Home  ›  Which of the Following Best Describes the Possible Impact of Tobacco Use on Families?

Which of the Following Best Describes the Possible Impact of Tobacco Use on Families?

Written By Friday, March 4, 2022 Add Comment Edit

Guidelines for School Wellness Programs to Preclude Tobacco Utilise and Habit

Summary

Tobacco use is the leading cause of preventable decease in the United States. The majority of daily smokers (82%) began smoking before 18 years of age, and more than three,000 immature persons begin smoking each mean solar day. Schoolhouse programs designed to prevent tobacco use could become ane of the most effective strategies available to reduce tobacco use in the United States. The following guidelines summarize schoolhouse-based strategies most probable to be effective in preventing tobacco apply among youth. They were developed by CDC in collaboration with experts from 29 national, federal, and voluntary agencies and with other leading authorities in the field of tobacco-use prevention to aid school personnel implement effective tobacco-use prevention programs. These guidelines are based on an in-depth review of inquiry, theory, and current practice in the area of school-based tobacco-utilise prevention. The guidelines recommend that all schools a) develop and enforce a school policy on tobacco use, b) provide instruction about the short- and long-term negative physiologic and social consequences of tobacco apply, social influences on tobacco employ, peer norms regarding tobacco use, and refusal skills, c) provide tobacco-use prevention education in kindergarten through 12th class, d) provide program-specific training for teachers, east) involve parents or families in back up of schoolhouse-based programs to prevent tobacco utilise, f) support cessation efforts amongst students and all school staff who employ tobacco, and thousand) assess the tobacco-use prevention programme at regular intervals.

INTRODUCTION

Tobacco use is the single most preventable cause of decease in the United States (1). Illnesses acquired by tobacco use increase demands on the U.Southward. health-intendance organization; lost productivity amounts to billions of dollars annually (2-3).

Because four out of every v persons who utilise tobacco begin before they reach machismo (1), tobacco-prevention activities should focus on schoolhouse-age children and adolescents. Evidence suggests that school health programs tin be an effective means of preventing tobacco use among youth (4-seven). The guidelines in this study have been developed to help school personnel plan, implement, and assess educational programs and school policies to prevent tobacco use and the unnecessary addiction, illness, and death tobacco apply causes. Although these guidelines accost school programs for kindergarten through twelfth course, persons working with youth in other settings likewise may find the guidelines useful.

The guidelines are based on a synthesis of results of research, theory, and current practice in tobacco-use prevention. To develop these guidelines, CDC staff convened meetings of experts from the fields of tobacco-employ prevention and education, reviewed published research, and considered the conclusions of the National Cancer Plant Expert Informational Panel on School-Based Smoking Prevention Programs (4) and the findings of the 1994 Surgeon Full general's Report, Preventing Tobacco Use Amongst Young People (8).

CDC adult these guidelines in consultation with experts representing the following organizations:

American University of Pediatrics American Association of Schoolhouse Administrators American Cancer Society American Federation of Teachers American Heart Association American Lung Association American Medical Clan Clan of Land and Territorial Directors of Public Health Didactics Association of State and Territorial Wellness Officials Council of Primary State Schoolhouse Officers Health Resources and Services Administration Indian Health Service National Clan of School Nurses National Clan of Secondary Schoolhouse Principals National Association of Land Boards of Education National Cancer Institute National Eye for Nursing Research National Congress of Parents and Teachers National Teaching Association National Centre, Lung, and Claret Institute National Institute of Child Health and Human Development National School Boards Association National School Health Educational activity Coalition Function of Illness Prevention and Wellness Promotion Part of Minority Health Substance Abuse and Mental Health Services Assistants The Society of State Directors of Health, Physical Education, and Recreation U.Southward. Department of Didactics Western Consortium for Public Health

BACKGROUND

School-based programs to forbid tobacco utilise can brand a substantial contribution to the wellness of the side by side generation. In this report, the term "tobacco use" refers to the utilise of any nicotine-containing tobacco production, such as cigarettes, cigars, and smokeless tobacco. These products often comprise additional substances (e.g., benzo(a)pyrene, vinyl chloride, polonium 210) that cause cancer in animals and humans (i). Contempo estimates advise that cigarette smoking annually causes more than 400,000 premature deaths and 5 million years of potential life lost (two). The estimated straight and indirect costs associated with smoking in the U.s. in 1990 totalled $68 billion (3).

In 1964, the Surgeon Full general's starting time report on smoking and wellness documented that cigarette smoking causes chronic bronchitis and lung and laryngeal cancer in men (9). Subsequent reports from the Surgeon Full general's role take documented that smoking causes coronary eye disease (10), atherosclerotic peripheral vascular disease (1), cerebrovascular disease (1), chronic obstructive pulmonary disease (including emphysema) (eleven), intrauterine growth retardation (1), lung and laryngeal cancers in women (12), oral cancer (13), esophageal cancer (13), and cancer of the urinary bladder (14). Cigarette smoking also contributes to cancers of the pancreas, kidney, and cervix (one,14). Further, low nascency weight and approximately 10% of babe mortality have been attributed to tobacco use by pregnant mothers (i). The 1994 Surgeon Full general'southward study on smoking and health describes numerous adverse wellness conditions caused by tobacco use amid adolescents, including reductions in the charge per unit of lung growth and in the level of maximum lung function, increases in the number and severity of respiratory illnesses, and unfavorable effects on blood lipid levels (which may accelerate development of cardiovascular diseases) (eight).

Breathing environmental tobacco smoke -- including sidestream and exhaled smoke from cigarettes, cigars, and pipes -- also causes serious health problems (15-sixteen ). For example, exposure to ecology tobacco smoke increases the risk for lung cancer and respiratory infections among nonsmokers and may inhibit the evolution of optimal lung function amidst children of smokers (16). Exposure to environmental tobacco smoke too may increase the risk for heart disease among nonsmokers (17-18). The Environmental Protection Agency recently classified ecology tobacco smoke as a Group A carcinogen, a category that includes asbestos, benzene, and arsenic (xix).

Employ of smokeless tobacco, including chewing tobacco and snuff, also tin can exist harmful to wellness. A written report of the Advisory Committee to the Surgeon Full general indicated that using smokeless tobacco causes oral cancer and leukoplakia (twenty). Early signs of these diseases, particularly periodontal degeneration and soft tissue lesions, are establish among young people who use smokeless tobacco (8).

