DOCUMENT RESUME ED 206 602 SP 018 840 AUTHOR Ellis, Bernard H., Jr., Ed.: And Others TITLE Smoking Programs for Youth. TNSTITOTION National Cancer Inst. (NM, Bethesda, Md. REPORT NO NH-80-2156 POE DATE Jun 80 NOTE 103p. EDRS PRICE MF01/PC05 Plus Postage. r2SCR/PTORS *Adolescents: Attitude Change: *Curriculum Development: Decision Making: *Health Education: Life Style: *Program Development: Role Models: Secondary Education: *Smoking: *Sociocultural Patterns: Teacher Role ABSTRACT The youth smoking problem is discussed and assistance is provided for teachers in developing smoking prevention and cessation programs. Four chapters serve as guides to understanding and working with the youth smoking problem. "Teenage Smoking in America" reviews trends in teenage smoking behavior and the factors that influence the initiation of smoking. "Approaches to Smoking in Schools: Regulation and Education" reviews the historical approaches to combating the teenage smoking problem. "How to Develop a School Smoking Program" suggests procedures for initiattug smoking education programs in curriculum development. "Current Smoking Education Programs" describes several innovative smoking education progress. The appendix presents information on additional resources, rssource organizations, and contemporary texts on school health education. (J N1 *********************************************************************** Reproductions supplied by !DRS are the best that can be made from the original document. *********************************************************************** SMOKING PROGRAMS FOR YOUTH U 8 DEPARTMENT OF tOUCATION NATIONAL INSTITUTE OF EDUCATION EDLCATIONAL RESOURCES INFORMATION CENTER JERI° This document has been reproduced as received from the mason or organization unginating It Minor changes have been made to improve reproduction quality Points of view o- opinions stated In this docu ment do not necessarily represent official NIE position or policy U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES* Public Health Service National Institutes of Health National Cancer Institute Bethesda, Maryland 20205 NIH Publication No. 80-2156 June 1980 *formerly the U.S. Department of Health, Education, and Welfare. 2 The following organizations have endorsed Smoking Programs for Youthand/or have provided promotional and distribution assistance: American Association of Elementary School Principals American Association of School Administrators American Association of Secondary School Principals American Cancer Society American Heart Association American Lung Association Boys' Clubs of America Girls' Clubs of America National Association of School Nurses National Interagency Council on Smoking and Health Society of State Directors of Health, Physical Education and Recreation United States Catholic ConferenceDepartment of Education YMCA YWCA z Smoking Programs for Youth was produced by the Office of Cancer Communications National Cancer Institute Bethesda, Maryland 20205 Edited by Bernard H. Ellis, Jr. Doris Indyke Nancy M. Debevoise Table of Contents Page PREFACE vii ACKNOWLEDGEMENTS ix Chapter 1:TEENAGE SMOKING Lq AMERICA 1 The Problem ' 1 Teenage Smoking Trends 2 Predictors o: Smoking Behavior 4 Age and Sex 5 School Environment 5 Peer Pressure 6 Advertising 7 Family Influences 7 Socioeconomic Influences 7 Individual Characteristics 8 Chapter 2:APPROACHES TO SMOKING IN SCHOOLS: REGULATION AND EDUCATION 9 Regulations and Policies 9 National, State, and Local Mandates on School Smoking 10 Policy Statements 10 State Laws 10 State Education Policies 11 School Smoking Regulations 11 Current School Smoking Regulations 13 Strict Smoking Prohibition Programs 13 Designated Smoking Area Programs 13 Regulation Combined with Education Programs 13 Education 15 School Health Education 15 Evolution of Health Education 15 State Health Education Mandates 15 Teacher Training 16 Approaches to Smoking Education 18 Past Approaches 18 Current Approaches 19 Chapter 3:HOW TO DEVELOP A SCHOOL SMOKING PROGRAM 21 Teacher as Role Model 21 Developing a Supportive Environment 23 Integrating Smokhig and Health into Existing Courses 23 Smoking Education Modules 24 A Comprehensive Smoking Education Program 25 Developing a Plan for a Comprehensive Smoking Education Program. 