Tobacco-free School Research Articles

Compliance to the tobacco-free educational institution policy (ToFEI study) in urban areas of selected districts of Karnataka: A situational analysis

BackgroundYouth smoking is a major concern as the average age at which people start smoking has been declining in recent years. Strengthening tobacco control policies at educational institutions (EI) will prevent the access to tobacco products for minors. The current study aims to assess teacher’s knowledge and compliance to tobacco-free-educational-institution (ToFEI) policy. MethodsFour districts of a south Indian state were chosen for the study. A face-to-face interview with approximately 50 head teachers from respective districts was carried out by a trained interviewer to assess the compliance to ToFEI guidelines. The shops within 100 yards of EI were visited to confirm the sale of tobacco using geographic information system. ResultsA total of 234 EI were surveyed, of which 79 (33.8%) institutions had ‘tobacco-free institution’ board. A display board prohibiting tobacco sale within 100 yards of school was present in 175 (74.8%) institutions. A total of 733 shops were found around 195 EI and of them, 9.7% (71/733) shops were selling tobacco products. ConclusionDespite the existence of tobacco-free school guidelines in India, there was a lacunae in compliance with provisions of guidelines among various EIs across Karnataka state. With nearly one-fifth of institutions having shops that sell tobacco within 100-yard of institutions, further laxity in implementation of tobacco control activities can be a threat and can lead to easy availability of tobacco products and attract more students to use the lethal products.

Adherence to the National Tobacco-Free School Policy in Selected Schools of Puducherry District in India: A Cross-Sectional Exploratory Study.

The objective of this study was to estimate the level of compliance and the factors associated with high adherence to the Tobacco-Free Educational Institutions (ToFEI) guidelines of the Government of India among schools in the district of Puducherry, India. This cross-sectional study was conducted among schools (N=50) in the Puducherry district in 2021-2022 using a "Self-Evaluation Scorecard" of the ToFEI guidelines. The assessment was done through in-person interviews with the schools' heads/representatives. The level of compliance to indicators was presented as proportions, and factors associated with high compliance were assessed using the chi-square test. No school met all the ToFEI indicators. The majority (88%) showed no evidence of the use of tobacco products inside the premises. More than half of the schools (58%) adhered to the criteria of not having tobacco shops within 100 yards and 56% reported the inclusion of the "No Use of Tobacco" norm in their guidelines. Schools located in rural areas (p-value <0.01) and those with teachers who attended any tobacco-related workshop were more likely to comply with the ToFEI indicators (p-value 0.05). After relaxing the criteria for 'High Adherence' to at least four indicators, we found that 20% of schools showed high adherence to the ToFEI indicators. Overall compliance of schools to the ToFEI guidelines is low in Puducherry. Sensitizing the relevant stakeholders in the district for implementing ToFEI guidelines and institutionalizing tobacco control activities in the school are the needs of the hour.

Knowledge, perception, and practices of teaching and nonteaching staff members regarding tobacco use surveillance before and after implementing the Tobacco-Free School Program: A serial cross-sectional study

Abstract Aims and Objectives: The present study assessed the knowledge, perceptions, and behaviors related to tobacco use surveillance among both teaching and nonteaching staff members before and after implementing the “Tobacco Free School” intervention. This initiative targeted establishing tobacco-free environments, specifically in Marathi medium-high schools within the Pimpri-Chinchwad Municipal Corporation, Pune District, Maharashtra, India. Materials and Methods: Data for the serial cross-sectional study were gathered using a validated questionnaire administered to teaching and nonteaching staff members at these schools at baseline and follow-up. The intervention was conducted in three schools between June 2019 and September 2020. The number and percentage for each question concerning knowledge, perception, and practice were calculated with a confidence interval of 95% and a P value of &lt;0.05 considered significant. The McNemar test was employed to assess whether there was a significant difference between pre- and post-study results. Results and Discussion: Ninety percent of teachers demonstrated awareness of the law. Familiarity with two specific sections of Cigarettes and Other Tobacco Products Act 2003: Sections 4 and 6 showed a 39% difference in knowledge acquired between pre- and post-study results. Staff members were better aware of the tobacco vendors setting up shop outside the educational institution post-survey (P = 0.03). Conclusion: Staff members learned about tobacco products’ content, ill effects, and better-perceived tobacco control. Based on the respondent’s reply (61%) on the presence of tobacco vendors within 100 yards, the offending vendor’s picture was uploaded on the “Tobacco Monitor App” so that prompt action could be initiated by the State Tobacco Control Cell.

