Tobacco Policy Policy Development Checklist

Rhode Island School District Tobacco Self-Assessment Tool School District: ______

I. Policy Yes Somewhat No 1. Does the school district policy related to tobacco: a. Explain the Intent of the Policy?    b. Contain a clear Rationale for the policy, focusing on reducing health and academic risks related to tobacco?    c. Specify that it is consistent with state and local laws? d. Prohibit students from possessing or using tobacco: i. in school facilities?    ii. on school grounds?   iii. in school vehicles?    iv. at school functions off school property?   

 e. Prohibit staff from using tobacco: i. in school facilities?    ii. on school grounds?   iii. in school vehicles?    iv. at school functions off school property?   

 f. Prohibit visitors, including contractors, from using tobacco: i. in school facilities?    ii. on school grounds?   iii. in school vehicles?    iv. at school functions off school property?   

 g. State that this prohibition applies 24 hours a day, 365 days a year?    h. Include provisions for swift, consistent and equitable enforcement?    i. Clearly identify consequences for violation for students, staff and visitors. j. Emphasize helpful consequences (i.e., education, counseling, community service, or referral to cessation services) rather than solely    punitive consequences? k. Identify roles and responsibilities of those who will be involved in

Rhode Island School District Tobacco Self-Assessment Tool enforcement?    l. Prohibit tobacco advertising and promotional items (e.g., on signs, T-shirts, sponsorship of school events) in school buildings, at functions, or in school publications?    m. Include a rejection of funding from the tobacco industry for any school-related operations, programs or events?    n. Require that all students receive comprehensive, standards-based    instruction in avoiding tobacco use? o. Contain clear procedures for communicating policy to those affected by it including students, staff, parents and visitors?    p. Provide access to cessation programs for students using tobacco?    q. Provide access to cessation programs for staff using tobacco?    r. Address family and community involvement in tobacco prevention?    s. Address coordination with community and media tobacco prevention programs? t. Address staff preparation and professional development in order to    implement all aspects of the policy? u. State when and how the policy will be evaluated and revised?   

Comments:

II. Policy Implementation Yes Somewhat No 2. Is there someone at the district level in charge of monitoring & enforcing the tobacco policy?    Name or position______3. Is there someone at the school level in charge of monitoring & enforcing the tobacco policy, in each school in the district?   

4. Are your tobacco-related policies effectively communicated to students, staff, parents and visitors through a variety of means such as signs posted in visible places, written statements in student and faculty handbooks, pamphlets, and staff announcements?   

5. Is the school tobacco-free policy consistently and equitably enforced: a. With students?    b. With staff?   c. With visitors?   

Rhode Island School District Tobacco Self-Assessment Tool 

6. Do ____ consistently comply with the school tobacco-free policy? a. Students?    b. Staff?   c. Visitors?   

7. Are students in violation of the tobacco use policy consistently offered help (i.e., education, counseling, or referral to cessation) rather than solely punitive consequences?   

8. Are out-of-school suspensions avoided or used only as a last resort?   

9. How many suspensions were there in the district during the last school year? a. Out-of-school ______b. In-school ______c. Alternate placements ______Comments:

Rhode Island School District Tobacco Self-Assessment Tool III. Curriculum Yes Somewhat No 10. Does the tobacco prevention education curriculum…?    a. Align fully with Health Literacy for All: The Rhode Island Health Education Framework?    b. Introduce tobacco prevention messages in elementary school, intensify them in middle/junior high school, and reinforce them in high school?    c. Use age- and developmentally-appropriate material?    d. Include evidence-based tobacco prevention curricula, such as those identified by the Substance Abuse and Mental Health Services Administration (SAMHSA), at the middle school level?    e. Teach about the short- and long-term physiological, legal, social, economic, and cosmetic consequences of tobacco use?    f. Decrease the acceptability of tobacco use?    g. Address the reasons why people might or might not use tobacco?    h. Counteract student overestimates of how many of their peers use tobacco?    i. Instruct how to find valid information and services related to tobacco?    j. Teaches how to recognize and respond appropriately to social influences on tobacco use, including media, family, peers, and culture?    k. Develops skills related to not using tobacco (e.g., communication, assertiveness, goal-setting, problem-solving, and decision-making skills)?    l. Cover addiction and brain chemistry?    m. Focus on secondhand smoke and the importance of a tobacco-free environment, as well as skills to cope with tobacco use by parents and other family members?    n. Specifically cover smokeless tobacco?    o. Cover other important issues, such as strategies tobacco manufacturers use to influence young people, substances in tobacco products, effects on athletic performance, effects on fetal development, laws and policies governing the sale and use of tobacco?   

