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Prevention

Youth prevention programs can be an effective way to prevent and decrease tobacco use. Nearly 30% of all high school students and approximately 12% of all middle school students surveyed nationwide, reported current tobacco use.1

Prevention for tobacco use can cover a wide range of activities, including school-based programs (such as Life Skills Training) and community/medical-based programs (such as Media Campaigns). In this prevention section, we are highlighting prevention strategies shown to be effective for reducing the initiation of tobacco use among youth who are not current, regular smokers (i.e., never smokers or experimental smokers). Please see Youth Cessation for effective cessation strategies for youth who are current, regular smokers.

CDC-approved Programs

The CDC (Center for Disease Control and Prevention) has commissioned a task force to evaluate smoking prevention programs among adolescents. The CDC then approves only those curricula that are shown to be effective. Currently, the CDC has approved two Prevention Curricula "as programs that work": Life Skills Training (LST) and Towards No Tobacco (TNT). These programs as well as other programs shown to be effective will be presented below in the Best Practices section.

Best Practices: School-based Programs

Elementary

  • Life Skills Training (LST)
    • LST is a classroom-based curriculum with an elementary, middle, and high school program designed to prevent the initiation of tobacco use as well as other substances.2
    • Developed by Glibert J. Botvin, Ph.D.3
    • Elementary curriculum recommended ages: 8 – 11 years, grades: 3 – 6.2
    • Delivered in a series throughout 3 years: 3 levels (8 sessions per level).4
    • Sessions can be intensive over short period or extended for a weekly schedule.4
    • LST uses lecture, discussion, and interactive exercises to help youth develop skills specific to:2
      • Drug resistance.
      • Personal self-management.
      • General social interaction.

Middle School

  • Life Skills Training (LST)
    • The LST middle school curriculum focuses on tobacco facts and myths, advertising influences, coping skills (ie. anger, anxiety) as well as personal social skills and much more. Session concepts advance as students progress through the levels.5
    • Recommended for grades 6 – 9: 30 sessions.6
    • Level 1 (grades 6-7): 15 sessions & 3 optional violence sessions.6
    • Level 2 (grades 7-8): 10 sessions & 2 optional violence sessions.6
    • Level 3 (grades 8-9): 5 sessions & 2 optional violence sessions.6

 

  • Project TNT (Toward No Tobacco Use)
    • Project TNT is a youth program (classroom-based) intended to prevent or reduce tobacco use.7
    • Developed by Steve Sussman, Ph.D.7
    • Recognized by SAMHSA (Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services) as a model program.7
    • Recommended for ages 10-14 years, classroom-based (grades 5-9).7
    • Delivered in 10 core and 2 booster lessons (40-50 min. duration).7
    • Project TNT will aid youth in:7
      • Identifying pro-tobacco advertising and misleading information.
      • Using effective refusal and coping skills under social pressure.
      • Realizing the negative consequences of tobacco use in their own life

  • Project ALERT
    • Project ALERT is classroom-based curriculum with a parent-child focus designed to prevent drug use in youth.8
    • Developed by Phyllis Ellickson, Ph.D. and colleagues at RAND Corporation.8
    • Recognized by SAMHSA as a model program.8
    • Recommended for ages 11 – 14 years.8
    • Delivered in 11 core lessons (1 week apart) in year 1 and 3 booster lessons in year 2 (3 weeks apart).8
    • Project ALERT aims to focus on relationships and choices within individual, family, peer, and school levels involving tobacco use and other drugs.8

High School

  • Life Skills Training (LST)
    • The LST high school curriculum focuses on issues such as independence, responsibility, and interpersonal relationships as well as drug abuse and risks to name a few. The high school curriculum is highly interactive and developmentally appropriate.10
    • Recommended for grades 9 –10: 10 classes (40 – 45 min).11

Best Practices: Community-based/Medical-based Prevention

Community-based/Medical-based prevention strategies can be another effective way to reduce tobacco use in the population. Community prevention interventions have the potential to reach a wide audience.

Community-based/Medical-based prevention strategies offer a promising solution to reducing and preventing the initiation of smoking and tobacco use. Community/Medical based prevention interventions can focus on altering tobacco use behavior, promoting tobacco use change within the community, and/or passing and enforcing anti-tobacco legislation. Below are just a few of the effective strategies that can be implemented in a community and/or medical setting to reduce tobacco use initiation and/or promote cessation.

