Guidelines for School Health Programs to Prevent Tobacco Use and Addiction
Contents
Each day, more than 3,000 young people across the United States become daily smokers.
Most start this deadly habit not fully understanding that nicotine in tobacco is as
addictive as heroin, cocaine, or alcohol. Most also underestimate the health consequences,
even though tobacco use is the leading cause of preventable death in the United States.
School programs to prevent tobacco use among young people can make a major contribution to
the health of the nation, particularly when these programs are coordinated with community
efforts.
Benefits of Preventing Tobacco Use Among Young People
- Helps prevent long-term health problems and premature death.
- Promotes optimal health and decreases school days missed because of respiratory
illnesses.
- Dramatically decreases the likelihood that a young person will become a regular tobacco
user as an adult.
Consequences of Tobacco Use
- Tobacco use causes more premature deaths in the United States than any other preventable
risk. Of all people less than 18 years old in 1995, an estimated 5 million will die
prematurely from smoking-related illnesses.
- Cigarette smoking causes heart disease; stroke; chronic lung disease; and cancers of the
lung, mouth, pharynx, esophagus, and bladder.
- Cigarette smoking increases coughs, shortness of breath, and respiratory illnesses;
decreases physical fitness; and adversely affects blood cholesterol levels.
- Smokeless tobacco is not a safe alternative to cigarettes. Using it causes cancers of
the mouth, pharynx, and esophagus; gum recession; and an increased risk for heart disease
and stroke.
- Smoking cigars increases the risk of oral, laryngeal, esophageal, and lung cancers.
- Second-hand tobacco smoke can cause respiratory illnesses, increase the risk of lung
cancer and heart disease, and trigger asthma attacks.
- Second-hand tobacco smoke can cause respiratory illnesses, increase the risk of lung
cancer and heart disease, and trigger asthma attacks.
Tobacco Use By Teens
- The rate of teen smoking is rising: 35% of high school students were current smokers in
1995, compared with 28% in 1991.
- 71% of high school students have tried cigarettes.
- The younger people are when they start using tobacco, the more likely they are to become
strongly addicted to nicotine.
- 89% of persons who ever smoked daily first tried a cigarette at or before age 18; 25% of
high school students smoked a whole cigarette before age 13.
- 11% of high school students use smokeless (snuff or chewing) tobacco; 27% have smoked a
cigar in the past year.
- 3 out of 4 teenage smokers have tried to quit at least once---but failed.
The Opportunity
- Well-designed, well-implemented school programs to prevent tobacco use and addiction
-
- Have proved effective in preventing tobacco use.
- Provide prevention education during the years when the risk of becoming addicted to
tobacco is greatest.
- Provide a tobacco-free environment that establishes nonuse of tobacco as a norm and
offers opportunities for positive role modeling.
- Can help prevent the use of other drugs, especially if the program addresses the use of
these substances.
CDC’s Guidelines for School Programs to Prevent Tobacco Use
CDC’s Guidelines for School Health Programs to Prevent Tobacco Use and
Addiction were designed to help achieve national health and education goals. They were
developed in collaboration with experts from 29 national, federal, and voluntary agencies
and are based on an extensive review of research and practice.
Key Principles
- School programs to prevent tobacco use and addiction will be most effective if they
- Prohibit tobacco use at all school facilities and events.
- Encourage and help students and staff to quit using tobacco.
- Provide developmentally appropriate instruction in grades K--12 that addresses the
social and psychological causes of tobacco use.
- Are part of a coordinated school health program through which teachers, students,
families, administrators, and community leaders deliver consistent messages about tobacco
use.
- Are reinforced by community-wide efforts to prevent tobacco use and addiction.
Recommendations
The guidelines include seven recommendations for ensuring a quality school program to
prevent tobacco use.
 Policy
- Develop and enforce a school policy on tobacco use. The policy--- developed in
collaboration with students, parents, school staff, health professionals, and school
boards--- should
- Prohibit students, staff, and visitors from using tobacco on school premises, in school
vehicles, and at school functions.
- Prohibit tobacco advertising (e.g., on signs, T-shirts, or caps or through sponsorship
of school events) in school buildings, at school functions, and in school publications.
- Require that all students receive instruction on avoiding tobacco use.
- Provide access and referral to cessation programs for students and staff.
- Help students who violate smoking policies to quit smoking rather than just punishing
them.
 Instruction
- Provide instruction about the short- and long-term negative physiologic and social
consequences of tobacco use, social influences on tobacco use, peer norms regarding
tobacco use, and refusal skills. This instruction should
- Decrease the social acceptability of tobacco use and show that most young people do not
smoke.
- Help students understand why young people start to use tobacco and identify more
positive activities to meet their goals.
- Develop students’ skills in assertiveness, goal setting, problem solving, and
resisting pressure from the media and peers to use tobacco.
- Programs that only discuss tobacco’s harmful effects or attempt to instill fear do
not prevent tobacco use.
 Curriculum
- Provide tobacco-use prevention education in grades K--12.
- This instruction should be introduced in elementary school and intensified in
middle/junior high school, when students are exposed to older students who typically use
tobacco at higher rates.
- Reinforcement throughout high school is essential to ensure that successes in preventing
tobacco use do not dissipate over time.
 Training
- Provide program-specific training for teachers. The training should include reviewing
the curriculum, modeling instructional activities, and providing opportunities to practice
implementing the lessons. Well-trained peer leaders can be an important adjunct to
teacher-led instruction.
 Family Involvement
- Involve parents or families in support of school-based programs to prevent tobacco use.
Schools should
- Promote discussions at home about tobacco use by assigning homework and projects that
involve families.
- Encourage parents to participate in community efforts to prevent tobacco use and
addiction.
 Tobacco Cessation Efforts
Support cessation efforts among students and school staff who use tobacco. Schools
should provide access to cessation programs that help students and staff stop using
tobacco rather than punishing them for violating tobacco-use policies.
 Evaluation
Assess the tobacco-use prevention program at regular intervals. Schools can use
CDC’s Guidelines for School Health Programs to Prevent Tobacco Use and Addiction
to assess whether they are providing effective policies, curricula, training, and
cessation programs.
Source: Centers for Disease Control and Prevention - June 1997
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