Implementation of tobacco-free school policies: A study protocol for a randomized controlled trial

Implementation of tobacco-free school policies: A study protocol for a randomized controlled trial

Community-Based Qualitative Study to Identify Challenges in Implementing Health Promoting Schools Framework in Government Schools of Khordha District, Odisha, India.

The WHO asserts every school should be a Health Promoting School (HPS) and laid a framework. The WHO is constantly working on expanding the number of schools modelled on it. The status of the level of health promotion needs to be explored to understand the local issues to identify key priority areas for policy making towards positive health. The study aims to explore the challenges in implementing the HPS framework in Government-run schools in Odisha. Method: A qualitative study was conducted with grounded theory using an inductive approach. In-depth interview was done among nine teachers from six government schools in the Khordha district who were selected through purposive sampling. A semi-structured open-ended interview was conducted using an interview guide among school science teachers and principals (n=9) regarding the challenges in implementing the HPS framework. Codes were generated from the transcript using the inductive approach from the WHO-HPS framework. Thematic analysis by Braun and Clarke model was using Quirkos software. Five themes with 12 codes were identified with the transcript. The respondents had little knowledge about the WHO-HPS framework. Their perception of health promotion was restricted to organizing health camps for school children. The themes were School health policy (inconsistent teachers recruitment policy, partial implementation of tobacco-free schools, outdated science syllabus),Coordination with the local community, Healthy school needs (lack of interactive and repetitive health-related training for school teachers, first aid box in schools and lack of supplementation of micronutrients like WIFS), Sanitation (inadequate funding for maintenance of sanitation) and an emerging issue of increased use of social media were reported in our findings. Conclusion: Our findings suggest that implementation of health-promoting schools requires imparting the skills to teachers by orientation and expanding the existing health services, backed with adequate funding and a firm policy commitment at the state level.

Compliance to the Tobacco-Free Educational Institution(ToFEI) guidelines at Madhyamik Vidhyalayas of Pimpri-Chinchwad, Pune, Maharashtra-A cross sectional study

IntroductionRevised guidelines for Tobacco-Free Educational Institutes (ToEFI) were laid down in 2019 and they provide for tobacco free environment leading to a healthy life, implementation of legal provisions, and recognition about various approaches available for tobacco cessation. ObjectiveTo assess Madhyamik Vidyalays (MVs) for their compliance to the guidelines for ToFEI at the baseline using self-evaluation score card as part of operational research. Material and methodA cross sectional study was carried out during March 2021 among 19 MVs of Pimpri-Chinchwad block in Pune District, Maharashtra using census sampling. Trained data collectors scored for all 9 ToFEI criteria including the mandatory one's and their weightage points were calculated. Results and discussionEight {42%(0.21–0.64)} MVs had displays on tobacco-free area and awareness on the harms of tobacco displayed inside the premises and another three (16%(0.04–0.37)} had only the display of ToFEI signage at their boundary wall. No MV met with 4 or more criteria out of the total 9 criteria. The highest weightage of 29–30 out of 100 was achieved by only 2 {11%(0.01–0.30)} MVs and 5 {26%(0.10–0.49)} MVs achieved 0 points. No significance was given to tobacco free school probably because of untrained teachers and unawareness of the guidelines. ConclusionThis study demonstrates that minimal importance has been given to the revised ToEFI guidelines in making MVs tobacco-free. Hence, none of the them could attain the tobacco-free status.

Components in tobacco-free school policies—A coding tool for assessment

Objective To develop an instrument to examine tobacco-free campus policy components. Participants Missouri two- and four-year, specialized/technical, and religious colleges and universities (N = 76). Methods: The instrument was informed via literature review and expert interviews. Coder agreement was strong (κ = .80). Qualitative policy language examples were identified. Results Model policy components including consideration for population, prohibited products, location restrictions, enforcement, consequences, promotions, communications, cessation, designated smoking areas and exemptions; comprehensive policies included all populations, for all tobacco products, and at all locations on the campus. Nineteen campuses had comprehensive tobacco-free policies, five had comprehensive smoke-free policies (cigarettes and e-cigarettes), and no policy included all model components. Fifty-two were non-comprehensive. Conclusions This instrument can allow campuses to identify components for comprehensive and model tobacco-free campus policies and assist officials in improving policy language. Future research can use this instrument to examine the effectiveness of components and their impact on tobacco use outcomes.

