the greater Los Angeles area. Sample sizes from the schools were approximately equal (65 for School A and 60 for School B). The schools were located approximately 10 miles apart in a urban area. These schools differed somewhat in ethnicity. School A subjects were 24% African-American, 51 % White, 20% Latino, and 5% Asian, whereas School B subjects were 4% African-American, 52% White, 30% Latino, and 13% Asian. However, the two schools did not differ as a function of gender, current smoking, or other demographic, behavioral, or socioenvironmental use characteristics (see Table 1).

Procedure and Questionnaire As part of a larger investigation, subjects received an 18-page questionnaire assessing (a) various demographic information; @) smoking behavior and intentions; and (c) knowledge, personality, and social type items such as personal need for refusal assertion training, coping effort, coping strategies, and perceived stress. These items were placed primarily on 4-to-5-point rating scales. Subjects were informed that they were participating in completion of self-report questionnaires which requested information about their or their peers' involvement in activities including tobacco use. They were informed that their responses were confidential, that their questionnaire would be identified by a number only, and that their responses would not be shared with nonproject staff. The subjects had not as yet received a health education program; their responses were not biased by program exposure. To reduce fatigue effects, two forms of the questionnaire were administered randomly to all students; approximately half of all students across the two schools received this questionnaire form. Items were worded at a 6th grade reading level to maximize response completion rate. In addition, questionnaires were administered over 1'/2 class


603

Table 1.

Subjects’ Characteristics(n = 125)


Gender Ethnic composition

Living situation

Parents’ occupation

Language spoken at home Cigarette use by subjects

Alcohol and marijuana use by subjects Subjects’ report of parental use of cigarettes and alcohol

48% Male 14% Black

26% Hispanic 51 % White 9% Asian 65% Both parents 30% Mother only 5 % Father or other adult 30% Father: professional or business owner 20% Mother: professional or business owner 18% Father: clerk or skilled laborer 11% Mother: clerk or skilled laborer 38% Father: semiskilled or unskilled laborer 14% Mother: semiskilled or unskilled laborer 10%Father: unemployed 54% Mother: housewife 85% English 15% Spanish 50% at least tried a cigarette 6% weekly smokers 10% intended to smoke in the future 15% tried at least 5 drinks in lifetime 11 % tried marijuana

25 % 1 parent smokes 15% both parents smoke 10%at least 1 parent drinks 3 or more drinks per day

periods to permit completion by a majority of participating students. Eighty-six percent of all enrolled students completed the questionnaire (10% were absent, 4 % declined participation). Four types of smoking-related items were employed as dependent measures. Two types of smoking behavior items included lifetime/cumulative smoking (“How many times have you smoked a cigarette in your whole life?”) and recent/current smoking [“How many cigarettes have you smoked in the last week (7 days)?”]. These items show adequate psychometric properties, and the accuracy of self-reports of smoking were maximized through use of CO biochemical measurement (e.g., Stacy et al., 1990). A refusal item read “How important is it to you that you be taught how to refuse cigarette offers?” (e.g.,

SUSSMAN ET AL.


604

as in Collins et al., 1987). Finally, cigarette smoking intention items read “Do you think you will ever smoke cigarettes in the future?” and “Do you think you might ever ask anyone to let you try a cigarette?” These two items were correlated .67, and so they were averaged to create a smoking intention index (e.g., Collins et al., 1987). Perceived stress was measured using the 14-item Perceived Stress Scale (Cohen et al., 1983); the average across these items was used as the measure (Cronbach’s alpha = 32). Coping strategy items were based on how frequently the student would do various activities when he or she had problems at school or home. These 11 items were on 5-point rating scales and included “something to try to solve the problem,” “something to try to see the problem as not being so bad,” “talking to a friend,” “talking to an adult,” “hanging out with other kids, partying,” “something to try to relax, sitting quietly,” “something to put the problem out of my mind,” “seeking spiritual comfort,” “go to a movie, watch TV, do some fun activity,” “get revenge,” or “be alone for awhile” (Wills, 1985a, 1985b, 1986). Coping effort consisted of three items which read “I am trying hard to not smoke cigarettes,” “I am working to not smoke cigarettes,” and “I am putting effort into not smoking cigarettes.” These items were highly correlated (Cronbach’s alpha = .83), and they were averaged to form a coping effort index.