Tobacco use is addictive and is responsible for more than one of every 5 deaths in the United States. Yet, many children and adolescents do not empathise the nature of tobacco addiction and are unaware of, or underestimate, the important health consequences of tobacco use (ane). On boilerplate, more than 3,000 young persons, most of them children and teenagers, begin smoking each mean solar day in the United States (21). Approximately 82% of adults ages 30- 39 years who e'er smoked daily tried their first cigarette before 18 years of age (8). National surveys indicate that 70% of high school students have tried cigarette smoking and that more than one-fourth (28%) reported having smoked cigarettes during the past 30 days (22).

THE Need FOR SCHOOL Wellness PROGRAMS TO PREVENT TOBACCO Utilise AND Habit

The challenge to provide effective tobacco-use prevention programs to all young persons is an ethical imperative. Schools are ideal settings in which to provide such programs to all children and adolescents. School-based tobacco prevention education programs that focus on skills training approaches have proven effective in reducing the onset of smoking, according to numerous independent studies. A summary of findings from these studies demonstrates positive outcomes across programs that vary in format, scope, and delivery method (viii).

To be most constructive, school-based programs must target young persons earlier they initiate tobacco use or drop out of school. In 1992, xviii% of surveyed U.S. high schoolhouse seniors reported smoking their first cigarette in elementary school, and 30% started in grades vii to nine (23). Among persons age 17-18 years surveyed in 1989, substantially more high school dropouts (43%) than high school attendees or graduates (17%) had smoked cigarettes during the calendar week preceding the survey (24).

Because considerable numbers of students begin using tobacco at or after historic period 15, tobacco-prevention didactics must be continued throughout high school. Among high school seniors surveyed in 1991 who had ever smoked a whole cigarette, 37% initiated smoking at age 15 or older (grades 10-12).

School-based programs offer an opportunity to prevent the initiation of tobacco utilise and therefore help persons avoid the difficulties of trying to stop afterwards they are addicted to nicotine. The majority of electric current smokers (83%) wish they had never started smoking, and nearly i-third of all smokers quit for at least a day each year (25). Most smokers (93%) who attempt to quit resume regular smoking within i year (21,26). Of those persons who successfully quit smoking for 1 year or longer, one-tertiary eventually relapse (14).

By experimenting with tobacco, immature persons place themselves at risk for nicotine habit. Persons who start smoking early take more difficulty quitting, are more likely to become heavy smokers, and are more than likely to develop a smoking-related disease (1,27). Between 1975 and 1985, approximately 75% of persons who had smoked daily during high schoolhouse were daily smokers 7-9 years later on; however, only 5% of those persons had predicted as high schoolhouse students that they would "definitely" smoke 5 years afterward (23). Smoking is addictive; three out of four teenagers who smoke take made at least ane serious, yet unsuccessful, effort to quit (28). The 1994 Surgeon Full general'southward report on smoking and wellness concludes that the probability of becoming addicted to nicotine after any exposure is college than that for other addictive substances (east.g., heroin, cocaine, or alcohol). Further, nicotine habit in immature people follows fundamentally the aforementioned process every bit in adults, resulting in withdrawal symptoms and failed attempts to quit (eight). Thus, cessation programs are needed to help the young persons who already use tobacco (4).

Schoolhouse-based programs to foreclose tobacco apply should be provided for students of all ethnic/racial groups. In high school, more white (31%) and Hispanic (25%) students than black students (13%) are current smokers (29). Although ages and rates of initiation vary by race and ethnicity, tobacco use is a problem for all indigenous/racial groups. Given the diversity of cultures represented in many schools, it is of import to tailor prevention programs for particular ethnic/racial subgroups of students. However, programs should be sensitive to, and representative of, a student population that is multicultural, multiethnic, and socio-economically various.

Effective school-based programs to foreclose tobacco use are equally important for both male and female person students. From 1975 to 1987, daily smoking rates amid twelfth-class females were every bit loftier or higher than males. Since 1988, smoking rates for males and females take been almost identical (23). However, rates of smokeless tobacco use differ by sex: in 1991, xix% of male person loftier schoolhouse students and only one% of females reported utilize during the past 30 days (22). Given the growing popularity of smokeless tobacco use, peculiarly amid males (thirty), and given the prevalent misconception that smokeless tobacco is rubber (23), school-based programs to preclude tobacco utilise must pointedly discourage the use of smokeless tobacco.

Despite gains made in the 1970s, progress in reducing smoking prevalence amidst adolescents slowed dramatically in the 1980s. For example, the per centum of seniors who report that they smoked on one or more days during the past calendar month has remained unchanged since 1980 -- at approximately 29% (23). Further, despite negative publicity and restrictive legislation regarding tobacco utilise, the proportion of loftier school seniors who perceive that cigarette users are at great risk for concrete or other harm from smoking a pack a day or more than has increased only minimally -- from 64% in 1980 to 69% in 1992 (23). Thus, efforts to forbid the initiation of tobacco apply among children and adolescents must be intensified.

School-based programs to prevent tobacco utilize also tin contribute to preventing the use of illicit drugs, such every bit marijuana and cocaine, particularly if such programs are also designed to prevent the utilize of these substances (31). Tobacco is one of the about commonly bachelor and widely used drugs, and its use results in the almost widespread drug dependency. Use of other drugs, such every bit marijuana and cocaine, is often preceded past the use of tobacco or alcohol. Although most young persons who use tobacco do non use illicit drugs, when further drug interest does occur, it is typically sequential -- from use of tobacco or booze to apply of marijuana, and from marijuana to other illicit drugs or prescription psychoactive drugs (32). This sequence may reverberate, in office, the widespread availability, acceptability, and use of tobacco and booze, every bit well as mutual underlying causes of drug utilise, such every bit risk-seeking patterns of behavior and deficits in communication and refusal skills. Contempo reports on preventing drug corruption suggest that approaches constructive in preventing tobacco use can as well help prevent the use of booze and other drugs (33-35).

PURPOSES OF School HEALTH PROGRAMS TO PREVENT TOBACCO USE AND Addiction

School-based health programs should enable and encourage children and adolescents who take not experimented with tobacco to continue to abjure from any utilise. For young persons who accept experimented with tobacco utilize, or who are regular tobacco users, school wellness programs should enable and encourage them to immediately terminate all apply. For those immature persons who are unable to finish using tobacco, school programs should help them seek additional help to successfully quit the use of tobacco.

