Effectiveness of School-Based Programs as a Component of a Statewide Tobacco Control Initiative

Objective: To understand tobacco use patterns and the context, implementation and reception of a 2-year school-based behavioural intervention to promote awareness and support for tobacco control policies. Design: Qualitative exploration of participating students’, parents’ and teachers’ perspectives, experiences and observations related to tobacco use and the school-based intervention, as well as suggestions for the more effective prevention of tobacco use. Setting: 1,440 schools (720 intervention, 720 control) in two districts of Andhra Pradesh and five districts of Gujarat, India, participated in the study. Method: Forty-six focus group discussions were conducted with 94 teachers, 105 parents and 138 students in the intervention schools. Results: Evaluation findings signal the influence of the social, economic and cultural context on the initiation and perpetuation of tobacco use. Positive health beliefs, the economic importance of tobacco and cultural practices related to tobacco use were at variance with mounting evidence on the adverse outcomes of tobacco use. Health behaviour change related to tobacco use was observed in participating students, teachers and their families. However, the wider community was not as much influenced. Analysis of the intervention revealed various inputs and gaps in the implementation of the intervention associated with low impact on tobacco use in the community. Conclusion: School-based interventions can effect significant perceived health behaviour change among students and families. Health promotion interventions need to acknowledge, harness and address cultural norms, economic pressures and policy implementation with respect to the initiation and perpetuation of tobacco use health behaviours.

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School-based tobacco-control programming and student smoking behaviour

Chronic Diseases in Canada ◽

10.24095/hpcdp.29.4.04 ◽

2009 ◽

Vol 29 (4) ◽

pp. 169-177 ◽

Cited By ~ 1

Author(s):

DA Murnaghan ◽

ST Leatherdale ◽

M Sihvonen ◽

P Kekki

Keyword(s):

Tobacco Control ◽

Prince Edward Island ◽

Evaluation System ◽

School Health ◽

Family Members ◽

Action Planning ◽

Control Program ◽

Smoking Behaviour ◽

Cross Sectional ◽

School Based

The study examined the association of a school-based tobacco-control program with students’ smoking behaviour over time using three cross-sectional, provincial census datasets (grade 10 students in 1999, grade 11 students in 2000, grade 12 students in 2001). Data were collected from all secondary schools in Prince Edward Island (Canada) using the Tobacco module of the School Health Action, Planning and Evaluation System (SHAPES). The proportion of regular smokers increased from grade 10 (22.3%) to grade 12 (27.8%, χ2 = 10.35, df = 1, p $lt; 0.001). Being exposed to different school-based tobacco programs and policies in grades 10 and 11 was not associated with the smoking behaviour of grade 12 students. The strongest predictors of smoking behaviour were having friends or close family members who smoke. This preliminary evidence suggests that programs and policies associated with banning smoking and enforcing smoking restrictions at school may be insufficient unless they also address the influence of smoking peers and family members and link to comprehensive programming within the broader context of other community and policy level interventions.

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Arizona's tobacco control initiative illustrates the need for continuing oversight by tobacco control advocates

Tobacco Control ◽

10.1136/tc.8.2.141 ◽

1999 ◽

Vol 8 (2) ◽

pp. 141-151 ◽

Cited By ~ 9

Author(s):

S. A. Bialous ◽

S. A Glantz

Keyword(s):

Tobacco Control ◽

Control Initiative

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School-Based Tobacco Control and Smoking in Adolescents: Evidence from Multilevel Analyses

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103422 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3422

Author(s):

Seong Yeon Kim ◽

Myungwha Jang ◽

Seunghyun Yoo ◽

Jung JeKarl ◽

Joo Youn Chung ◽

...