An observational study of compliance with tobacco-free school guidelines in Udupi district, Karnataka (India)

Background: National tobacco-free school guidelines were introduced in India in 2009. We assessed compliance with these guidelines across both government, government-aided, and private schools in Udupi district of Karnataka state in India. Methods: We visited 915 upper primary and high schools across Udupi district and used a standardized checklist for visual inspection of the school environment and interviews with a school representative to ascertain compliance with guidelines (display of a tobacco-free school/institution board, presence of no smoking signage, no tobacco sale within 100 yards, presence of a Tobacco Control Committee, integration of tobacco control activities into the school health program, and availability of a copy of Cigarettes and Other Tobacco Products Act). Results: A tobacco-free school board was displayed at the main entrance of 73% of schools, and there was no evidence of tobacco products on sale within 100 yards of 96% of schools. However, only 5% of the schools reported having the Committee; 4% reported having a copy of the Cigarettes and Other Tobacco Products Act, 2003 with the school, and no smoking signage was observed in &lt; 1%. Integration of tobacco control activities into the school health program was reported in 91% of schools. Conclusions: Compliance with tobacco-free school guidelines in Udupi was far from complete, indicating the need for enhanced implementation and monitoring.

Development and Validation of a Comic Tool: An Innovative Approach to Raise Awareness about Tobacco Control among School Teachers.

National legislation (COTPA) in India has focused on school children with dedicated section (6a and 6b) for tobacco control at Educational Institutions. Innovative mediums like Comic offer unique and engaging medium for dissemination of health information. However, its true potential remains unexplored in tobacco control. The study was conducted to develop and validate Comic for promotion of tobacco control laws in school settings. The present cross-sectional study was conducted among school teachers in Delhi in three phases: (1) need assessment, (2) development of Comic, and (3) validation (face/content validity by experts in public health/tobacco control, and construct validity by school teachers). Ethical clearance was obtained from Institutional Ethical Review Board. Prevalidated, structured, close-ended, and self-administered Questionnaire was used for the data collection. SPSS version 21 was used for descriptive and inferential results. Phase 1 showed, out of 150 school teachers, 121 participated (80.66%). Mean age and teaching experience was 41.85 ± 9.76 years and 10.35 ± 6.53 years, respectively. Overall awareness about COTPA was 47.9% (n = 58) and COTPA sections 4 and 6 were 37.2% (n = 45). Majority 59.5% (n = 72) reported lack of access to training material. Phase 2 and 3 showed overall content validity index (CVI) score of 0.84. Construct validity evaluation from pre-postintervention yield mean ± SD scores of 3.94 ± 0.99 and 7.97 ± 1.17, respectively, (P < 0.001). Comic was developed on sound theoretical basis with satisfactory face, content and construct validity, to raise awareness about tobacco control among school children, and teachers to promote tobacco-free school.

Tobacco legislation perception and barriers: A qualitative insight towards tobacco free schools in Delhi, India

Tobacco legislation perception and barriers: A qualitative insight towards tobacco free schools in Delhi, India

Testing the effectiveness of a teacher-training intervention for tobacco-free schools (TFS) in five districts in the state of Maharashtra, India: Results from a quasi-experiental post-only study

Testing the effectiveness of a teacher-training intervention for tobacco-free schools (TFS) in five districts in the state of Maharashtra, India: Results from a quasi-experiental post-only study

Advocacy campaign to achieve 100% tobacco-free (government) schools in Maharashtra state in India

Advocacy campaign to achieve 100% tobacco-free (government) schools in Maharashtra state in India

Achievement of tobacco free schools in India and its role in preventing tobacco initiation among adolescents

Achievement of tobacco free schools in India and its role in preventing tobacco initiation among adolescents

Capacity building of teachers: A key to success of Tobacco Free School campaign

Capacity building of teachers: A key to success of Tobacco Free School campaign

Monitoring of tobacco free schools through smart phones

Monitoring of tobacco free schools through smart phones

Socio-demographic profile of tobacco consuming students in age group of 15 to25 years in Jammu region

Introduction: Consumption of tobacco leads to a myriad of ill effects among the smokers as well as those in their proximity. This study was conducted in the population in the age group of 15-24 years, the vulnerable period of life when most of health-related behaviours develop. Materials and Methods: 1.Study design: Cross- sectional study. 2. Participants: 300 students; 75 each from Schools, degree colleges, professional colleges and post graduate departments of University of Jammu, in the age group of 15- 24 years belonging to different regions of Jammu, Kashmir and Ladakh. 3. Sampling: Stratified Systemic Sampling technique. 4. Study instrument: A subset of key questions from Global Adult Tobacco Survey (GATS) 2nd edition. Results: Prevalence of smoking was 11.33%. Non indulgence in smoking was seen among students aged below 16 years, and was seen to be twice among over 20 years (16.77%) as compared to 17-19 years group (9.37%). Among male students, it was ten- times (20.66%) higher than females (2%). It was higher in government than in private institutions (13.33% vs. 9.33%). Prevalence of smokeless tobacco consumption was 2%; 3.35% in ?20 years age group, 1.04% among 17-19 years and nil among ?16 year age. Male to female ratio was 5 to 1. Ratio of prevalence in Private institutions to government institutions was more than 3 to 1. Conclusion: There is an urgent need to curb the use of tobacco among the sub-groups of students with higher prevalence. This can be achieved by strengthening political and administrative will, implementing tobacco free school guidelines and establishing effective multi-sectoral coordination, as tobacco control is beyond the scope of health department. Keywords: Framework Convention for Tobacco Control, Global Adult Tobacco Survey, Non Communicable Diseases.