NATIONAL HEALTH OBJECTIVES, NATIONAL EDUCATION GOALS, AND THE YOUTH Risk BEHAVIOR SURVEILLANCE SYSTEM

CDC'south Guidelines for School Health Programs to Prevent Tobacco Use and Addiction were designed in part to help attain published national health objectives and educational activity goals. In September 1990, 300 national wellness objectives were released by the Secretary of the Department of Health and Human Services as part of Salubrious People 2000: National Wellness Promotion and Disease Prevention Objectives (36). The objectives were designed to guide health promotion and disease prevention policy and programs at the federal, land, and local levels throughout the 1990s. School-based programs to foreclose tobacco apply tin can help accomplish the following objectives from Healthy People 2000 (37):

three.4 Reduce cigarette smoking to a prevalence of no more than xv%

amidst people aged 20 and older. (Baseline: 29% in 1987) three.5 Reduce the initiation of cigarette smoking by children and

youth so that no more than 15% have become regular cigarette smokers by age 20. (Baseline: 30% in 1987) three.7 Increment smoking cessation during pregnancy so that at to the lowest degree

60% of women who are cigarette smokers at the time they become pregnant quit smoking early in pregnancy and maintain abstinence for the rest of their pregnancy. (Baseline: 39% in 1985) 3.8 Reduce to no more than twenty% the proportion of children anile 6

and younger who are regularly exposed to tobacco smoke at habitation (Baseline: 39% in 1986) 3.nine Reduce smokeless tobacco use by males aged 12 through 24 to a

prevalence of no more 4%. (Baseline: 6.6% for age 12-17 in 1988) iii.10 Found tobacco-free environments and include tobacco use

prevention in the curricula of all uncomplicated, middle, and secondary schools, preferably as part of quality {comprehensive} school health education. (Baseline: 17% of school districts were smoke-free, and 75%-81% of school districts offered antismoking education in 1988) 3.11 Increase to at least 75% the proportion of worksites {such as

schools} with a formal smoking policy that prohibits or severely restricts smoking at the workplace. (Baseline: 54% of medium and large companies in 1987) 3.12 Enact in fifty states comprehensive laws on clean indoor air that

prohibit or strictly limit smoking in the workplace and enclosed public places {such as schools}. (Baseline: 13 states in 1988)

School-based programs to prevent tobacco use can also help accomplish one of the six National Teaching Goals (38): By the year 2000, every schoolhouse in America will exist complimentary of drugs and violence and will offering a disciplined environment conducive to learning (Goal 6).

In 1990, CDC established the Youth Risk Behavior Surveillance Arrangement to help monitor progress toward attaining national health and education objectives past periodically measuring the prevalence of half dozen categories of health adventure behaviors usually established during youth that contribute to the leading causes of decease and disease (39); tobacco apply is one of the six categories. CDC conducts a biennial Youth Adventure Behavior Survey (YRBS) of a national probability sample of high school students and likewise enables interested state and local education agencies to bear the YRBS with comparable probability samples of loftier school students in those states and cities (22 ). The specific tobacco-use behaviors monitored past the YRBS include (forty):

  • e'er tried cigarette smoking

  • age when first smoked a whole cigarette

  • always smoked cigarettes regularly (ane cigarette every day for 30 days)

  • age when first smoked regularly

  • number of days during past month that cigarettes were smoked

  • number of cigarettes smoked per day during by month

  • number of days during past month that cigarettes were smoked on school property

  • ever tried to quit smoking cigarettes during past six months

  • whatsoever employ of chewing tobacco or snuff during past month

  • any apply of chewing tobacco or snuff during past calendar month on school property.

States and big cities are encouraged to utilise the YRBS periodically to monitor the comparative prevalence of tobacco use among school students in their jurisdictions, and school officials are encouraged to implement programs specifically designed to reduce these behaviors. These national, country, and local information are being used to monitor progress in reducing tobacco utilise amid youth and to monitor relevant national health objectives and education goals.

RECOMMENDATIONS FOR School HEALTH PROGRAMS TO PREVENT TOBACCO Apply AND Addiction

The seven recommendations below summarize strategies that are constructive in preventing tobacco use amidst youth. To ensure the greatest bear on, schools should implement all seven recommendations.

  1. Develop and enforce a schoolhouse policy on tobacco use.

  2. Provide instruction about the short- and long-term negative physiologic and social consequences of tobacco use, social influences on tobacco utilize, peer norms regarding tobacco use, and refusal skills.

  3. Provide tobacco-use prevention didactics in kindergarten through 12th grade; this instruction should be particularly intensive in inferior loftier or centre school and should be reinforced in high school.

  4. Provide program-specific training for teachers.

  5. Involve parents or families in support of school-based programs to forbid tobacco use.

  6. Support cessation efforts amid students and all school staff who employ tobacco.

  7. Assess the tobacco-use prevention program at regular intervals.

Discussion of Recommendations

Recommendation 1: Develop and enforce a school policy on tobacco use.

A schoolhouse policy on tobacco use must exist consistent with land and local laws and should include the following elements (41):

  • An explanation of the rationale for preventing tobacco use (i.e., tobacco is the leading cause of death, disease, and disability)

  • Prohibitions against tobacco employ past students, all school staff, parents, and visitors on school property, in school vehicles, and at schoolhouse-sponsored functions away from school property

  • Prohibitions against tobacco advertising in school buildings, at school functions, and in school publications

  • A requirement that all students receive didactics on avoiding tobacco utilize

  • Provisions for students and all school staff to have admission to programs to assistance them quit using tobacco

  • Procedures for communicating the policy to students, all school staff, parents or families, visitors, and the community

  • Provisions for enforcing the policy

To ensure broad support for school policies on tobacco use, representatives of relevant groups, such every bit students, parents, schoolhouse staff and their unions, and school board members, should participate in developing and implementing the policy. Examples of policies accept been published (41), and additional samples tin can be obtained from state and local boards of teaching.