Analysis Four sets of multiple regression models were calculated to test the relations of coping effort with the coping strategies and their redundancy as concurrent predictors of smoking: (1) the concurrent prediction of four smokingrelated items from the 11 coping strategies which had been used by Wills; (2) the prediction of these coping strategies by coping effort, perceived stress, and coping effort x perceived stress; (3) the prediction of four smoking-related items by coping effort, perceived stress, or their interaction; and (4) the prediction of the four smoking-related items by coping effort, perceived stress, their interaction, and by the coping strategy items. Gender and ethnic group were entered first into each of the models to serve as demographic covariates.

RESULTS Coping Strategies as Predictors of Smoking-Related Behavior First, a series of multiple regression models were calculated, controlling for covariation among the predictors, where the dependent variable was: (1) lifetime smoking, (2) number of cigarettes smoked in the last 7 days, (3) per-



605

ceived need to learn tobacco offer refusal skills, or (4) intention to use cigarettes in the future (model df = 12,124; effect df = 1,124). The predictors were the 1 1 types of coping strategy measures (see Note 1). The model predicting lifetime smoking was significant (F = 2.49, p < .006,R2 = .26). The only significant effects were for hanging out with friends, partying (F = 8.58, p < .004), and something to try to relax, sitting quietly ( F = 4.50, p < .04). Partying was positively related, and involvement in relaxation was inversely related, to lifetime smoking. The model predicting smoking in the last 7 days was only significant at p < . 1 ( F = 1.65, p < .09, R2 = .19). The only significant effects were for hanging out with friends, partying (F = 8.92, p < .OM), and getting revenge (F = 3.47, p < .07). Partying and getting revenge were positively related to current smoking. The model predicting personal need for refusal skills was significant (F = 2.12, p < .02, R2 = .24). The only significant effects were for hanging out with friends, partying (F = 17.74, p < .OOOl) and seeking spiritual advice (F = 2.32, p < .05).Partying was inversely related, and seeking spiritual comfort was positively related, to perceived need for refusal training. The same pattern of results was obtained regarding predicting smoking intentions as with current smoking (model F = 1.98, p < .03, R2 = .23; partying effect F = 8.21, p < .005; get revenge effect F = 4.14, p < .04).Both predictors were positively related to cigarette smoking intentions. The four coping strategies which were significant predictors in at least one of these four models were retained as dependent variables for a subsequent set of analyses (see Note 2).

Coping Effort, Perceived Stress, and Their Interaction as Predictors of Coping Strategies The next series of analyses predicted partying, relaxation, seeking spiritual comfort, and getting revenge as dependent variables. In these models, predictors included gender, ethnic group, perceived stress, coping effort, and the coping x stress interaction (model df = 5,124, effect df = 1,124). The model predicting partying was significant ( F = 4.69, p < .0oO4, R2 = .13), but no effects achieved significance. In a model without the interaction term, both coping effort (F = 4.00, p < .05) and perceived stress (F = 6.54, p < .01) were significant effects. Lower coping effort or greater stress was positively associated with partying. The model predicting relaxation was not significant ( F = 0.95, p > .46, R2 = .05), the model predicting seeking spiritual support was not significant (F = 1.71, p > . l , R2 = .09), but the model predicting getting revenge was significant ( F = 2.77, p < .02, R2 = .13); however, the only significant effect was gender (F = 5.54, p < .02). Males were more likely to use revenge as a coping strategy.

606

SUSSMAN ET AL.


Coping Effort, Perceived Stress, and Their Interaction as Predictors of Smoking-Related Behavior A series of multiple regression models were calculated, controlling for covariation among the predictors, where the dependent variable was: (1) lifetime smoking, (2) number of cigarettes smoked in the last week, (3) perceived need to learn tobacco offer refusal skills, or (4) intention to use cigarettes in the future. The predictors were gender, ethnic group, perceived stress, coping effort, and the coping x stress interaction (model df = 5,124; effect df = 1,124). The model predicting lifetime smoking was not significant ( F = 1.69, p > . l , R2 = .08). The model predicting current smoking was significant (F = 7.55, p < .OOOl, R2 = .28). Both the coping effort effect (F = 6.09, p c .02) and the coping x stress interaction effect (F = 13.82, p c .0003) were significant predictors. The lower the coping effort, and the lower the coping effort along with greater stress, the more likely was the student to have smoked within the last 7 days. The model predicting the student’s subjective need to be taught refusal skills was significant ( F = 9.37, p c .OOOl; R2 = .33), but the only significant effect was the coping x stress interaction effect (F = 7.78, p < .006). The model predicting cigarette smoking intentions also was significant (F = 3.86, p < .003, R2 = .17), and the only significant effect was the interaction term (F = 4.07, p < .05). The greater the perceived stress and the lower the coping effort to not smoke, the less was the subjective need for refusal training and the greater were the intentions to smoke cigarettes in the future.

