School Tobacco Research Articles

Targeting School Tobacco Policy: Lessons From the Acadiana Coalition of Teens Against Tobacco (ACTT)

This case study examines the comparative effect of no-use school tobacco policies and restricted-use tobacco policies on teacher and student smoking behaviors and attitudes. Data from teachers (n = 1,041) and ninth-grade students (n = 4,763) at 20 schools in five districts in southern Louisiana were available. No significant difference was observed between teacher smoking (11% vs. 13%, p = .42) or student smoking (24.6% vs. 25.2%, p = .75) at no-use versus restricted-use policy schools. The proportion of teachers smoking on campus at no-use or restricted-use schools was not significantly different. Teachers at restricted-use schools were however less concerned about students seeing teachers smoke and less supportive of a no-use policy than teachers at no-use schools. Tobacco use policies are often not promoted, and enforcement of policies impacting teachers is complex. Changing social norms for smoking at high schools through policy promotion and enforcement is understudied.

Commentary: Why are we biased against bias?

health behavior: some empirical evidence. Health Econ 2006;15:125–46. 55 de Walque D. Does education affect smoking behaviors? Evidence using the Vietnam draft as an instrument for college education. J Health Econ 2007;26:877–95. 56 Power B, Neilson S, Perry IJ. Perception of the risks of smoking in the general population and among general practitioners in Ireland. Ir J Med Sci 2004;173: 141–14. 57 Fernandez E, Schiaffino A, Borrell C et al. Social class, education, and smoking cessation: long-term follow-up of patients treated at a smoking cessation unit. Nicotine Tob Res 2006;8:29–36. 58 Wills TA, Sandy JM, Yaeger AM. Stress and smoking in adolescence: a test of directional hypotheses. Health Psychol 2002;21:122–30. 59 Novak SP, Clayton RR. The influence of school environment and self-regulation on transitions between stages of cigarette smoking: a multilevel analysis. Health Psychol 2001;20:196–207. 60 Diez Roux AV, Merkin SS, Hannan P, Jacobs DR, Kiefe CI. Area characteristics, individual-level socioeconomic indicators, and smoking in young adults: the coronary artery disease risk development in young adults study. Am J Epidemiol 2003;157:315–26. 61 de Vries H, Candel M, Engels R, Mercken L. Challenges to the peer influence paradigm: results for 12-13 year olds from six European countries from the European Smoking Prevention Framework Approach study. Tob Control 2006;15:83–89. 62 Kumar R, O’Malley PM, Johnston LD. School tobacco control policies related to students’ smoking and attitudes toward smoking: national survey results, 1999–2000. Health Educ Behav 2005;32:780–94. 63 Cook PJ, Hutchinson R. Smoke Signals: Adolescent Smoking and School Continuation (Working Paper No 12472) Cambridge, MA: National Bureau of Economic Research, 2006. 64 Fersterer J, Winter-Ebmer R. Smoking, discount rates, and returns to education. Econ Educ Rev 2003;22:561–66. 65 van Oort FV, van Lenthe FJ, Mackenbach JP. Material, psychosocial, and behavioural factors in the explanation of educational inequalities in mortality in The Netherlands. J Epidemiol Community Health 2005;59: 214–20. 66 Blakely T, Wilson N. The contribution of smoking to inequalities in mortality by education varies over time and by sex: two national cohort studies, 1981-84 and 1996-99. Int J Epidemiol 2005;34:1054–62. 67 Emery S, Gilpin EA, Ake C, Farkas AJ, Pierce JP. Characterizing and identifying ‘‘hard-core’’ smokers: implications for further reducing smoking prevalence. Am J Public Health 2000;90:387–94. 68 Chou CP, Montgomery S, Pentz MA et al. Effects of a community-based prevention program on decreasing drug use in high-risk adolescents. Am J Public Health 1998;88:944–48. 69 Sorensen G, Glasgow RE, Topor M, Corbett K. Worksite characteristics and changes in worksite tobacco-control initiatives. Results from the COMMIT study. J Occup Environ Med 1997;39:520–26. 70 Tengs TO, Osgood ND, Chen LL. The cost-effectiveness of intensive national school-based anti-tobacco education: results from the tobacco policy model. Prev Med 2001;33:558–70.