Clearly articulated school policies, practical fairly and consistently, tin can assistance students decide not to utilise tobacco (42). Policies that prohibit tobacco use on schoolhouse property, require prevention education, and provide access to cessation programs rather than solely instituting punitive measures are most effective in reducing tobacco use amongst students (43).

A tobacco-free school environment tin can provide wellness, social, and economic benefits for students, staff, the school, and the district (41). These benefits include decreased fires and discipline problems related to pupil smoking, improved compliance with local and state smoking ordinances, and easier budget and maintenance of school facilities and grounds.

Recommendation ii: Provide instruction about the short- and long-term negative physiologic and social consequences of tobacco utilize, social influences on tobacco employ, peer norms regarding tobacco use, and refusal skills.

Some tobacco-use prevention programs have been limited to providing but factual information most the harmful effects of tobacco utilise. Other programs have attempted to induce fear in immature persons about the consequences of use (44). However, these strategies solitary practise not forbid tobacco utilise, may stimulate curiosity nigh tobacco employ, and may prompt some students to believe that the wellness hazards of tobacco apply are exaggerated (45- 47).

Successful programs to forbid tobacco use accost multiple psychosocial factors related to tobacco use amidst children and adolescents (48-51). These factors include:

  • Immediate and long-term undesirable physiologic, cosmetic, and social consequences of tobacco use. Programs should help students understand that tobacco use tin can result in decreased stamina, stained teeth, foul-smelling breath and clothes, exacerbation of asthma, and ostracism past nonsmoking peers.

  • Social norms regarding tobacco apply. Programs should use a diversity of educational techniques to decrease the social acceptability of tobacco use, highlight existing antitobacco norms, and help students sympathise that most adolescents exercise non fume.

  • Reasons that adolescents say they smoke. Programs should help students empathise that some adolescents smoke because they believe information technology will help them be accepted by peers, appear mature, or cope with stress. Programs should help students develop other more positive ways to attain such goals.

  • Social influences that promote tobacco use. Programs should help students develop skills in recognizing and refuting tobacco-promotion messages from the media, adults, and peers.

  • Behavioral skills for resisting social influences that promote tobacco use. Programs should aid students develop refusal skills through direct didactics, modeling, rehearsal, and reinforcement, and should coach them to assistance others develop these skills.

  • Full general personal and social skills. Programs should aid students develop necessary assertiveness, communication, goal-setting, and trouble-solving skills that may enable them to avert both tobacco use and other health gamble behaviors.

Schoolhouse-based programs should systematically address these psychosocial factors at developmentally appropriate ages. Item instructional concepts should exist provided for students in early elementary school, afterward elementary school, junior high or center school, and senior loftier school (Table_1). Local school districts and schools should review these concepts in accordance with student needs and educational policies to make up one's mind in which grades students should receive particular instruction.

Recommendation 3: Provide tobacco-use prevention education in kindergarten through 12th grade. This didactics should be especially intensive in junior high or middle school and should be reinforced in high school.

Education to prevent tobacco use should be provided to students in each course, from kindergarten through twelfth class (4). Because tobacco use oft begins in grades six through 8, more intensive instructional programs should exist provided for these class levels (4-v). Specially important is the year of entry into junior loftier or middle school when new students are exposed to older students who use tobacco at college rates. Thereafter, annual prevention teaching should be provided. Without continued reinforcement throughout loftier schoolhouse, successes in preventing tobacco employ misemploy over time (52,53). Studies betoken that increases in the intensity and duration of education to forestall tobacco use event in concomitant increases in effectiveness (54- 56).

Almost evidence demonstrating the effectiveness of school-based prevention of tobacco utilise is derived from studies of schools in which classroom curricula focused exclusively on tobacco use. Other testify suggests that tobacco-use prevention as well can be effective when appropriately embedded within broader curricula for preventing drug and alcohol employ (57) or inside comprehensive curricula for school health education (31). The effectiveness of school-based efforts to forbid tobacco use appears to be enhanced past the add-on of targeted communitywide programs that accost the role of families, community organizations, tobacco-related policies, antitobacco ad, and other elements of adolescents' social environment (eight).

Considering tobacco use is ane of several interrelated wellness risk behaviors addressed by schools, CDC recommends that tobacco-use-prevention programs be integrated every bit role of comprehensive school health education inside the broader school health programme (58).

Recommendation 4: Provide plan-specific training for teachers.

Adequate curriculum implementation and overall programme effectiveness are enhanced when teachers are trained to deliver the plan equally planned (59,sixty). Teachers should be trained to recognize the importance of advisedly and completely implementing the selected program. Teachers also should become familiar with the underlying theory and conceptual framework of the program likewise as with the content of these guidelines. The training should include a review of the programme content and a modeling of plan activities by skilled trainers. Teachers should exist given opportunity to do implementing programme activities. Studies betoken that in-person training and review of curriculum-specific activities contribute to greater compliance with prescribed program components (iv,5,61,62).

Some programs may elect to include peer leaders equally part of the instructional strategy. By modeling social skills (63) and leading role rehearsals (64), peer leaders can assist counteract social pressures on youth to use tobacco. These students must receive training to ensure accurate presentation of skills and information. Although peer-leader programs can offer an important adjunct to teacher-led pedagogy, such programs require boosted time and endeavor to initiate and maintain.

Recommendation 5: Involve parents or families in support of schoolhouse-based programs to prevent tobacco use.

Parents or families can play an important role in providing social and ecology support for nonsmoking. Schools can capitalize on this influence by involving parents or families in programme planning, in soliciting community back up for programs, and in reinforcing educational messages at home. Homework assignments involving parents or families increase the likelihood that smoking is discussed at dwelling house and motivate developed smokers to consider cessation (65).

Recommendation half dozen: Back up cessation efforts among students and all schoolhouse staff who apply tobacco.

Potential practices to help children and adolescents quit using tobacco include self-assist, peer support, and community cessation programs. In do, however, these alternatives are rarely bachelor inside a schoolhouse system or community. Although the options are ofttimes express, schools must support student efforts to quit using tobacco, especially when tobacco use is disallowed by schoolhouse policy.

Constructive abeyance programs for adolescents focus on immediate consequences of tobacco use, accept specific accessible goals, and use contracts that include rewards. These programs provide social support and teach avoidance, stress management, and refusal skills (66-69). Further, students need opportunities to practice skills and strategies that volition aid them remain nonusers (66,67,lxx).