Coping Strategies Versus the Coping Effort Items as Predictors of Smoking-Related Behavior A final series of models entered the four coping strategy items, coping effort, perceived stress, and the coping x stress interaction items as predictors of the four smoking-related items (model df = 9,124; effect df = 1,124). The model predicting lifetime smoking was significant (F = 3.20, p C .002, R2 = .24). Only the coping strategy items were significant predictors: partying (F = 4.5, p c .@ relaxation I), ( F = 3.9, p C .05), getting revenge (F = 3.9, p c .05), but not spiritual support (F = 2.6, p = . l ) , The model predicting current smoking was significant (F = 4.77, p < .OOOl, R2 = .33). Significant effects included coping effort (F = 4.96, p C .03), and the coping x stress interaction (F = 11.31, p c .001), but no other predictor. The model predicting personal need for refusal skills was significant (F = 7.05, p c .OO01, R2 = .42). Significant effects included partying and seeking spiritual support as coping strategies (F = 10.94, p c .001 and F = 4.77, p c .03, respectively), and the coping x stress interaction (F = 5.3 1,


607

p < .02). Finally, the model predicting cigarette smoking intentions was significant (F = 3.76, p < .0005, R2 = .28). Significant effects included partying and getting revenge as coping strategies [ F = 4.32, p < .04 and F = 3.37, p < .07 (marginal), respectively] and the coping x stress interaction (F = 2.88, p < .09, marginal).


DISCUSSION Of the 11 coping strategies, partying, relaxation, seeking spiritual guidance, and getting revenge were related to at least one of the four cigarettesmoking-related items. Partying was a significant predictor in all four models. Relaxation was only a significant predictor of one’s smoking history, whereas seeking spiritual support was predictive of one’s need to learn refusal assertion skills. Getting revenge was predictive of current smoking and smoking intentions. These results were similar to some of those obtained by Wills (1986). The fact that three of four coping strategies were not related to coping effort suggests that these two types of variables tap different dimensions of coping. Coping effort probably measures motivation and immediate attempts to cope, whereas coping strategies are measures of means of coping. Of course, coping effort and perceived stress were significantly related to partying as a coping strategy. One may speculate that when a youth attends a party, he or she expects there to be cigarette smoking occurring and, as such, is not showing maximum coping effort to not smoke. He or she may expect to experiment with a cigarette there or use smoking as a means of alleviating negative affect (e.g., related to perceived stress). While partying and coping effort were related to each other, they were differentially related to recent versus lifetime smoking. This study found that coping effort to not smoke was a more statistically direct predictor of recent behavior than were coping strategies. Conversely, coping strategies were the only predictors of lifetime smoking. One reason that the present relations were found could be that partying, getting revenge, and relaxation as coping strategies involve engaging in certain behaviors which, in the short run, may or may not also lead to smoking. Whether or not certain coping strategies lead to smoking depends on whether or not cigarettes are available, and the normative climate, within different life situations. For example, attending a party as a means of coping may lead one to place him or herself at risk for smoking, but the person may not have the opportunity to smoke on that occasion. Alternatively, the person may try hard not to smoke but, after repeated attendance at such parties, the person may succumb to temptation or pressures usually present in this circumstance. In the long run, attending parties is likely to be a good predictor of longer-term smoking behavior. Coping effort to not smoke,


608

SUSSMAN ET AL.