Family, school, peer and individual influences on early adolescent alcohol use: first‐year impact of the Resilient Families programme

This study aimed to examine: (a) the influence of family factors relative to school, peer and individual influences on the development of adolescent alcohol use during the first year of secondary school; and (b) the feasibility of preventing adolescent alcohol use by modifying family factors. Twenty-four schools in Melbourne, Australia were randomly assigned to either the 'Resilient Families' intervention or a control condition. A baseline cohort of 2315 grade 7 students (mean age 12.3 years) were followed-up one year later (n=2128 for longitudinal analyses). A sub-set of parents (n=1166) also returned baseline surveys. The prevalence of lifetime alcohol use in year 7 was 33% and rose to 47% by year 8. Student-reported predictors of year 8 alcohol use included baseline alcohol [Odds Ratio (OR) 3.64] and tobacco use (2.68), and school friend's alcohol (1.41) and tobacco use (1.64). After adjusting for other influences, student-reported family factors were not maintained as significant predictors of year 8 alcohol use. Parent-report predictors of student-reported alcohol use included allowing alcohol use in the home (2.55), parental alcohol use (1.88) and child hyperactivity (1.85). Protective factors included attendance at brief parent education (0.60) and parent involvement in school education (0.65). The intervention appeared to benefit education-related outcomes, but no overall effect in reducing student alcohol use was found in year 8. Intervention effects on alcohol misuse may become significant in later secondary school once the entire program has been implemented. Considerable alcohol use was detected in early secondary school, suggesting that interventions to reduce alcohol use may be usefully implemented prior to this period.

The pit and the pendulum: the impact on teen smokers of including a designated smoking area in school tobacco control policy

Thirty per cent of school districts in British Columbia do not ban smoking outright on school grounds, and in several instances, smoking is permitted in smoking pits, regardless of school district policy. While there is evidence to suggest that enforcing a tobacco-free environment for students does reduce adolescent smoking rates, the concomitant safety and discipline problems it creates for school staff and administration are demanding and complex, and may override concerns regarding student smoking. This study uses a qualitative approach to explore the meanings that students place on tobacco control policy and the impact that these meanings have on their own smoking behaviours. We found that students were surprised and concerned that smoking was permitted on school property and that it negatively impacted their own tobacco prevention/control/cessation attempts.

Association of the Presence of State and District Health Education Policies With School Tobacco Prevention Program Practices*

Texas does not require health education or tobacco use prevention education (TUPE) in its middle schools. During planning for the Texas Tobacco Prevention Initiative, this baseline research was conducted to (1) describe tobacco prevention and control practices in middle schools prior to the pilot, (2) analyze implementation of a state law prohibiting tobacco use on campuses and at school events, and (3) identify how schools are influenced by district policies requiring health education. Written surveys derived from the 2000 School Health Education Profile Tobacco Module developed by the Centers for Disease Control and Prevention were completed by principals and health coordinators at schools in districts requiring health education (n = 31) and schools without district requirements (n = 32). School tobacco policy familiarity and enforcement were consistently reported in response to a state law with rigorous recommendations prohibiting tobacco use. Significantly more activity in numerous components of TUPE was reported in schools in districts with a health education requirement. Results have implications for intervention programs planned in schools located in states seeking to develop or strengthen state laws, or in states without health education or specific health content requirements.

Association of the Presence of State and District Health Education Policies with School Tobacco Prevention Program Practices

Journal of School HealthVolume 77, Issue 4 p. 215-217 Association of the Presence of State and District Health Education Policies with School Tobacco Prevention Program Practices April 2007 issue of Journal of School Health First published: 02 April 2007 https://doi.org/10.1111/j.1746-1561.2007.00193.x Journal of School Health : is written and produced by the American School Health Association. Activity planning, test questions and pilot testing were conducted by Susan F. Wooley, PhD, CHES, and selected members of ASHA’s Editorial Board and Professional Development Committee. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Volume77, Issue4April 2007Pages 215-217 RelatedInformation

The HYP program—Targeted motivational interviewing for adolescent violations of school tobacco policy

Objective. To evaluate the efficacy of a short-term tobacco-focused intervention for high school students referred by school administrators because of tobacco use. Method. A sample of 56 adolescents (66% male, mean age 15 years) was recruited through referrals from three state high schools. Participants were randomly assigned to a one-hour motivational interview (MI) session or to standard care (advice/education). The two groups were followed up at one, three, and six-month intervals. Results. The MI intervention resulted in significant short-term reductions in quantity and frequency of smoking relative to standard care, however, effects were not maintained at 3- and 6-month follow-up. Improvements in refusal self-efficacy were significant relative to standard care. Conclusion. For adolescents who are established smokers and at high risk of other problems, motivational interviewing was associated with modest short-term gains relative to standard care.