25 4 iii Page Identifying Interested Groups and Individuals 25 Convening the Working Group and Approaching Decision-Makers 26 Localizing Problems and Goals 26 Developing the Program Plan 27 Hypothetical Example of a Smoking Education Plan 27 Submitting the Plan for Approval 29 Implementing the Smoking Education Program 2 Program Evaluation 29 Reasons for Evaluation 30 "Process" and "Outcome" Measures 30 Long-Term Evaluation 31 Comparative Analysis 32 Chapter 4:CURRENT SMOKING EDUCATION PROGRAMS 33 Yolith-Coordinated Projects 35 Youth Gives a Damn 36 Youth Board 38 Other Youth-Coordinated Projects 39 Illustration of Immediate Effects of Smoking 40 Biofeedback 41 Other Projects that Demonstrate the Immediate Effects of Smoking 43 Youth-to-Youth Teaching 44 Students Teaching Students 45 Project CLASP 47 Other Youth-to-Youth Projects 49 Lifestyle Education 50 Life Skills Training 51 Sunflower Project 53 Other Lifestyle Education Programs 55 Health Hazard Appraisal 56 Know Your Body 57 Other Health Hazard Appraisal Programs 58 Health Education Curricula With Smoking Components 59 Chicago Heart Health Curriculum Program 60 Primary Grades Curriculum Project 63 School Health Curriculum Project 66 An Early Start to Good Health and ACS Health Network 68 Other Curricula and Curricula-Support Materials 71 Smoking Cessation Programs 73 5 Page Teenage Health Program on Smoking 74 Smoking Cessation Clinics for High School Students 76 Other Cessation Projects 78 Smoking Cessation Programs Offered to Students Violating School Smoking Regulations 79 CONCLUSION 81 APPENDIX 83 Additional Resources 83 Resource Organizations 85 Contemporary Tests on School Health Education 86 REFERENCES 89 e V Preface Smoking Programs for Youth is the result of numerous requests from teachers, school administrators, health professionals, and parents who had read The Smoking Digest (published by the National Cancer Institute in 1977), and who indicated the need for a companion document devoted to youth. The Office of Cancer Communications began work on Smoking Programs for Youth in the summer of 1978. Since then, the document has undergone numerous revisions, partly stimulated by the release of Smoking and Health: A Report of the Sur- geon General (1979), Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention (1979), and Teenage Smoking: Immedia, e and Long-Term Patterns, the most recent survey of teenage smoking behavior released by the National Institute of Education in November 1979. Healthy People emphasizes what many scientists, health professionals, and public officials believe about the improvement of health in the United States; namely, that the factors which contributed to health improvement in the past greater food production, improved sanitation, and advances in medical technologywill have only marginal impact in the future. The next "break- through" in health improvement in the United States will come when there is widespread acceptance of the role indiviluals must play in safeguarding their own health, as well as a greater understamang of the specific actions that can be taken. The acceptance of personal responsibility in the areas of diet, exercise, al- cohol and drug use, stress management, and regular examinations for the early detection of disease is extremely important. However, one personal-choice be- haviorcigarette smokinghas consistently and unequivocally been identified as the leading preventable cause of death and disability in the United States. Most smoking-related diseases (cancer, heart disease, emphysema, chronic bronchitis, and others), once they have advanced to the detectable stage, have already done much damage. Although medical professionals can attempt to re- 4.;14ce the impact of these diceaseb, death and disability from smoking-related illnesses can be expected to increase unless individuals make the firm decision to avoid the smoking habit entirely, or abandon it early. The most appropriate place to begin the educational procesi to encourage nonsmoking is in elementary and secondary schools, before most people have initiated the smoking habit. Smoking Programs for Youth is intended to be an action-oriented document, one that will provide information necessary to under- stand the youth smoking problem and to stimulate decision-makers to develop smoking prevention and cessation programs. The document is divided into four sections: 1.Teenage Smoking in America. -This chapter reviews trends in teenage smoking behavior, and the major factors that influence the initiation of smok- ing. 2. Approaches to Smoking in Schools: Regulation and Education. The his- < torical approaches to combating the teenage smoking problem are discussed as well as the characteristics of more promising approaches in use today. 3. How to Develop a School Smoking Program.Chapter 3 suggests proce- aureb fcr initiating smoking education programs, ranging from easily under- taken projects through comprehensive curriculum development. 7 vii V 1. 4.Current Smoking Education Programs.The final section reviews in de- tail numerous innovative smoking education programs which have been pilot- tested and can be considered for adoption by interested school districts. This document is intended to bridge the gap between the