A recent review indicated that the most promising cigarette smoking prevention approaches focus on the psychosocial factors that promote initiation of cigarette smoking. Such approaches fall into two general categories: (a) those that focus on the social influences believed to promote substance use, and (b) those that provide coping skills training designed to enhance personal and social competence. Results of a recent 24-month study involving 689 sixth-grade elementary students showed that youths who received both health information and skills interventions had less intention to smoke and less cigarette use than youths who received no intervention or health information alone. Prior studies using peer-led models with seventh graders report similar results.