The impact of school smoking policies and student perceptions of enforcement on school smoking prevalence and location of smoking

The purpose of this study was to comprehensively assess the impact of school tobacco policy intention, implementation and students' perceptions of policy enforcement on smoking rates and location of tobacco use during the school day. Data were obtained from all students in Grades 10-11 (n = 22,318) in 81 randomly selected schools from five Canadian provinces. Policy intention was assessed by coding written school tobacco policies. School administrators most familiar with the tobacco policy completed a survey to assess policy implementation. Results revealed policy intention and implementation subscales did not significantly predict school smoking prevalence but resulted in moderate prediction of tobacco use on school property (R(2) = 0.21-0.27). Students' perceptions of policy enforcement significantly predicted school smoking prevalence (R(2) = 0.36) and location of tobacco use (R(2) = 0.23-0.63). The research findings emphasize: (i) the need to consider both written policy intention and actual policy implementation and (ii) the existence of a policy is not effective in controlling tobacco use unless the policy is implemented and is perceived to be strongly enforced.

The Global School Personnel Survey: a cross-country overview

Teachers and administrators are role models for students, conveyors of tobacco prevention curricula, and key opinion leaders for school tobacco control policies. School teachers and administrators have daily interaction with...

Bajo desempeño escolar relacionado con la persistencia del tabaquismo en una cohorte de estudiantes en México

To evaluate the independent effect of poor school performance and tobacco persistence using a prospective population study of students who remained on school grounds during the follow-up period. Two measurements were taken over a period of three years. A cohort study conducted within school confines was developed over the period 1998 to 1999 and 2000 to 2001, with 2,568 students, including both tobacco persistent students and non-consumers. Multiple logistic regression models were designed and structured according to educational performance using two standards: students who maintained and/or improved performance and those with poor performance, based on the first and second measurements. In the reference cohort, 5.2% of the students reported to have persisted with tobacco consumption during the study period, while 64.2% remained unexposed. Poor school performance was associated with tobacco persistence for the total population (OR 2.27, 95%CI 1.4-3.6), as well as for females (OR 3.0 95%CI 1.4-6.7) and males (OR 2.2 95%CI 1.1-4.1). Poor school performance has an excess risk of tobacco persistence, independently of other co-variables. The greatest difference in prevalence, using poor school performance as a reference, was observed in those subjects having depressive symptomolgy, with an excessive tobacco persistence of 21.3%. Interventions that foster healthy lifestyles within school environments should be adopted in a comprehensive manner. In addition, students who perform poorly should be considered vulnerable to unhealthy lifestyles. It will therefore be necessary to identify them as high risk subjects and implement interventions among this population, particularly with regard to combatting addictions.

School Tobacco Control Policies Related to Students’ Smoking and Attitudes Toward Smoking: National Survey Results, 1999-2000

The belief that schools can play a powerful role in preventing tobacco use among adolescents has led to the implementation of various tobacco-related policies and practices. This study examines the association between school policies regarding monitoring student behavior, severity of action taken for infraction of policies, and tobacco use by staff, and student smoking behavior and attitudes. Data on students' smoking behavior and attitudes were obtained from the 1999 and 2000 Monitoring the Future surveys of nationally representative samples of 8th-, 10th-, and 12th-grade students. Data on school policies and practices were obtained from administrators in those same schools. Hierarchical analyses using HLM5 were conducted. Strictness of monitoring was significantly negatively associated with daily cigarette use by middle school students. Permitting staff to smoke was significantly positively associated with students' daily cigarette use and negatively with their disapproval of cigarette use. Policy implications are discussed.

School Tobacco Policies in a Tobacco‐Growing State

ABSTRACT: This study examined factors associated with tobacco‐free policies and tobacco cessation in schools serving children in grades 6 to 12 in a tobacco‐growing state using a cross‐sectional telephone survey of school administrators from public and private middle and high schools (N = 691), representing 117 of the 120 Kentucky counties. Trained health department staff contacted 1028 schools; 691 (67%) participated in a phone survey, which lasted an average of 19 minutes. Variables of interest were indoor and outdoor smoking policies, fund‐raising in Bingo halls, provision of cessation and prevention programs, owning or leasing a tobacco base, if the school received money from tobacco companies, type of school (public vs private), and school setting (urban vs rural). Only 20% of Kentucky schools reported comprehensive tobacco‐free policies. Urban area schools were nearly twice as likely to have a tobacco‐free campus than rural schools. Schools that did fund‐raising in smoky Bingo halls were 30% less likely to have tobacco‐free school policies. While few schools had a tobacco affiliation, those that received money from tobacco companies or grew tobacco were nearly 3 times as likely to provide cessation resources, compared to schools without tobacco affiliation. Rural schools were less likely to be tobacco free and provide cessation services. School‐related, off‐campus, extracurricular events might be considered as an element of tobacco‐free school policy. Schools with tobacco affiliation may provide more cessation resources due to the increased prevalence of tobacco use in these areas.

