The skills-based program aims to increased teens' confidence that they can say no to an offer of a cigarette. The researchers note that peer pressure to try smoking and media images that portray smoking in a positive light can make teens fear rejection if they refuse a cigarette. ``Kids have real social concerns about the negative consequences of refusing an offer from their peers,'' said study co-author Rick Petosa, an associate professor of health promotion at Ohio State University in Columbus. ``While this program was not able to change that, it did reinforce students' existing levels of skill and confidence in refusing cigarettes.'' Petosa and colleagues used the Minnesota Smoking Prevention Program -- a 6-lesson smoking prevention model -- as the focus of the study, administering the social influence-based program in the spring of 1997 twice a week for 3 weeks to five 6th-grade classes. The students engaged in group discussions and role-playing regarding peer pressure, cigarette advertising, and personal issues involving smoking. An anonymous 78-item questionnaire was given before and after the completion of the program, measuring the students' views on smoking pressures in four primary areas: their ability to resist positive images of smoking; their ability to say no to an offer to smoke; and their levels of both good and bad expectations regarding making a decision not to smoke. When compared with students of the same age and backgrounds, the program was credited with having a significant positive impact on the students' ability to say no to an offer to smoke. However, the program did not have any effect on the teens' ability to objectively evaluate positive media images of smoking, or on their fears of negative reactions from their peers. Petosa said that the study results, published in the Journal of School Health, showed that the program ``did reinforce students' existing levels of skill and confidence in refusing cigarettes,'' even though it did not change their fears regarding the negative consequences of refusing an offer. ``Lecturing to teenagers about the health risks of smoking does not discourage them from smoking,'' said Petosa. ``Social influence programs, on the other hand, focus specifically on the things adolescents worry about. These programs address the social meaning behind smoking.'' With 85% of all new smokers beginning the habit before the age of 18, Petosa emphasized the importance of the fact that ''the smoking prevention programs that work go beyond the simple delivery of health information.'' He referred to earlier studies of similar programs, which have found that such social influence-based curriculum can help cut the rate at which adolescents begin to smoke by 30% to 50%.

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