Rhode Island School District Tobacco Self-Assessment Tool p. Teach skills for supporting others who abstain from or want to quit using tobacco?    q. Include school and community action to support a tobacco-free environment?   

Comments:

Rhode Island School District Tobacco Self-Assessment Tool IV. Instruction Yes Somewhat No 11. Are a wide variety of instructional methods including direct instruction, modeling, and rehearsal used to help students develop    tobacco specific knowledge, attitudes and skills? 12. Is the tobacco instruction integrated as part of comprehensive health instruction within the broader school health program?   

13. Are tobacco-use prevention concepts integrated into the instruction of the other subject areas?   

14. Are trained peer educators/leaders assisting with the classroom instruction?   

15. Does your school regularly involve community agency staff as guest speakers?   

16. Does tobacco prevention instruction engage family members as partner’s in students’ education and promote discussions at home?   

17. Is tobacco prevention instruction coordinated with the Great American Smokeout, Kick Butts Day, or other events?   

18. Is tobacco-use prevention coordinated with tobacco programs or education in the community?   

Comments:

V. Staff Preparation Yes Somewhat No 19. Are funds allocated and/or release time provided to support professional development for teachers of health on tobacco education, curricula, programs, cessation, and policies? 20. Does your district provide training or other staff development for all teachers and other school staff who provide tobacco instruction which… a. Helps them understand the theory and model underlying the specific    curriculum? b. Includes a review of the entire program or curriculum and rationale for    including each part?    c. Models and helps staff practice instructional activities? 21. Do all students who teach other students about tobacco (peer

Rhode Island School District Tobacco Self-Assessment Tool educators) participate in training specific to curriculum or program?   

22. Are all school staff provided information and training on enforcement of the district tobacco policy?   

23. Are all school staff provided information and training on the district tobacco policy and their responsibilities pertaining to it?   

Comments:

VI. Family & Community Involvement Yes Somewhat No 24. Were parents or families involved in developing school tobacco programs, policies, and procedures?   

25. Were youth involved in developing school tobacco programs, policies and procedures?   

26. Are families encouraged to reinforce anti-tobacco messages at home and to maintain tobacco free homes and vehicles?   

27. Does your school provide parent education on tobacco use prevention, smoking cessation resources, and parent/child communication?   

Comments:

VII. Tobacco Cessation* Yes Somewhat No 28. Does your school offer tobacco-use cessation services at school for students?   

29. Does your school refer students to tobacco-use cessation services in the broader community?   

30. Does your school offer tobacco-use cessation services at school for school staff or refer to services in the broader community?   

Comments:

Rhode Island School District Tobacco Self-Assessment Tool VIII. Tobacco Prevention Programs Yes Somewhat No 31. Do schools in your district conduct activities to promote a tobacco free lifestyle – such as activities around Kick Butts Day or the Great    American Smoke Out? 32. Are there any active groups or clubs run by students with tobacco use prevention & reduction as one of their main goals? (e.g. TATU - Teens    Against Tobacco Use)? 33. Is the school district working with the local Substance Abuse Task Force on tobacco prevention activities?   

34. Are you working with any other organizations on tobacco prevention activities (e.g. Rhode Island Student Assistance Services, American Cancer Society, American Lung Association, Asthma Coalition, local law enforcement)?   

Comments:

IX. Evaluation Yes Somewhat No 35. Does your school regularly and systematically assess the effectiveness of its tobacco-related policies?   

36. Does your school regularly and systematically assess the effectiveness of its tobacco curriculum and instruction?   

37. Does your school regularly and systematically assess the effectiveness of the tobacco use prevention staff development trainings?   

38. Does your school regularly and systematically assess the effectiveness of its referrals for tobacco use cessation programs for students?   

Comments:

Rhode Island School District Tobacco Self-Assessment Tool Parts of this self-assessment tool were adapted from: o Utah Tobacco Prevention & Control Program. A School’s Guide to Comprehensive Tobacco Control. o North Carolina Tobacco Free Schools. Assessment Tool for Becoming a Tobacco Free School. o Centers for Disease Control & Prevention. Guidelines for School Health Programs to Prevent Tobacco Use. o National Association of State Boards of Education. Fit, Healthy & Ready to Learn.

Rhode Island School District Tobacco Self-Assessment Tool