Is there a relation between school smoking policies and youth cigarette smoking knowledge and behaviors?

To comply with workplace legislation, New Zealand schools are required to have policies regarding tobacco smoking. Many schools also have policies to prevent tobacco use by students, including education programmes, cessation support and punishment for students found smoking. This paper investigated the associations between school policies and the prevalence of students' cigarette smoking. Furthermore, we investigated the association between school policy and students' tobacco purchasing behavior, knowledge of health effects from tobacco use and likelihood of influencing others not to smoke. Data were obtained from a self-report survey administered to 2,658 New Zealand secondary school students and staff from 63 schools selected using a multi-stage sampling procedure. Components of school policy were not significantly associated with smoking outcomes, health knowledge or health behavior, and weakly related to a punishment emphasis and students advising others to not smoke. Similarly, weak associations were found between not advising others to not smoke and policies with a punishment emphasis as well as smoke-free environments. The results suggest that having a school tobacco policy was unrelated to the prevalence of tobacco use among students, tobacco purchasing behavior and knowledge of the negative health effects of tobacco.

School Tobacco Policies in a Tobacco‐Growing State

This study examined factors associated with tobacco-free policies and tobacco cessation in schools serving children in grades 6 to 12 in a tobacco-growing state using a cross-sectional telephone survey of school administrators from public and private middle and high schools (N = 691), representing 117 of the 120 Kentucky counties. Trained health department staff contacted 1028 schools; 691 (67%) participated in a phone survey, which lasted an average of 19 minutes. Variables of interest were indoor and outdoor smoking policies, fund-raising in Bingo halls, provision of cessation and prevention programs, owning or leasing a tobacco base, if the school received money from tobacco companies, type of school (public vs private), and school setting (urban vs rural). Only 20% of Kentucky schools reported comprehensive tobacco-free policies. Urban area schools were nearly twice as likely to have a tobacco-free campus than rural schools. Schools that did fund-raising in smoky Bingo halls were 30% less likely to have tobacco-free school policies. While few schools had a tobacco affiliation, those that received money from tobacco companies or grew tobacco were nearly 3 times as likely to provide cessation resources, compared to schools without tobacco affiliation. Rural schools were less likely to be tobacco free and provide cessation services. School-related, off-campus, extracurricular events might be considered as an element of tobacco-free school policy. Schools with tobacco affiliation may provide more cessation resources due to the increased prevalence of tobacco use in these areas.

Implementation of a Smoke-Free Policy on School Premises and Tobacco Control as a Priority Among Municipal Health Promotion Activities: Nationwide Survey in Japan

We conducted a nationwide survey to evaluate the effect of implementing a smoke-free policy in municipalities that forbid teachers to smoke on school premises. Questionnaires were mailed to 3207 municipalities throughout Japan. After we adjusted for population size and the standardized mortality ratio for male lung cancer, we found that assigning a high priority to tobacco control in municipal health promotion activities was significantly associated with implementation of school tobacco-control policies (odds ratio = 1.50, 95% confidence interval=1.24, 1.81).

School Children and Tobacco Addiction: Education and Management of Young Smokers in Public Schools

PURPOSE: Tobacco addiction and comorbidities associated with smoking is an enormous global health problem. According to the Surgeon General's report, tobacco use begins in early adolscence and the average age for initial tobacco use is 14 years. Eighty eight percent of smokers tried the first cigarrette before the age of 18 years. This emphazes the need for early education and intervention among school children.

