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Vital Signs

No butts about it on website aimed at girls

By Boer Deng

For Dr. Henry Bernstein, the importance of not smoking is close to his heart. "When I was growing up," he recalls, "my mom smoked, and [my siblings and I] tried desperately to get her to stop." A professor of pediatrics at DMS, Bernstein now tries to keep his young patients from starting to smoke. That's why he created nosmokingroom.org, a website for girls aged 8 to 11.

"It's always been important to me to do things to promote the health and well-being of patients in the context of their family and in the context of their community," Bernstein says. The website, which was launched a few months ago, aims to give girls and their families a fun, secure forum for discussing how to say no to smoking or how to stop if they've started.

Videos: Girls who visit the website can send e-cards, keep a journal, or create invitations and door signs-all while learning from quizzes and videos about the hazards of tobacco. Smokers are two to four times more likely than nonsmokers to develop coronary heart disease, for example, and 10 to 20 times more likely to have lung cancer.

The goal is to reach girls before their teen years, since some 4,000 young people between 12 and 17 start smoking each day, according to the Centers for Disease Control. The prospects are especially dire for women, for their rate of smoking is on the rise. And, Bernstein notes, "once women start to smoke, they find it more difficult to quit than do men, due to lack of social support for quitting."

Savvy: Using the internet is especially germane given the audience Bernstein has targeted. "Young kids today are pretty technologically savvy," he points out. "Kids used to play a lot of board games or be outside," but now they spend much of their time on the web. Although pediatricians generally recommend limiting computer and television use, time in front of a screen can be valuable if it is in a controlled, educational setting, Bernstein believes.

To make the site as usable and appealing to young girls as possible, Bernstein and his collaborators sought input from focus groups through the national organization Girls Inc. They held additional focus groups in the two states with the highest smoking rates-Kentucky and Indiana. "It was important to us to go where smoking is really happening," says Bernstein, "to try to understand what works best with this particular age group." Nine of the girls who helped design the site now serve as an advisory board.

Bernstein doesn't yet know how much traffic nosmokingroom.org is getting, but he hopes to soon evaluate various aspects of the site, including user satisfaction, knowledge acquisition, and success at preventing smoking. For now, Bernstein and his team are promoting the project at professional meetings, where it has garnered much interest, and distributing door signs with information about the site.

"Our plan is for these [door signs] to be in every pediatric office," as well as schools and daycare centers, says Bernstein. (A related web project, aimed at training health professionals to counsel girls about not smoking, is at www.pediatricspractice.org.)

Quit: "I've always cared so much about not smoking," Bernstein says. "Knowing my mom was smoking, it was [a] lifelong thing to get her to stop." His mother was able to quit only after suffering a heart attack. Now Bernstein hopes to prevent others from reaching that stage.

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