Summary
Tobacco, despite its legal status, has become increasingly recognized as a dangerous substance. The U.S. Centers for Disease Control (CDC) cites tobacco use as the leading cause of preventable death in the United States (CDC, “Guidelines for School Health Programs to Prevent Tobacco Use and Addiction”). In this literature review, tobacco use refers to any use of any nicotine-containing tobacco product, i.e., cigarettes, cigars, smokeless tobacco, and electronic cigarettes.
According to the CDC, serious negative health consequences are attributable to tobacco use, impacting the whole body, including the circulatory, respiratory, and reproductive systems, as well as being linked to a number of forms of cancer. Approximately one-half million Americans die prematurely from actively using or second-hand smoke from tobacco products each year, leading to a significant public health problem.
The financial burden attributed to smoking and second-hand smoke is estimated to be $300 billion annually. On a positive note, a decline in tobacco use has been noted among youth in states that have invested in tobacco control programs. In New York State, between the years 2001 – 2010, a state-endorsed tobacco control program reported declines in smoking among youth, with a resulting decrease in health care expenditures in 2010 (CDC, Best Practices for Comprehensive Tobacco Control Programs: 2014).
According to the CDC, “Each day in the United States, more than 3,200 youth aged 18 years or younger smoke their first cigarette, and an additional 2,100 youth and young adults become daily cigarette smokers” (CDC, “Youth and Tobacco Use”). In response, in my literature review, I will discuss prevention programs used to prevent tobacco use among youth. I will also include information about initiatives that states and schools have taken to help address this issue. Although in its 1994 “Guidelines for School Health Programs to Prevent Tobacco Use and Addiction,” the CDC states that schools are “ideal settings in which to provide [tobacco use prevention programs],” the success of such programs is highly dependent on support at community, state, and national levels (CDC, “Guidelines for School Health Programs to Prevent Tobacco Use and Addiction”).
Introduction
Learning institutions are in a better position to fight the use of tobacco products among young people. Children spend a considerable share of their time in school. As a result, they acquire smoking behaviors from their peers in school (Goldstein et al.). Over 80% of adult smokers claim that the practice originated in school. Research conducted in American schools in 2015 showed that a significant number of eighth, tenth, and twelfth-grade students use tobacco products.
Some students have claimed that the behavior started when they were in the sixth grade. Nicotine is “a highly addictive drug and adolescents who are still going through critical periods of growth and development are particularly vulnerable to its effects” (Adams et al.).
Thus, it is imperative for schools to initiate programs and implement policies that prohibit the use of tobacco products within the zones of the learning institutions. Statistics show that in the United States, the number of young smokers increases by over 2,100 youths every day. In addition, each day, over 3,200 teens use tobacco products for the first time. The statistics are startling and call for immediate action. This paper will discuss some of the existing prevention programs that schools use to deter smoking amid youths in the United States. The paper will also discuss the programs that the state of Georgia has put in place to resolve the issue of smoking in schools.
Goals in Preventing Tobacco Use
The primary goals in preventing tobacco use among youths in United States are to reduce tobacco-related deaths and cut down on government expenditures. Smoking is one of the leading causes of death amid teens in United States. For instance, in Georgia, the state loses over 10,000 youths every year due to tobacco-related illnesses. Another startling statistic reveals that the state spends over $5 billion to treat tobacco-related health complications (Georgia Tobacco Control Strategic Plan -1). For these goals to be effective, comprehensive tobacco control programs have to be initiated to help prevent introduction to tobacco products and continuing use among youth.
School-based programs
School-based tobacco use prevention programs enable and encourage students to abstain from using tobacco products. For those students who have used or are using tobacco products, schools have established programs that enable and encourage them to stop immediately. If the students are unable to stop, they are provided with more resources they can use to seek additional assistance.
In the United States, many schools have initiated school-based education programs to enlighten the students on the dangers of using tobacco products. The programs focus on “all aspects of smoking, including the short and long-term adverse health effects, social acceptability, social influences, and peer pressure” (Bach). Additionally, the programs teach students how to overcome the temptation to indulge in cigarette smoking, and aim to make a difference in health of coming generation.
Education using media
Media literacy is critical in preventing tobacco use among youths and young adults. Consequently, school-based programs emphasize media literacy. Students are trained in how to overcome the temptations that result from exposure to tobacco advertising. The schools ensure that students receive anti-tobacco instruction for as long as they stay in school. Besides the use of school-based educational programs, learning institutions have been pronounced tobacco-free zones (Bach).
Zero use of tobacco among staff and visitors on school grounds and during school events
School administrations do not allow visitors, staff, and students to use tobacco while on school premises. Students tend to emulate their teachers or elders. Allowing teachers and guests to smoke within the school environment may send a bad message to students, making it difficult for society to discourage students from smoking or using tobacco products. Hence, no one is allowed to smoke within the school environs as a way to send a powerful message to the students (Bach).
