Designing the Next Generation of Youth Alcohol and Tobacco Prevention and Early Intervention Programs

    • July 23, 2009

James O. Prochaska, PhD, Director, Cancer Prevention Research Center Professor of Clinical and Health Psychology University of Rhode Island Kingston, R.I.

The project: James Prochaska, PhD, has been recognized (along with Innovator Carlo C. DiClemente) for his work illuminating how addicted people change in their interest and ability to achieve abstinence. Their work on the Transtheoretical Model of Change and "stages of change" has emerged as the bedrock of many substance abuse treatment and smoking-cessation programs.

In 2002, Prochaska received an Innovators Combating Substance Abuse award and got a chance to advance his work. The Robert Wood Johnson Foundation (RWJF) created the Innovators program to nurture and promote innovation in combating substance abuse. Between 2000 and 2003, some 20 senior researchers, practitioners and policy-makers received Innovators awards.

Prochaska used his Innovators award to design a promising approach to prevention and early intervention to prevent and reduce youth alcohol and tobacco abuse.

He worked with a multidisciplinary and multicultural team of students and faculty to analyze and integrate data from eight major alcohol and tobacco studies. He used the analysis to explore lessons learned, to add measures to future studies, to design a next generation of prevention and early intervention programs and to disseminate discoveries and lessons.

Prochaska and his colleagues also invited experts in the fields of substance abuse prevention and early intervention to give presentations on lessons learned from their work.


Prochaska reported the following findings from his work to RWJF:

  • Peoples' readiness to change a behavior is reflected in differences in a series of intermediate measures. People not intending to change a behavior in the foreseeable future are much more likely to identify the cons of changing behavior than they are to identify the pros of changing behavior.

  • People in both the control and treatment groups followed common pathways to stopping smoking. People in the intervention group who had quit smoking for six or more months had decreased the temptations of smoking, decreased the cons of quitting smoking and increased the pros of quitting compared with stable smokers. Across eight studies examining addictive behaviors in a range of populations, researchers found that about 90 percent of people who had never used drugs are in the "precontemplation" stage of change and do not intend to use the substance of focus in the study. The people least likely to use the substance studied had low scores on scales measuring temptation to use and high scores on the pros of not using.