on the other hand, may predict cigarette smoking at a given time point, but not over a longer period of time (as would be indicated in a cumulative measure). Analogously, aggressive coping is likely to reflect a risk-taking or deviant disposition (Wills, 1985). Even if a person exerts coping effort to not smoke, in the long run the person may be likely to succumb to his or her own intrapsychic tendencies [e.g., experience a psychological reversal (Miller, 1985)l. Perhaps both coping effort to not smoke and knowledge of coping strategies such as relaxation and spiritual support are necessary for a teenager to maximize the likelihood of not becoming a regular smoker (Marlatt, 1985). School or community-based research should consider both the need to increase youths’ motivation to not smoke and teach coping skills to assist them in resisting cigarette smoking in high risk situations. Activities such as normative restructuring or correction of inflated prevalence estimates of use, which change the desirability or perceived popularity of use, probably help increase motivation to not smoke. Also, school or community policies restricting smoking probably increase motivation to not smoke. Further, behavioral modeling on the part of faculty and staff can reinforce norms established in the classroom. One may speculate that institutional coping effort expressed in demonstration of nonsmoking behavior and attitudes on the part of faculty and staff, and a willingness to expend organizational resources to provide a smoke-free environment, may strengthen both classroom and schoolwide norms. Such organizational norms can contribute to both intra-institutional and extrainstitutional diffusion of student coping effort to not smoke. Coping skills protective of smoking may include relaxation training and seeking spiritual support, as suggested in this paper. In addition, conversational skills, refusal assertion skills, and cognitive restructuring strategies are likely means of productive coping. Skills which help the teenager to think through and act on a situation are likely to be helpful to the individual. Partying probably reflects a means of distraction coping, of coping by avoiding thinlung through a problem, which may predispose teenagers to engage in selfdestructive acts such as smoking. Teaching about high risk situations and how to avoid them, or how to control oneself within them, is needed to maximize learning of coping strategies protective of smoking. Role playing using coping strategies in different high risk tobacco use situations could help maximize generalization of skills outside the classroom environment. In summary, of the three possibilities mentioned in the Introduction, the one receiving the most support in the data is the perspective of coping effort as a motivational variable. Because it is a better concurrent predictor of recent behavior than are coping strategies, more research is needed to study this alternative coping construct. The fact that coping effort was tied to a specific behavior differentiates this measure from most coping dispositions. Perhaps coping effort to not smoke is not really a coping disposition but rather a coping


609


“attitude” which expresses motivation to not smoke. Since it was a marginal predictor of smoking intentions, it is not simply a redundant measure of smoking intentions. Future studies should measure the stability of both coping effort and coping strategies, and examine their prospective relations with smoking and other drug use, in order to better understand how these two types of coping constructs are related to each other and to behavior.

ACKNOWLEDGMENT Supported by grants from the National Institute on Drug Abuse (DA03468 and DA07601) and by a grant from the National Cancer Institute (CA44907).

Instead of averaging scores across several problem areas as did Wills, we requested what students might typically do when they have problems at school or home. We entered all 11 coping strategies simultaneously to control for covariation among the predictors. 2. To approximate the type of analyses done by Wills (1986), a total of 44 models were calculated, predicting each of the four cigarette-smoking-related items from gender, ethnic group, perceived stress, each of the 11 coping strategy items, and each of the perceived stress x coping strategy interactions. The same four coping strategies resulted in significant models as main effects. It served an economic function to present the results as was done herein. I.

REFERENCES COHEN, F., and LAZARUS, R. S. (1979). Coping with the stresses of illness. In G. C. Stone, F. Cohen, and N. E. Adler (Eds.), Health Psychology. San Francisco: Jossey-Bass. COHEN, S., KAMARCK, T., and MERMELSTEIN, R. (1983). A global measure of perceived stress. J. Health SOC. Behav. 24: 385-395. COLLINS, L. M., SUSSMAN, S., RAUCH. J. M., DENT, C. W., JOHNSON, C. A., HANSEN, W. B., and FLAY, B. R. (1987). Psychosocial predictors of young adolescent cigarette smoking: A sixteen-month, three-wave longitudinal study. J. Appl. SOC. Psychol. 17: 554-573. MARLATT, G. A. (1985). Coping and substance abuse: Implications for research, prevention, and treatment. In S. Shiffman and T. A. Wills (Eds.), Coping and Substance Abuse. New York: Academic Press, pp. 367-386. MILLER, W. R. (1985). Addictive behavior and the theory of psychological reversals. Addict. Behav. 10: 177-180. STACY, A. W., FLAY, B. R., SUSSMAN, S., BROWN, K. S., SANTI, S., and BEST, J. A. ( 1990). Validity of alternative self-report indices of smoking among adolescents. Psychol. Assess. 2: 442-446. WILLS, T. A. (1985a). Stress, coping, and tobacco and alcohol use in early adolescence. In S. Shiffman and T. A. Wills (Eds.), Coping and Substance Abuse. New York: Academic Press, pp. 67-94. WILLS, T. A. (1985b). Supportive functions of interpersonal relationships. In S. Cohen and S. L. Symes (Eds.), Social Support and Health. New York: Academic Press, pp. 23-42. WILLS, T. A. (1986). Stress and coping in early adolescence: Relationships to substance use in urban school samples. Health Psychol. 5 : 503-529.