Implement tobacco-free school policies
In Creating Effective Tobacco-free School-Based Policies, a handbook intended to provide guidelines for schools in the mid-Cumberland region of Tennessee, the authors infer from the Surgeon General’s Report on Reducing Tobacco Use that “comprehensive school-based programs, combined with community and mass-media efforts, can effectively prevent or postpone smoking onset by 20 to 40 percent among U.S. teens” (MTSU Center for Health and Human Services, Youth Led Tobacco Use Prevention Program). According to guidelines defined by the Centers for Disease Control and Prevention (CDC), schools are recommended to develop and enforce policies that prohibit tobacco use by students, staff, visitors, and parents on school property (CDC, “Guidelines for School Health Pgms to Prevent Tobacco Use & Addiction”). Schools should enforce policy on tobacco use that is consistent with the state and local districts that should include but not be limited to:
- Explanation and rationale for preventing tobacco use, for example, stating that tobacco use is the leading cause of disease, disability, and death.
- Prohibition of tobacco use by staff, students, visitors, and parents on school property, vehicles, and functions sponsored by schools, whether on school property or not.
- Prohibition of advertising or publicity promoting tobacco products in publications created or promoted by the school, anywhere on school premises, and at school functions on or off school property.
- Providing all students with information about avoiding use of tobacco on school property, and the consequences.
- Creation and implementation of procedures for publicizing details of the school’s tobacco-free policy to all who are associated with the school, including staff, parents, students, those in the immediate neighborhood, and visitors.
- Provisions and enforcement of the policy (Guide).
For example, in Georgia, visitors who violate the school’s tobacco-free policy are asked to leave school grounds. Failure to comply may result in the school administration filing a complaint with law enforcement agencies. Such a person can be prosecuted for violating the Georgia Smoke-Free Air Act (Georgia Tobacco Control Strategic Plan -1).
When school policies are applied consistently and justly, they can help students remain tobacco free, with a payoff in benefits to staff as well as students. Considering health, safety, and economic benefits, not only are tobacco products costly to purchase, but their effect on health and impact on fire safety compound the cost. Tobacco-free policies also promote compliance with local and state smoking/tobacco ordinances (Guide).
Schools in George have organized educational campaigns to sensitize the students and staff on tobacco-free school policy. Additionally, the employees and students are regularly updated on the results of the policy. Keeping the students and members of staff updated on the outcomes of the policy encourages them to support the program. Apart from sensitizing the staff members and students, the schools are also to notify other interested parties (Georgia Tobacco Control Strategic Plan -1). The parties include the community and individuals who visit the schools. The school boards are given the responsibility of implementing these policies. Staff members, students, and visitors are forbidden from using tobacco products at all times.
Training and educational programs
Many schools train their teachers in how to discourage tobacco use among their students. Teachers are equipped with skills to employ a tobacco prevention syllabus. Furthermore, many schools have reviewed their curricula to include lessons that touch on the dangers of smoking. Some schools work together with families and parents to sensitize their students about the dangers of tobacco use (Bach).
Knowing that parents play a significant role in developing students’ perceptions about smoking, schools appreciate the role of families and parents in managing tobacco use among students. Teachers encourage parents and family members to initiate discussions on the dangers of smoking to discourage students from taking up or continuing the habit. In addition, family members are advised not to use tobacco products in the presence of their children.
Community-Based Programs
In an effort to reduce tobacco use among school-age children, the combined efforts of the community are warranted. By engaging at all levels and providing education, the community as a whole can communicate to the public the importance of preventing youth access to tobacco products. Community tobacco-free resources like families, faith-based organizations, businesses, social services, media, and health agencies can be used to encourage changes in individual behavior. Communities can have a common goal toward the context in which the young people obtain tobacco products.
For example, media campaigns and restrictions on accessing tobacco by young people can be implemented. Mobilizing parents and community outside of the school and including the media can enhance school-based interventions and help increase the potential of a lasting behavioral impact among youth.
Tobacco-free projects
Schools can engage and encourage students to develop projects showing how to strengthen tobacco-free schools and prevent use of tobacco products among the youth. Students can work on projects, for example, on reduction of tobacco’s influence in their communities. They can go out in their communities and survey how tobacco products are advertised and sold, and write proposal letters urging retailers to stop or reduce sales of tobacco products. One example of a youth-oriented program to promote avoidance of tobacco products is the national youth initiative, Kick Butts Day, an annual event aimed at informing young people about the negative impacts of tobacco products, and equipping them to resist tobacco advertising and other inducements (Bach).
Measures taken by states
States have taken numerous steps to prevent smoking among youths and young adults.
Counter-advertising initiative
The state of California is renowned for applying for a counter-advertising program against the use of tobacco products. The state uses this strategy to combat misleading messages that the tobacco companies convey on their advertisements. The counter-advertising program focuses on exposing the lies that the tobacco companies peddle in their endeavor to promote tobacco use. Unfortunately, the program is gradually fading, due to inadequate funding.