Smoking in Ontario Schools

Studies in other countries have shown that school tobacco control policy has potential to prevent smoking uptake in adolescents. Since no Canadian research has studied this association, we assessed the statistical link between school tobacco policy and smoking status in Ontario elementary and secondary schools.We conducted secondary analysis of data collected using the School Smoking Profile, a cross-sectional, self-report questionnaire. School policy variables were formed from five survey items concerning students' perceptions of school tobacco control policy. Smoking status was determined through self-report measures which had been validated by carbon monoxide testing. Logistic regression models used school policy variables to explain smoking status in elementary and secondary schools, controlling for school location, school size, and student's grade level.The smoking policy variables, rules and enforcement, explained smoking status after controlling for other variables. In elementary schools, perceptions of stronger enforcement reduced the odds of being a smoker (OR = 0.39, CI99 = 0.34-0.44). In secondary schools, enforcement lost its protective effect (OR = 1.05, CI99 = 1.00-1.10). In addition, student perceptions that rules were strong were indicative of increased smoking in secondary schools (OR = 1.32, CI99 = 1.27-1.37).Strong enforcement of school tobacco control policy appears to be effective in elementary schools but is not as helpful in secondary schools. Secondary school policymakers should consider modifying their sanctions to avoid alienating smokers.

Personal Strengths and Assets Among Adolescents: A Comparison of Smokers and Nonsmokers

There is limited research on the relationship between adolescent smoking and related social and psychological factors, but it is known that adolescent tobacco users are at higher risk for behavioral disorders and substance abuse. Of great interest to those who work in youth tobacco prevention is expanding knowledge about those factors that lead to tobacco use as well as about those that may buffer against its use. This study examined protective factors and personal strengths in 386 adolescents as part of a high school Tobacco Use Prevention Education (TUPE) program funded by the California Department of Education. Multivariate analysis indicated a significant relationship between gender, smoking status, and personal strengths with smokers having lower levels of personal strengths. It is suggested that cessation programs consider smoking within the context of youths’ personal assets and their social support networks. School support services professionals can contribute to youth tobacco prevention efforts by attending to smoking behavior and its correlates when they are involved in assessments, consultation, or direct counseling with students.

Effect of school policy on tobacco use by school personnel in Bihar, India.

This study examined the relationship between school tobacco policies and tobacco use prevalence among school personnel. Two subsets of schools were identified in Bihar, India: Federal Schools (with a tobacco policy), and State schools (without a tobacco policy). Stratified probability samples of 50 schools each were selected. The survey was conducted through an anonymous, self-administered questionnaire. School personnel from State Schools (non-policy schools) reported significantly higher daily cigarette smoking and daily current smokeless tobacco use compared to personnel in Federal schools (policy schools). Teachers in State schools did not teach about health consequences of tobacco, and they had not received training for such teaching. Extent of teaching about health consequences of tobacco varied across topics for teachers in Federal schools. They received negligible training, but more than 35% reported access to teaching materials. More than one-half the personnel from Federal schools knew about their school's policy prohibiting tobacco use among students and school personnel, and about policy enforcement. Personnel in State schools did not know about tobacco control policy in their schools. All school personnel in both types of schools were near unanimous in supporting policy prohibiting tobacco use in schools. The study demonstrated an association between enacting a school policy regarding tobacco use and school personnel's use of tobacco, curricular teaching, and practical training of students. Findings suggest that more extensive introduction of comprehensive school policies may help reduce tobacco use among school personnel.

Passage of 100% tobacco-free school policies in 14 North Carolina school districts.

Though comprehensive tobacco-free school policies constitute an important component of state tobacco control efforts, little research exists about their adoption process. In the past two years, efforts occurred in North Carolina to increase the number of school districts adopting 100% tobacco-free school policies. As part of the North Carolina Youth Empowerment Study (NC-YES), researchers developed a school tobacco policy interview guide to conduct interviews with 40 key people (e.g., school board member, principal, etc.) in each of 14 school districts that adopted a 100% tobacco-free school policy by the end of 2001. Results showed seven districts adopted their school policy in the past two years. Seven themes emerged: 1) Catalysts: Local adult and youth "champions" facilitated policy change; 2) Process of Adoption: Most school policies were adopted with an administrator or other adult initiating the change, but youth involvement increased in recent years; 3) Methods of Adoption: Advocates personalized health concerns by focusing on children and role modeling by adults; 4) Political Leadership: Governors of North Carolina, through letters to school districts and a policy summit, played an important role in stimulating policy change; 5) Barriers to Adoption: Concerns expressed before policy adoption, about teacher attrition or inability to enforce the policy, did not occur as feared; 6) Enforcement Issues: A key to policy enforcement involved being consistent, supportive, and firm; and 7) Economics of Tobacco Farming/Manufacturing: Though a local tobacco economy did little to influence policy adoption, districts that adopted policies were not located in counties with heavy tobacco production. Public health advocates may use this information to encourage school districts to adopt 100% tobacco-free school policies.