610

SUSSMAN ET AL.

ZUBIN, J., and SPRING, B. (1977). Vulnerability-A new view of schizophrenia. J . Abnonn. Psychol. 86: 103-126.


THE AUTHORS Steve Sussman, Ph.D., received his doctorate in Clinical-Social Psychology from the University of Illinois at Chicago in 1984. He served on a clinical psychology residency at Jackson VA and University of Mississippi Medical Centers, and now is an Associate Professor of Preventive Medicine at the University of Southern California. He has published over 40 articles in the area of drug use prevention and cessation. Subareas of particular focus are psychosocial prediction of drug use, school-based tobacco use prevention and cessation, and relapse prevention. Bonnie R. Brannon, Ed.D., received her doctorate from the University of Southern California in 1983 and served as Research Associate at USC from 1984 to 1989. She was awarded a postdoctoral fellowship in health behavior from the National Cancer Institute in 1989. In 1990, Dr. Brannon received a First Investigator award from the National Institute on Alcohol Abuse and Alcoholism to study the effects of institutional selfefficacy on adolescent alcohol use. She is now Research Assistant Professor in the Department of Psychiatry and Behavioral Sciences in the University of Washington School of Medicine.



61 1

Clyde W. Dent, Ph.D., received his doctorate in Quantitative Psychology from the Psychology Department at the University of North Carolina, Chapel Hill, in 1984. He is an Assistant Professor of Research at the University of Southern California. His current areas of interest include methodological and applied issues in biometrics, quantitative psychology, and behavioral statistics.

William B. Hansen received his Ph.D. in Social Psychology from the University of Houston in 1978. As a graduate student, Dr. Hansen participated in the first tobacco prevention project funded by the NIH. He has continued to be an active researcher in the primary prevention of behaviors that are risk factors to health including tobacco, alcohol, and drug misuse, and sexual activity among teenagers. He has participated in several key prevention studies including the Houston Tobacco Prevention Project, Project SMART, and the Midwest Prevention Project (also known as Project STAR). He is currently Principal Investigator of three projects: the Adolescent Alcohol Prevention Trial (NIAAA), Effective School-based Prevention (NIDA), and the Prevention of Adolescent Pregnancy Problems (Kate B. Reynolds Health Care Trust). He also serves as the principal evaluator of a partnership demonstration project funded by OSAP. In addition to his research activities, Dr. Hansen serves as an advisor to the national evaluation of OSAP community partnership demonstration projects (ISA Associates, Alexandria, Virginia), the national training conference for OSAP partnership evaluators, and the national evaluation of the U.S.Department of Education Drug Free Schools and Communities project (RTI, Research Triangle Park, North Carolina).


612

SUSSMAN ET AL.

C. Anderson Johnson, Ph.D., received his doctorate in Social Psychology from Duke University in 1974. He was Assistant Professor at the University of Minnesota from 1975 to 1980. Since 1980 he has been Associate Professor of Preventive Medicine at the University of Southern California and Director of the USC Institute for Health Promotion and Disease Prevention Research. He has received support from the National Cancer Institute, the National Heart, Lung, and Blood Institute, the National Institute for Child Health and Human Development, the National Institute on Drug Abuse, the W. T. Grant Foundation, and the Kaiser Family Foundation. Brian R. Flay, received his D.Phi1. in Social Psychology from Waikato University in New Zealand in 1976. After receiving postdoctoral training at Northwestern University (Evanston, Illinois) under a Fulbright/Hays Fellowship, he started research on smoking prevention at the University of Waterloo (Ontario, Canada). He continued work on smoking prevention and developed work in the areas of drug use prevention and the use of mass media for smolung cessation at the University of Southern California. Dr. Flay is now Director of the Prevention Research Center in the School of Public Health, University of Illinois at Chicago, where he continues his research in the above areas as well as AIDS prevention.