Adherence to the tobacco-free educational institution guidelines at schools of Raipur Rani, Haryana.

Tobacco-Free Educational Institution (ToFEI) guidelines are required to be followed by the schools. This cross-sectional study conducted in the year 2019 assessed the accordance with ToFEI guidelines among all the 84 schools of Raipur Rani educational block, Haryana. Investigators collected data from all the government (71) and private (13) schools during school working days. Tobacco sales within 100 yards of the school premises was covertly observed. None of the schools thoroughly complied with the tobacco-free school policy, though the compliance score for private schools (26.77 ± 19.15) was better than the government schools (13.65 ± 4.38). Only two private schools achieved the mandatory score of 50. All private schools and few government schools (42.3%) had successfully implemented the ban on tobacco sale within 100 yards of the school. None of the schools could achieve a ToFEI status in the present study. The policymakers and implementers should prioritize ToFEI agenda & support schools in achieving tobacco-free status.

Implementing Prevention against Tobacco Dependence (PAD) ”Toward the Tobacco-Free Schools, Neighborhoods, and Cities": Study Protocol

Introduction: Although tobacco consumption in Iran has decreased in recent years, in 2010, the exposure to cigarette smoke was the fifth leading risk factor for death in Iran. This article is presenting the protocol for the prevention against tobacco dependence (PAD) project, an initiative planned and implemented by the Iranian Anti-Tobacco Association (IATA) of Iran in the city of Varamin. Study design: A prospective cohort study. Methods: This project is carried out based on a participatory community-oriented approach and an action research method. It includes four inter-related, prospective studies phases; pilot, tobacco-free school (TFS), tobacco-free neighborhood (TFN), and tobacco-free city (TFS). The measuring tools for each phase were designed primarily using CDC and WHO guidelines and preliminary details were identified. Each phase is a combination of different methods (including systematic observation, questionnaire, heuristic interview, and structured interview). The studies will examine twelve goals and meet 9 project objectives in a comprehensive evaluation of ongoing progress with TFS, TFN, and TFC. Discussion: This project seeks to achieve indicators of tobacco-free schools, neighborhoods, and cities through direct and indirect education of all the target groups in the community. Participation of stakeholders and supporters in problem-solving can increase the effectiveness and influence of the project. The outcomes of the first two phases will be expanded to the wider settings.

Implementing Prevention against Tobacco Dependence (PAD) "Toward the Tobacco-Free Schools, Neighborhoods, and Cities": Study Protocol.

Background: Although tobacco consumption in Iran has decreased in recent years, in 2010, the exposure to cigarette smoke was the fifth leading risk factor for death in Iran. This article is presenting the protocol for the prevention against tobacco dependence (PAD) project, an initiative planned and implemented by the Iranian Anti-Tobacco Association (IATA) of Iran in the city of Varamin. Study design: A prospective cohort study. Methods: This project is carried out based on a participatory community-oriented approach and an action research method. It includes four inter-related, prospective studies phases; pilot, tobacco-free school (TFS), tobacco-free neighborhood (TFN), and tobacco-free city (TFS). The measuring tools for each phase were designed primarily using CDC and WHO guidelines and preliminary details were identified. Each phase is a combination of different methods (including systematic observation, questionnaire, heuristic interview, and structured interview). The studies will examine twelve goals and meet 9 project objectives in a comprehensive evaluation of ongoing progress with TFS, TFN, and TFC. Discussion: This project seeks to achieve indicators of tobacco-free schools, neighborhoods, and cities through direct and indirect education of all the target groups in the community. Participation of stakeholders and supporters in problem-solving can increase the effectiveness and influence of the project. The outcomes of the first two phases will be expanded to the wider settings.

Empowering teachers to implement tobacco free school campaigns in schools

Empowering teachers to implement tobacco free school campaigns in schools