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Youth

Culturally Tailored Tobacco and Betel Nut Prevention Curriculum Effective in US-Affiliated Pacific Islands

Strategic Insights

— 2 min read

Researchers from the University of Hawai'i Cancer Center have developed a culturally tailored school-based tobacco and betel nut use prevention curriculum, Fuetsan Manhoben (FM), specifically designed for adolescents in Guam, a US-affiliated Pacific Island. The FM curriculum aimed to prevent the initiation of tobacco and betel nut use among adolescents in the region. A pilot randomized controlled trial was conducted to examine the efficacy of FM, and the results suggest that it has a positive direct effect on risk perceptions of both cigarettes and betel nut, as well as an indirect effect on reducing intent to use betel nut.

Key Takeaways:

  • The Fuetsan Manhoben (FM) curriculum, a culturally tailored school-based tobacco and betel nut use prevention program, was developed for adolescents in Guam, a US-affiliated Pacific Island.
  • The FM curriculum was shown to have a statistically significant positive direct effect on risk perceptions of both cigarettes and betel nut among Guam public middle school students.
  • At posttest, FM had an immediate effect on betel nut use risk perceptions and an indirect effect on reducing intent to use betel nut at follow-up through its effect on betel nut use risk perceptions at posttest.
  • The results provide initial support for the efficacy and feasibility of FM in preventing tobacco and betel nut use among adolescents in Guam.
  • The study was a pilot randomized controlled trial conducted on 538 Guam public middle school students, with 269 students assigned to the FM intervention condition and 269 students assigned to the control condition.
  • Data were collected at baseline, posttest (4 weeks after baseline), and 3-month follow-up.
  • The study's findings have implications for the development of culturally tailored prevention programs for tobacco and betel nut use in US-affiliated Pacific Islands.
  • Additional authors for this research include Francisco Dalisay, Yoshito Kawabata, and Pallav Pokhrel.

Statistics:

  • 538 Guam public middle school students participated in the pilot randomized controlled trial.
  • 269 students were assigned to the FM intervention condition.
  • 269 students were assigned to the control condition.
  • Data were collected at baseline, posttest (4 weeks after baseline), and 3-month follow-up.
  • At posttest, FM had a statistically significant positive direct effect on risk perceptions of both cigarettes and betel nut (p < 0.001).

Sources:

  • The Fuetsan Manhoben Curriculum: Effects on Risk Perceptions and Intentions Regarding Tobacco and Betel Nut Use Among Adolescents in Guam. Substance Use & Misuse, 2025:1-11.
  • NewsRx. Studies from University of Hawai'i Cancer Center in the Area of Science Reported (The Fuetsan Manhoben Curriculum: Effects on Risk Perceptions and Intentions Regarding Tobacco and Betel Nut Use Among Adolescents in Guam). Clinical Trials Week. September 22, 2025; p 2779.

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