Background:
While substantial evidence demonstrates long-term effectiveness of youth cigarette smoking prevention and cessation programs, the evidence for non-cigarette youth tobacco prevention and cessation programs is limited.

Objectives:
The current study reports on the development of a theory-based universal group delivered Youth Brief Tobacco Intervention (Y-BTI) plus automated text messaging to prevent tobacco initiation and promote cessation among high school youth.

Methods:
This study used a sequential, multi-method research design to develop the interventions. In Phase 1, 347 students completed a survey and discussion activity. A facilitator asked 6 open-ended questions about perceptions of tobacco use. Students then wrote their responses and placed them on a board. The responses were summarized, and the facilitator elicited discussion. Class discussions were coded for themes. Students also provided preferences for timing and frequency of receiving text messages. In Phase 2, 336 students watched video content for the Y-BTI and ranked each video (e.g., relevance, believability, concern and impact). They also completed pretest and posttest surveys that assessed changes in harm perceptions, addictiveness, and willingness to use tobacco.

Results:
In Phase 1, students’ discussions mapped to the constructs of the Health Belief Model and the Theory of Planned Behavior. Thus, in Phase 2, anti-tobacco videos were selected that aligned with these theoretical constructs. The video messages appeared to be effective. Willingness to use tobacco decreased across all tobacco products from pretest to posttest (p’s<0.001). Additionally, the percentage of students who reported ‘Don’t know’ to questions about tobacco harm and addictiveness decreased across all tobacco products from pretest (11.9%) to posttest (6.9%).

Conclusion:
Results from this study will be used to develop a universal tobacco control program for high school youth addressing all forms of tobacco, which is significant given the changing tobacco landscape and the increased benefits of cessation at a younger age.