Cessation programs with these characteristics may already be available in the community through the local health department or voluntary health agency (eastward.m., American Cancer Society, American Eye Association, American Lung Clan). Schools should identify bachelor resource in the customs and provide referral and follow-upwards services to students. If cessation programs for youth are not available, such programs might be jointly sponsored by the school and the local health department, voluntary health bureau, other community health providers, or interested organizations (due east.thou., churches).

More is known about successful cessation strategies for adults. School staff members are more likely than students to find existing cessation options in the community. Virtually adults who quit tobacco use do so without formal assistance. Withal, cessation programs that include a combination of behavioral approaches (e.g., group back up, private counseling, skills training, family interventions, and interventions that can be supplemented with pharmacologic treatments) take demonstrated effectiveness (71). For all school staff, health promotion activities and employee assist programs that include abeyance programs might help reduce exhaustion, lower staff absenteeism, subtract health insurance premiums, and increase commitment to overall school health goals (41).

Recommendation 7: Assess the tobacco-use prevention program at regular intervals.

Local schoolhouse boards and administrators tin use the following evaluation questions to assess whether their programs are consequent with CDC's Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. Personnel in federal, state, and local education and wellness agencies also can use these questions to

  1. assess whether schools in their jurisdicition are providing effective educational activity to prevent tobacco use and b) identify schools that would do good from additional grooming, resources, or technical assistance. The post-obit questions tin can serve as a guide for assessing program effectiveness:

  1. Do schools have a comprehensive policy on tobacco use, and is it implemented and enforced as written?

  2. Does the tobacco didactics plan foster the necessary knowledge, attitudes, and skills to foreclose tobacco use?

  3. Is education to prevent tobacco use provided, as planned, in kindergarten through twelfth grade, with special emphasis during inferior loftier or middle school?

  4. Is in-service training provided, as planned, for educators responsible for implementing tobacco-apply prevention?

  5. Are parents or families, teachers, students, school health personnel, school administrators, and appropriate community representatives involved in planning, implementing, and assessing programs and policies to prevent tobacco use?

  6. Does the tobacco-apply prevention program encourage and support cessation efforts by students and all school staff who use tobacco?

Decision

In 1964, the outset Surgeon General'due south written report on smoking and health warned that tobacco use causes serious health problems. 30 years later, in 1994, the Surgeon General reports that tobacco use withal presents a key threat to the well-being of children. School health programs to prevent tobacco employ could go ane of the most effective national strategies to reduce the burden of concrete, emotional, and budgetary expense incurred by tobacco utilise.

To accomplish maximum effectiveness, school wellness programs to prevent tobacco use must exist carefully planned and systematically implemented. Research and feel caused since the kickoff Surgeon General's written report on smoking and health accept helped in agreement how to produce school policies on tobacco use and how to plan school-based programs to prevent tobacco utilize and then that they are most effective. Carefully planned school programs can be constructive in reducing tobacco utilise among students if school and community leaders make the commitment to implement and sustain such programs.

References

  1. CDC. Reducing the health consequences of smoking: 25 years of progress -- a report of the Surgeon General. Washington, DC: U.s.a. Department of Health and Homo Services, Public Health Service, CDC, 1989; DHHS publication no. (CDC)89-8411.

  2. CDC. Cigarette smoking-attributable mortality and years of potential life lost -- United States, 1990. MMWR 1993;42:645-9.

  3. Part of Technology Assessment. Smoking-related deaths and fiscal costs: Office of Technology Assessment estimates for 1990. Washington, DC: US Congress, 1993.

  4. National Cancer Institute. School programs to foreclose smoking: the National Cancer Institute guide to strategies that succeed. Rockville, Doc: U.s. Department of Wellness and Human Services, Public Health Service, National Institutes of Wellness, National Cancer Institute, 1990; DHHS publication no. (NIH)90-500.

  5. Glynn T. Essential elements of school-based smoking prevention programs. J Sch Health 1989;59:181-8.

  6. Walter H. Principal prevention of chronic disease amidst children: the school-based "Know Your Trunk" intervention trials. Health Educ Q 1989;16:201-fourteen.

  7. Walter H, Vaughn R, Wynder E. Main prevention of cancer among children: changes in cigarette smoking and nutrition after 6 years of intervention. J Natl Cancer Inst 1989;81:995-9.

  8. CDC. Preventing tobacco apply amidst young people: a report of the Surgeon General. Atlanta, GA: U.s. Department of Health and Human Services, Public Health Service, CDC, 1994; DHHS publication no. Due south/Due north 017-001-00491-0.

  9. Public Health Service. Section of Health, Education, and Welfare. Smoking and health: report of the Advisory Committee to the Surgeon General of the Public Health Service. Washington, DC: US Department of Health, Didactics, and Welfare, Public Health Service, 1964; DHHS publication no. (PHS)64-1103.

  10. Public Health Service. The health consequences of smoking: cardiovascular disease -- a written report of the Surgeon General. Rockville, Dr.: United states Department of Wellness and Human Services, Public Health Service, 1983; DHHS publication no. (PHS)84-50204.

  11. Public Health Service. The health consequences of smoking: chronic obstructive lung disease -- a report of the Surgeon Full general. Rockville, Doc: US Department of Health and Human being Services, Public Health Service, 1984; DHHS publication no. (PHS)84-50205.

  12. Public Health Service. The health consequences of smoking for women: a report of the Surgeon Full general. Rockville, MD: U.s. Section of Health and Human being Services, Public Health Service, 1980.

  13. Public Health Service. The wellness consequences of smoking: cancer -- a written report of the Surgeon Full general. Rockville, Medico: US Department of health and Human Services, Public Health Service, 1982; DHHS publication no. (PHS)82-50179.

  14. CDC. The health benefits of smoking cessation: a report of the Surgeon General. Us Department of Health and Human Services, Public Health Service, CDC, 1990; DHHS publication no. (CDC)90-8416.

  15. National Establish of Occupational Safety and Health. Ecology tobacco smoke in the workplace: lung cancer and other wellness effects. Cincinnati, OH; U.s. Department of Health and Human being Services, Public Wellness Service, 1991; DHHS publication no. (NIOSH)91-108.

  16. CDC. The health consequences of involuntary smoking: a report of the Surgeon General, 1986. U.s.a. Section of Health and Human Services, Public Health Service, CDC, 1986; DHHS publication no.(CDC)87-8398.

