Evaluation Research
Several published research trials of Project EX have been conducted worldwide, and more are currently being conducted. These studies include implementation in the U.S. and in several other countries, including China, Israel and partners, Russian Federation, Spain, India, Korea, and Thailand, thus far.
In the first evaluation (Project EX-1), 18 schools were assigned to the three conditions using a randomized block design. A total of 335 smokers participated in the study, making that the largest controlled teen smoking cessation field trial conducted at that time. Results at 3-month follow-up (five months after the quit day) showed that 17% of the smokers enrolled in the clinics (intent-to-treat quit rate) had quit smoking for at least the last 30 days, compared to only 8% of the control condition smokers over than same time period.
The third evaluation (Project EX-3) was a randomized two-condition trial that used the addition of nicotine gum as a pharmacological adjunct. This study was conducted in both regular and continuation (alternative) high schools. The nicotine gum condition was compared to a herbal gum placebo condition (CigArrest). Results at 2-month follow-up showed that the intent-to-treat 7-day quit rates were 11% in the Nicorette condition and 13% in the CigArrest condition. At 6-month follow-up, the intent-to-treat 7-day quit rates were 16% in the Nicorette condition and 15% in the CigArrest condition.
The fourth evaluation (Project EX-4) was a randomized trial that tested the effects of the a prevention/cessation version of Project EX in a classroom based setting. In this study, while smokers were provided with cessation material, non-smokers were provided with some prevention material and could serve as support persons for the smokers trying to quit. This study was conducted in 12 continuation high schools in Southern California. The study focused on 6 month and 1 year self-reported behavioral outcomes. The weekly smoking prevalence was reduced by 7.6% and 5.1%, and intent-to-treat quit rates contrasting the program to control condition was 30.6% versus 24.8% , and 30.7% versus 24.3%, respectively during the 6 month and 1 year follow-up.
International partnerships have demonstrated that the Project EX curriculum is quite translatable and adaptable to the host country. See the list of Project EX research articles below:
UNITED STATES
Sussman, S., Dent, C.W., & Lichtman, K.L. Project EX: Outcomes of a teen smoking cessation program. Addictive Behaviors 26, 425-438, 2001.
Sussman, S., McCuller, W.J., Zheng, H., Pfingston, Y.M., Miyano, J., & Dent, C.W. Project EX: A program of empirical research on adolescent tobacco use cessation. Tobacco Induced Diseases, 2(3), 119-132, 2004.
*Sussman, S., Miyano, J., Rohrbach, L.A., Dent, C.W., & Sun, P. Six-month and one-year effects of Project EX4: A classroom-based smoking prevention and cessation intervention program. Addictive Behaviors 32, 3005-3014, 2007.
*Sussman, S., Miyano, J., Rohrbach, L.A., Dent, C.W., & Sun, P. Corrigendum to “Six-month and one-year effects of Project EX4: A classroom-based smoking prevention and cessation intervention program”. Addictive Behaviors, 35(8), 803, 2010.
CHINA
Zheng, H., Sussman, S., Chen, X., Wang, Y., Xia, J., Gong, J., Liu, C., Shan, J. Unger, J., & Johnson, C.A. Project EX – A teen smoking cessation initial study in Wuhan, China. Addictive Behaviors, 29, 1725-1733, 2004.
RUSSIA
Idrisov, B., Sun, P., Akmadeeva, L., Arpawong, T.E., Kukhareva, P., & Sussman, S. Immediate and six-month effects of Project EX Russia: A smoking cessation intervention pilot program. Addictive Behaviors, 38(8), 2402-2408, 2013.
SPAIN
Espada, J.P., Gonzálvez, M.T., Orgilés, M., Guillén-Riquelme, A., Soto, D., & Sussman, S. Pilot clinic study of Project EX for smoking cessation with Spanish adolescents. Addictive Behaviors 45, 226-231, 2015.
*Gonzálvez, M.T., Espada, J.P., Orgilés, M., Soto, D., & Sussman, S. One-year effects of Project EX in Spain: A classroom-based smoking prevention and cessation intervention program. PLOS ONE, 10(6), 1-9, 2015.
Espada, J.P., Gonzálvez, M.T., Orgilés, M., & Sussman, S. One-year effects of Project EX: A smoking intervention pilot program with Spanish adolescents. Journal of Health Psychology 22(8), 1067-1074, 2017.
*Gonzálvez, M.T., Espada, J.P., Orgilés, M., & Sussman, S. Two-year effects of Project EX: A classroom-based smoking prevention and cessation intervention program. European Addiction Research 23(3), 122-128, 2017.
INDIA
*Sidhu, A.K., Sussman, S., Tewari, A., Bassi, S., & Arora, M. Project EX-India: A classroom-based tobacco use prevention and cessation intervention program. Addictive Behaviors 53(1), 53-57, 2016.
THAILAND
Chansatitporn, N., Charoenca, N., Sidhu, A., Lapvongwatana, P., Kungskulniti, N., & Sussman, S. Three-month effects of Project EX: A smoking intervention pilot program with Thai adolescents. Addictive Behaviors 61(10), 20-24, 2016.
ISRAEL & partners
Isralowitz, R., Afifi, M., Reznik, A., & Sussman, S. Cigarette smoking among youth: A regional health problem. In: R. Isralowitz & P.A. Findley (Eds.), Mental Health and Addiction Care in the Middle East, Advances in Mental Health and Addiction. Cham, Switzerland: Springer International, pps. 93-108 (Chapter 7), 2016.
KOREA
Yu, S., Galimov, A., Sussman, S., Jeong, G.C., & Shin, S.R. Three-month effects of Project EX: A smoking intervention pilot program with Korean adolescents. Addictive Behavior Reports, 9, 100152, 6 pages, 2019.
Yu, S., Galimov, A., Sussman, S., Jeong, G.C., & Shin, S.R. Corrigendum to “Three-month effects of Project EX: A smoking intervention pilot program with Korean adolescents”. Addictive Behavior Reports, 9, 100152, 1 page, 2019.
*Includes Project EX tobacco prevention/cessation programming.