The state of Florida has two programs that seek to prevent smoking among students, Students Working Against Tobacco (SWAT) and the Truth Campaign (Goldstein et al.). The two programs have proven effective in preventing tobacco use among students. Unfortunately, the state’s legislators are not committed to the implementation of these programs; the programs are currently underfunded, a condition that might impinge on their effectiveness. The state of Florida also has school-based programs that fight the use of tobacco products among youth. The state takes the programs seriously and supports them in a similar manner to other initiatives that fight drug abuse. Through the programs, the government of Florida has managed to reduce the rate of tobacco use by over 35% (Goldstein et al.).
Tobacco taxes
The American government applies taxation to regulate tobacco use among the teens and young adults. In this way, the government ensures that the consumer experiences the direct impact of the excise tax charged on tobacco products. The publication of the Surgeon General’s Report revealed the danger that smoking posed to young people. The report led to the government raising the excise duty as a measure to reduce tobacco use.
Economists claimed that an increase in excise duty helped to curb cigarette smoking among youth. Presently, tobacco products are among the most highly taxed commodities in the United States, which has led to tobacco products being too expensive for many youths. Thus, this tax has discouraged many children from engaging in smoking (U.S. Department of Health and Human Services).
Tobacco advertising restrictions
The government of the United States has advocated the use of standardized packages for tobacco products, mainly cigarettes. The government requires tobacco companies to use plain boxes to package the cigarettes. The use of branded boxes is cited as one of the factors that lead to youth using tobacco products. Presently, many tobacco companies use plain packages that only bear their brand name. Furthermore, the companies must ensure that the packages contain prominent health warnings. The use of standardized packages has helped to reduce the incidence of new cases of tobacco users among youth (U.S. Department of Health and Human Services).
Additionally, the use of clear health warnings has made many young people better understand and believe in the health hazards of use tobacco products. Before the introduction of standardized packages, many youths thought that some brands of tobacco were more harmful than others. In addition, they believed that it was easier to quit using some brands than others. The government introduced the use of standardized packages to show that all tobacco brands were equally dangerous. This helped to inform the beliefs that most youths had toward different brands of tobacco products, therefore discouraging them from using all brands.
Forming coalitions
According to the Centers for Disease Control and Prevention, for a tobacco-free program to be considered comprehensive, a coalition has to be in place, actively advocating for policy change. Tobacco prevention coalitions come together to help prevent youth from easily accessing tobacco products, coming up with ways of reducing tobacco advertising, and working and encouraging policy makers in passing laws and policies to protect youth from tobacco products. States can use coalitions to enhance their efforts in controlling and exposing the tobacco industry. Communities, organizations, and companies are encouraged to adopt tobacco-free policies with an aim of stopping tobacco use (CDC, Best Practices for Comprehensive Tobacco Control Programs: 2014).
Evaluation of tobacco-free programs
Tobacco-free programs put in place by schools and states should be evaluated regularly to ensure they are being adhered to, and also to evaluate their success. Evaluation is important to ensure that the programs are effective. Programs can also be evaluated from positive and negative feedback from the end users, with an eye to identifying areas for improvement (Bach).
Conclusion
The United States has come up with numerous programs to prevent tobacco use among young people. Both the federal and state governments support anti-tobacco-use programs aimed at discouraging youth from using tobacco products. The federal government regulates the advertising and branding of tobacco products. In addition, state governments have launched counter-advertising campaigns to expose the lies that the tobacco companies use to lure customers.
Tobacco use in public areas is now prohibited by law in every state. Schools are in a better position to prevent tobacco use by young people. Thus, the schools, in collaboration with state governments, are implementing tobacco-free school policies that ensure that no one uses tobacco products in the school environment. The policies have prevented many youths from being introduced to smoking, and hold much promise for the future (Bach).
Works Cited
Adams, Monica L., et al. “The Relationship Between School Policies and Youth Tobacco Use.” Journal of School Health 79.1 (2009): 17–23. Print.
Bach, Laura. How Schools Can Help Students Stay Tobacco-Free. N.p.: Campaign for Tobacco-Free Kids. 2016. Web.
Centers for Disease Control and Prevention (CDC). Guidelines for school health programs to prevent tobacco use and addiction. CDC. 1994. Web.
—. Youth and tobacco use. CDC. 2016. Web.
—. Best Practices for Comprehensive Tobacco Control Programs: 2014. 2014. Web.
Georgia Smokefree Air Act of 2005. n.pag. 2013. Web.
“Georgia Tobacco control strategic plan -1.” n.d. Web.
Goldstein, Adam O., et al. “Passage of 100% Tobacco-Free School Policies in 14 North Carolina School Districts.” Journal of School Health 73.8 (2003): 293-299. Print.
Guide, The Community. TFFRS – tobacco: Smoke-free policies. 2014. Web.
MTSU Center for Health and Human Services, Youth Led Tobacco Use Prevention Program, ed. Creating Effective Tobacco-Free School-Based Policies. Murfreesboro, TN: Middle Tennessee State University, 2006. Web.
U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994. Web.