  17. Glantz S, Parmley W. Passive smoking and heart disease. Circulation 1991;88:1-12.

  18. Steenland K. Passive smoking and the risk of heart disease. JAMA 1992;267:94-ix.

  19. U.s.a. Environmental Protection Agency. Respiratory health effects of passive smoking: lung cancer and other disorders. Washington, DC: United states Environmental Protection Bureau, 1992; Publication no. EPA/90006F, December, 1992.

  20. National Institutes of Health. The health consequences of using smokeless tobacco: a report of the Advisory Committee to the Surgeon General, 1986. Rockville, MD: US Department of Wellness and Human Services, Public Health Service, 1986; DHHS publication no. (NIH)86-2874.

  21. Pierce JP, Fiore MC, Novotny TE, Hatziandreu EJ, Davis RM. Trends in cigarette smoking in the United States: projections to the Twelvemonth 2000. JAMA 1989;261(1):61-5.

  22. CDC. Tobacco, booze, and other drug use among high school students -- The states, 1991. MMWR 1992;41:698-703.

  23. National Plant on Drug Abuse. National survey results on drug apply from Monitoring the Future Report, 1975-1992. Rockville, Dr.: US Department of Health and Human being Services, Public Health Service, 1993; DHHS publication no. (NIH)93-3597.

  24. CDC. Cigarette smoking among youth -- United States, 1989. MMWR 1991;twoscore:712-5.

  25. Gallup G Jr., Newport F. Many Americans favor restrictions on smoking in public places. Gallup Poll Monthly 1990; 298:19-27.

  26. Hatziandreu EJ, Pierce JP, Lefkopoulou G, et al. Quitting smoking in the United States in 1986. J of Natl Cancer Inst 1990;82;1402-6.

  27. Taioli Due east, Wynder Due east. Result of the historic period at which smoking begins on frequency of smoking in adulthood. New Engl J Med 1991;325:968- 9.

  28. CDC. Contempo trends in adolescent smoking, smoking-uptake correlates, and expectations virtually the future. Advance Information from vital and health statistics of the Centers for Disease Control and Prevention/National Center for Health Statistics; No. 221, Dec two, 1992.

  29. Kann L, Warren W, Collins JL, Ross J, Collins B, Kolbe LJ. Results from the national schoolhouse-based 1991 Youth Risk Behavior Survey and progress toward achieving related health objectives for the nation. Public Health Rep 1993;106(suppl one):47-55.

  30. Role of the Inspector Full general. Spit tobacco and youth. Dallas, TX: The states Section of Wellness and Human Services, 1992; DHHS publication no. (OEI)06-92-00500.

  31. Errecart MT, Walberg HJ, Ross JG, Aureate RS, Fiedler JL, & Kolbe LJ. Effectiveness of Teenage Health Pedagogy Modules. J Sch Health 1991;61(suppl ane):19-42.

  32. Yamaguchi Thou, Kandel D. Patterns of drug employ from boyhood to young adulthood. Two. Sequences of progression. Am J Public Health 1984;74:668-72.

  33. Tobler NS. Meta-assay of 143 boyish drug prevention programs: quantitative outcome results of programme participants compared to a control or comparison grouping. Periodical of Drug Issues 1986;17:537-67.

  34. Hansen WB. School-based substance abuse prevention: a review of the state of the art in curriculum. Health Educ Res 1992;vii:3:403- 30.

  35. Botvin GJ, Botvin EM. School-based and customs based prevention approaches. In: Lowinson J, Ruiz P, Millman R, eds. Compehensive textbook of substance corruption. 2nd ed.Baltimore, Md: Williams & Wilkins, 1992. 910-27.

  36. Public Health Service. Good for you people 2000: national health promotion and affliction prevention objectives -- full report, with commentary. Washington, DC: Us Department of Wellness and Human Services, Public Wellness Service, 1992; DHHS publication no.(PHS)91-50212.

  37. McGinnis JM, Degraw C. Salubrious schools 2000: creating partnerships for the decade. J Sch Health 1991;61:292-7.

  38. National Education Goals Console. The national education goals report. Washington, DC: National Education Goals Panel, 1991.

  39. Kolbe LJ, Kann L, Collins JL. Overview of the Youth Run a risk Behavior Surveillance System. Public Health Rep 1993;106 (suppl 1):2-10.

  40. Marcus SE, Giovino GA, Pierce JP, Harel Y. Measuring tobacco employ amidst adolescents. Public Health Rep 1993;106 (suppl 1):20-4.

  41. National School Boards Clan. No smoking: a lath member's guide to nonsmoking policies for the schools. Alexandria, VA: National School Boards Association, 1987.

  42. Grimes JD, Swisher JD. Educational factors influencing adolescent decision-making regarding employ of booze and drugs. J Alcohol Drug Educ 1989;35:i-15.

  43. Pentz MA, Brannon BR, Carlin VL, Barrett EJ, MacKinnon DP, Flay BR. The power of policy: the relationship of smoking policy to adolescent smoking. Am J Public Wellness 1989;79:857-62.

  44. Part of Substance Abuse Prevention. Stopping alcohol and other drug use before it starts: the future of prevention. Rockville, MD: US Department of Health and Human Services, Public Health Service, 1989; DHHS publication no.(ADM)89-1645.

  45. Swisher J, Crawford J, Goldstein R, Yura M. Drug didactics: pushing or preventing. Peabody J Educ 1971;49:68-75.

  46. Flay B, Sobol J. The role of mass media in preventing boyish substance abuse. In: Glenn T, Leukevald C, eds. Preventing adolescent drug abuse: intervention strategies. Washington, DC: National Institute on Drug Abuse, 1983:5-35.

  47. Leventhal H, Cleary PD. The smoking problem: a review of research and theory in behavioral risk modification. Psychological Bull 1980;88:370-405.

  48. Botvin 1000. Personal and social skills training: applications for substance abuse prevention. In: Proceedings of 6 regional workshops: strengthening health education for the 1990s. New York: Health and Condom Education Sectionalisation, Medical Section, Metropolitan Life Insurance Company, 1991.

