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Changes in adult cigarette smoking in the Minnesota Heart Health Program.

H A Lando, T F Pechacek, P L Pirie, D M Murray, M B Mittelmark, E Lichtenstein, F Nothwehr and C Gray

Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015.

OBJECTIVES. The Minnesota Heart Health Program was a research and demonstration project designed to reduce risk factors for heart disease in whole communities. This paper describes smoking-specific interventions and outcomes. METHODS. Three pairs of matched communities were included in the study. After baseline surveys, one community in each pair received a 5-year education program, while both cross-sectional and cohort surveys continued in all sites. Adult education programs for smoking cessation included Quit and Win contests, classes, self-help materials, telephone support, and home correspondence programs. RESULTS. Encouraging short-term results were obtained for several adult education programs. Overall long-term outcomes were mixed, with evidence of an intervention effect only for women in cross-sectional survey data. Unexpectedly strong secular declines in smoking prevalence were observed in comparison communities. CONCLUSIONS. The findings suggest that community education may be unlikely to exceed dramatic secular reductions in smoking prevalence. The success of several key interventions and the incorporation of Minnesota Heart Health Program interventions by education communities are encouraging, however.

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