Keyword(s):

Secondary Schools ◽

Tobacco Control ◽

School Environment ◽

Smoking Behavior ◽

Adolescent Smoking ◽

School Level ◽

Tobacco Prevention ◽

Control Programs ◽

School Based ◽

The Impact

Since 2015, universal comprehensive school-based tobacco control programs have been provided in all primary and secondary schools in Korea. This study explored the association of school-level tobacco control with adolescent smoking, and the interactions to investigate whether gender moderates the impact of school tobacco control programs and school-level norms. Both school- and individual-level data were drawn from the 2015 School-Based Tobacco Prevention Program Survey. Multilevel logistic regression analyses were performed using data from 4631 students (ages 10–18 years) who were nested in 62 secondary schools in Seoul, Korea. Students who participated in more prevention programs were less likely to smoke (OR = 0.47, 95% CI 0.30–0.74). The effect of the programs was significantly moderated by gender. For boys, exposure to a greater number of programs decreased the risk of smoking (OR = 0.32, 95% CI 0.18–0.57) but not for girls. At the school level, the school norm regarding tobacco control regulations was negatively associated with smoking (OR = 0.28, 95% CI 0.11–0.76), and its effect was significant for girls only (OR = 0.35, 95% CI 0.17–0.76). This study highlights how the school environment is associated with adolescent smoking behavior, and the effects of programs and norms are different by gender. The findings suggest the need to develop strategies to enhance school-based tobacco control programs and the school norm considering gender differences.

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Enhanced Tobacco Control Initiative at Johns Hopkins Health System: Employee Fairness Perception

Health Promotion Practice ◽

10.1177/1524839918759525 ◽

2018 ◽

Vol 20 (2) ◽

pp. 206-213

Author(s):

Shabnum Durrani ◽

Meg Lucik ◽

Richard Safeer

Keyword(s):

Health System ◽

Tobacco Control ◽

Unintended Consequences ◽

Senior Management ◽

Employee Benefits ◽

Component Model ◽

Fairness Perception ◽

The Past ◽

Four Component Model ◽

Control Initiative

Organizations often fail to establish a clear awareness of what employees consider fair when implementing changes to employee benefits in the workplace. In 2016, the Johns Hopkins Health System (JHHS) enhanced their tobacco control efforts. In addition to enhanced smoking cessation benefits, employees were offered an increased reduction in their insurance premiums if they were nonsmokers. To qualify for the reduction, employees participated in testing rather than relying on self-reporting as had been done in the past. The shift to testing prompted a concern by some senior management at JHHS who did not want employees to feel they were not trusted. As the program unfolded at JHHS, the four-component model of procedural justice was applied to provide a framework for reviewing the implementation of the new voluntary tobacco testing at JHHS from a fairness lens. The purpose of this article is to illustrate the application of the four-component procedural model of justice to the tobacco testing process at JHHS. As approximately 75% of employees participated in the program, the experience at JHHS can be instructive to other employers who are looking to implement changes in their workplaces and how to minimize unintended consequences with their employees.

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EAT-Brazil Award for Tobacco Control: a brief description of its first edition

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.65.6.775 ◽

2019 ◽

Vol 65 (6) ◽

pp. 775-778

Author(s):

Paulo César Rodrigues Pinto Corrêa ◽

Rayanna Mara de Oliveira Santos Pereira ◽

José Gomes Temporão ◽

Tânia Maria Cavalcante ◽

Oscar Campos Lisboa ◽

...

Keyword(s):

Risk Factor ◽

Tobacco Control ◽

Undergraduate Students ◽

Preventable Death ◽

Global Risk ◽

Support Materials ◽

School Based ◽

Anonymous Questionnaire ◽

The Subject ◽

Undergraduate Programs

SUMMARY Smoking is a major global risk factor for preventable death and disability. EAT is an acronym for Education Against Tobacco, a multinational network of physicians and medical students that aims to improve tobacco control by means of school-based prevention targeted at adolescents through counseling, use of software and support materials. The first EAT-Brazil Award, launched in March 2018, was a competition designed to encourage the proposal of objective solutions for tobacco control in Brasil, and identify new talents in the area. Brazilian undergraduate students from any field of study could submit a one-page essay on the subject, competing for the amount of R$ 1000.00 (one thousand reais). There were a total of 39 applicants (20 women and 19 men) from 9 Brazilian states and 18 undergraduate programs, with a mean age of 22.5 years (SD = 3.7). Data from an online anonymous questionnaire answered after the submission of their essays revealed that most applicants were students of institutions from in the state of Minas Gerais (n = 26/39; 66.6%), studied medicine (n = 20/39, 51.3%), and had no prior knowledge of the EAT-Brazil Network (n = 27/39, 69.2%). The winner of the award was Lucas Guimarães de Azevedo, a fourth-year medical student at Federal University of Western Bahia. The next editions of the award should focus on increasing the number of applicants and diversifying their geographical distribution.

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