  49. Flay B. Psychosocial approaches to smoking prevention: a review of findings. Wellness Psychol 1985;4:449-88.

  50. Botvin GJ. Substance abuse prevention enquiry: recent developments and future directions. J Sch Health 1986; 56: 369-74.

  51. All-time JA, Thomson SJ, Santi SM, Smith E, Brownish KS. Preventing cigarette smoking amid school children. Ann Rev Public Health 1988;9:161-201.

  52. Murray DM, Pirie P, Luepker RV, Pallonen U. Five- and half-dozen-year follow-up results from four seventh-grade smoking prevention strategies. J Behav Med 1989;12:207-18.

  53. Flay BR, Koepke D, Thomson SJ, Santi S, All-time A. Six-yr follow-up of the first Waterloo Schoolhouse Smoking Prevention Trial. Am J Public Health 1989;79:1371-vi.

  54. Botvin GJ, Baker Eastward, Dusenbury Fifty, Tortu Due south, Botvin EM. Preventing adolescent drug corruption through a multimodal cognitive-behavioral approach: results of a three-year study. J Consul Clin Psychol 1990;58:437-46.

  55. Botvin GJ, Renick NL, Baker Due east. The effects of scheduling format and booster sessions on a broad-spectrum psychosocial smoking prevention program. J Behav Med 1983;vi:359-79.

  56. Botvin GJ, Baker E, Dusenbury L, Botvin EM, Filazzola Advertizement. Preventing adolescent drug abuse through a multi-modal cerebral-behavioral approach: results of a vi-year study. Ithaca, NY: Cornell University Medical College, Plant for Prevention Research, 1993; technical report no. 93-ten.

  57. Hansen W, Graham J. Preventing alcohol, marijuana, and cigarette employ amid adolescents: peer pressure level resistance preparation versus establishing conservative norms. Prev Med 1991;20:414-30.

  58. The National Commission on the Role of the School and the Community in Improving Adolescent Health: Code blueish: uniting for healthier youth. Alexandria, VA: National Association of Land Boards of Education, 1990.

  59. Connell DB, Turner RR, Mason EF. Summary of findings of the school health education evaluation: health promotion effectiveness, implementation, and costs. J Sch Health 1985;55:316-21.

  60. Gold RS, Parcel GS, Walberg HJ, Luepker RV, Portnoy B, Rock EJ. Summary and conclusions of the THTM evaluation: the skilful work group perspective. J Sch Health 1991;61:39-42.

  61. Tortu S, Botvin GJ. School-based smoking prevention: the teacher training procedure. Prev Med 1989;eighteen:280-90.

  62. Perry CL, Murray DM, Griffin G. Evaluating the statewide broadcasting of smoking prevention curricula: factors in teacher compliance. J Sch Health 1990;60:501-four.

  63. Perry C, Telch M, Killen J, Shush A, Maccoby N. High schoolhouse smoking prevention: the relative efficacy of varied treatments and instructors. Adolescence 1983;17:561-6.

  64. Clarke J, MacPherson B, Holmes D, Jones R. Reducing adolescent smoking: a comparison of peer-led, teacher-led and skilful interventions. J Sch Health 1986;56:102-half dozen.

  65. Perry CL, Pirie P, Holder W, Halper A, Dudovitz B. Parental interest in cigarette smoking prevention: 2 pilot evaluations of the "unpuffables program." J Sch Health 1990;threescore:443-seven.

  66. Flay BR. Youth tobacco use: risks, patterns and command. In: Nicotine addiction: principles and direction. New York: Oxford University Press, 1993.

  67. Brink SG, Simons-Morton DG, Harvey CM, Parcel GS, Tiernan KM. Developing comprehensive smoking-command programs in schools. J Sch Health 1988;58:177-lxxx.

  68. St. Pierre RW, Shute RE, Jaycox South. Youth helping youth: a behavioral approach to the self-control of smoking. Health Educ 1983;xiv:28-31.

  69. Weissman W, Glasgow R, Biglan A, Liechtenstein Eastward. Development and preliminary evaluation of a cessation program for adolescent smokers. Psychol Addict Behav 1987;ane:84-91.

  70. Perry C, Killen J, Telch M, Slinkard LA, Danaher BG. Modifying smoking behavior of teenagers: a school-based intervention. Am J Public Wellness 1980;70:722-4.

  71. CDC. The health consequences of smoking: nicotine habit -- a written report of the Surgeon General. Rockville, MD: US Section of Health and Human Services, Public Health Service, CDC, 1988; DHHS publication no. (CDC)88-8406.


Table_1
Annotation: To print large tables and graphs users may have to alter their printer settings to mural and use a modest font size. 

                          TABLE 1. Instructional concepts (kindergarten through form twelve) ====================================================================================  ---------------------------------------+------------------------------------------                                        � Early on Elementary School                �   Subsequently Elementary Schoolhouse                                        � ---------------------------------------+------------------------------------------ KNOWLEDGE:  Students will larn        �   Noesis:  Students will larn   that                                 �      that ---------------------------------------+------------------------------------------ - A drug is a chemical that changes    � - Stopping tobacco use has short- and   how the trunk works.                  �   long-term benefits *                                        � - All forms of tobacco comprise a drug  � - Environmental tobacco smoke is   called nicotine.                     �   dangerous to health. *                                        � - Tobacco employ includes cigarettes and  � - About young persons and adults practise   smokeless tobacco.                   �   not utilise tobacco *                                        � - Tobacco use is harmful to health.    � - Nicotine, contained in all forms of to-                                        �   bacco, is an addictive drug. - Stopping tobacco use has short-term  �   and long-term benefits.              � - Tobacco use has curt-term and                                        �   long-term physiologic and corrective - Many persons who utilise tobacco have    �   consequences.   problem stopping.                    �                                        � - Personal feelings, family, peers, and - Tobacco smoke in the air is danger-  �   the media influence decisions about   ous to anyone who breathes it.       �   tobacco use.                                        � - Many fires are caused by persons     � - Tobacco advertising is often directed   who smoke.                           �   toward immature persons                                        � - Some advertisements try to per-      � - Young persons tin can resist pressure to   suade persons to use tobacco.        �   use tobacco.                                        � - Most young persons and adults practice     � - Laws, rules, and policies regulate   not use tobacco.                     �   the sale and use of tobacco.                                        � - persons who choose to use tobacco    �   are not bad persons.                 � ---------------------------------------+------------------------------------------ ATTITUDES:  Students will              � ATTITUDES:  Students will   demonstrate                          �   demonstrate ---------------------------------------+------------------------------------------ - A personal delivery not to use     � - A personal delivery not to use   tobacco.                             �   tobacco *                                        � - Pride almost choosing not to employ to-  � - Pride about choosing not to utilise to-   bacco.                               �   bacco *                                        �                                        � - Support for others' decisions non to                                        �   employ tobacco                                        �                                        � - Responsibleness for personal health. ---------------------------------------+------------------------------------------ SKILLS:  Students will be able to      � SKILLS: Students will be able to ---------------------------------------+------------------------------------------ - Communicate knowledge and per-       � - Communicate cognition and per-   sonal attitudes near tobacco use.   �   sonal attitudes near tobacco use. *                                        � - Encourage other persons not to use   � - Encourage other persons not to utilize   tobacco.                             �   tobacco. *                                        �                                        � - Demonstrate skills to resist tobacco                                        �   use.                                        �                                        � - State the benefits of a smoke-gratis en-                                        �   vironment.                                        �                                        � - Develop counterarguments to to-                                        �   bacco advertisements and other                                        �   promotional materials                                        �                                        � - Support persons who are trying to                                        �   end using tobacco. ---------------------------------------+------------------------------------------                                        � Eye School/Junior High School       � Senior Loftier School                                        � ---------------------------------------+------------------------------------------ KNOWLEDGE:  Students will larn        � Cognition:  Students will learn   that                                 �   that ---------------------------------------+------------------------------------------ - Most immature persons and adults practice     � - Most young persons and adults do   not smoke. *                         �   not smoke. *                                        � - Laws, rules, and policies regulate   � - Tobacco use has short- and long-   the sale and use of tobacco. *       �   term physiologic, cosmetic, social,                                        �   and economic consequences. * - Tobacco manufacturers use various    �   strategies to direct advertisements  � - Cigarette smoking and smokeless to-   toward young persons, such equally "im-   �   bacco use accept direct health con-   age" advertizing. *                  �    sequences. *                                        � - Tobacco use has short- and long-     � - Community organizations take in-   term physiologic, cosmetic, social,  �   germination about tobacco employ and can   and economic consequences. *         �   help persons stop using tobacco. *                                        � - Cigarette smoking and smokeless to-  � - Smoking cessation programs can be   bacco utilise have direct health con-    �   successful. *   sequences. *                         �                                        � - Tobacco use is an unhealthy way to - Maintaining a tobacco-complimentary environ-  �   manage stress or weight. *   ment has wellness benefits.            �                                        � - Tobacco employ during pregnancy has - Tobacco apply is an unhealthy way to   �   harmful effects on the fetus.   manage stress or weight.             �                                        � - Schools and community organiza- - Community organizations have in-     �   tions can promote a smoke-gratis   germination almost tobacco use and tin can  �   environment.   help persons cease using tobacco.     �                                        � - Many persons detect it hard to finish u.s.- - Smoking cessation programs tin can be    �   ing tobacco, despite knowledge   successful.                          �   most the health hazards of tobacco                                        �   use. - Tobacco contains other harmful sub-  �   stances in addition to nicotine.     � ---------------------------------------+------------------------------------------ ATTITUDES:  Students will              � ATTITUDES:  Students will   demonstrate                          �   demonstrate ---------------------------------------+------------------------------------------ - A personal commitment non to use     � - A personal delivery not to apply   tobacco. *                           �    tobacco. *                                        � - Pride most choosing not to utilize to-  � - Pride about choosing not to utilise to-   bacco. *                             �   bacco. *                                        � - Responsibility for personal health. *� - Responsibility for personal health. *                                        � - Support for others' decisions non to � - Support for others' decisions not to   use tobacco. *                       �    use tobacco. *                                        � - Confidence in personal power to    � - Confidence in personal ability to   resist tobacco use.                  �   resist tobacco apply. *                                        �                                        � - Willingness to apply schoolhouse and com-                                        �   munity resources for data                                        �   virtually, and help with, resisting or                                        �   quitting tobacco apply. ---------------------------------------+------------------------------------------ SKILLS:  Students will exist able to      � SKILLS: Students will exist able to ---------------------------------------+------------------------------------------ - Encourage other persons non to use   � - Encourage other persons not to use   tobacco. *                           �   tobacco. *                                        � - Support persons who are trying to    � - Support persons who are trying to   cease using tobacco. *                �    stop using tobacco. *                                        � - Communicate knowledge end per-       � - Communicate noesis and per-   sonal attitudes virtually tobacco use. * �   sonal attitudes about tobacco utilize. *                                        � - Demonstrate skills to resist tobacco � - Demonstrate skills to resist tobacco   utilize. *                               �    utilize. *                                        � - Identify and counter strategies used � - Place and counter strategies used   in tobacco advertisements and other  �   in tobacco advertisements and other   promotional materials. *             �   promotional materials. *                                        � - Develop methods for coping with to-  � - Develop methods for coping with to-   bacco use by parents and with other  �   bacco utilize past parents and with other   difficult personal situations, such  �   difficult personal situations, such   as peer pressure to utilise tobacco.     �   as peer pressure to use tobacco. *                                        � - Asking a fume-free surroundings.    � - Use school and community re-                                        �   sources for information about and                                        �   help with, resisting or quitting to-                                        �   bacco apply.                                        �                                        � - Initiate school and community action                                        �   to support a smoke-free environ-                                        �   ment. ---------------------------------------+------------------------------------------  * These concepts reinforce content introduced during earlier grades. ====================================================================================

Return to superlative.

Disclaimer All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, only are referred to the electronic PDF version and/or the original MMWR paper re-create for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.Due south. Regime Printing Function (GPO), Washington, DC 20402-9371; phone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.

Page converted: 09/xix/98

This page last reviewed v/2/01

johnsoncrand1993.blogspot.com

Source: https://www.cdc.gov/mmwr/preview/mmwrhtml/00026213.htm

0 Response to "Which of the Following Best Describes the Possible Impact of Tobacco Use on Families?"

Post a Comment

Subscribe to: Post Comments (Atom)

Iklan Atas Artikel

Iklan Tengah Artikel 1

Iklan Tengah Artikel 2

Iklan Bawah Artikel