Awareness Campaigns/Media Coverage

Tobacco advertising and promotion activities appear to simultaneously encourage adult consumption and to increase the risk of youth initiation. Thus, counter-marketing strategies can be powerful tools to counteract the influence of tobacco promotion. Highlighted below are just a few Awareness Campaigns:

  • American Lung Association of Maryland
    The American Lung Association of Maryland has a public awareness program, "Tobacco Smoke Hurts My Lungs." It is an awareness campaign designed to:
    • Educate smokers about the effects of secondhand smoke on children's health.
    • Encourage smokers (particularly parents or guardians who smoke) to protect children from exposure.
      • The campaign consists of printed materials including a brochure, a poster, and a static cling sticker that reads, "Children Breathing. Please don't smoke here."
      • Maryland residents, who want to help spread the message and increase the awareness of the dangers of exposure to secondhand smoke, can e-mail indoorair@marylandlung.org to receive a static cling sticker.
    • Visit ALA of Maryland to locate the 4 offices within the state. You will find events and programs for youth, sponsored by Maryland's state chapter as well as local tobacco-related news.
    • For residents of other states you can contact your local lung association at 1-800-LUNG-USA

  • American Legacy Foundation: Truth® Campaign
    • The American Legacy Foundation has used selling tactics similar to those used by consumer marketers. They are trying to sell teens on not smoking cigarettes.
    • Farrelly and colleagues12 reported finding that the American Legacy Foundation's truth® campaign prevented hundreds of thousands of youth from initiating smoking in a 2 year period.

  • Maryland's Smoking Stops Here Campaign
    • Maryland Smoking Stops Here is a grassroots movement led by the Maryland Department of Health & Mental Hygiene (DHMH) in conjunction with health departments, community organizations, schools and colleges, businesses and the citizens of Maryland.
    • Together, these individuals and groups educate local communities about tobacco and secondhand smoke initiatives across the state.

 

Other Community Strategies

  • Faith-Based Programs.
  • Health Promotion Activities (e.g., Health Fairs).
  • Computer-based systems.13
  • Peer-based interventions.13
  • Penalties for possession and use (for adolescents).13
  • School policies.13
  • Vendor penalties.13
  • Clean indoor air laws.13

Helpful Links

  • Campaign for Tobacco Free Kids: The latest global, federal, and state initiatives on tobacco as well as local tobacco facts for each state. Youth advocacy is also highlighted in addition to numerous organizational partners.

  • Centers for Disease Control and Prevention, Youth Tobacco Prevention: Access to Surgeon General's Reports, Morbidity and Mortality Weekly Report releases, as well as many other educational materials and guidelines for youth tobacco use prevention.

  • Kidsource: A Guide to Youth Smoking Prevention Policies and Programs: You will find this webpage particularly helpful for parents. There are many anti-tobacco education tips listed and organized into school, community, and family areas of interest.

  • MedLine Plus: Smoking and Youth: This website provides the latest news, research, and statistics related to youth smoking.
  • TTAC COLLEGE TOBACCO PREVENTION RESOURCE: "The College Tobacco Prevention Resource (CTPR) aims to provide practical information, ideas, and guidance to assist college leaders with planning, implementing, and evaluating effective campus tobacco policies and programs."

References

1 Centers for Disease Control and Prevention (2005). Tobacco use, access, and exposure to tobacco in media among middle and high school student-United States 2004. Morbidity & Mortality Weekly Report, 54,(12), p 298.

2 SAMHSA Model Programs: Info on Model Programs, Brief Program Description of LST (2005). Retrieved September 13, 2006.

3 Life Skills Training: Program Developer (2005). Retrieved September 22, 2006 from http://www.lifeskillstraining.com/developer.php

4 Life Skills Training, Elementary School Program. Retrieved September 27, 2006 from http://www.lifeskillstraining.com/lst_elementary.php

5 Life Skills Training, Middle School Program, Scope and Sequence (unknown).Retrieved September 27, 2006 from http://www.lifeskillstraining.com/uploads/media/MS_Scope_Sequence2005.pdf

6 Life Skills Training, Middle School Program. Retrieved September 27, 2006 from http://www.lifeskillstraining.com/lst_middle.php

7 SAMHSA Model Programs: Info on Model Programs, TNT. Retrieved September 13, 2006.

8 SAMHSA Model Programs: Info on Model Programs, Project ALERT. Retrieved September 13, 2006.

10 Life Skills Training, High School Program, Scope and Sequence (unknown). Retrieved September 27, 2006 from http://www.lifeskillstraining.com/uploads/media/HS_scope.pdf

11 Life Skills Training, High School Program. Retrieved September 27, 2006 from http://www.lifeskillstraining.com/lst_hs.php

12 Farrelly, M. C., Davis, K. C., Haviland, M. L., Messeri, P. & Healton, C. G. (2005). Evidence of a Dose-Response Relationship Between "truth" Antismoking Ads and Youth Smoking Prevalence. American Journal of Public Health, 95, 425 - 431.

13 Lantz, P. M., Jacobson, P. D., Warner, K. E., Wasserman, J., Pollack, H. A., Berson, J., & Ahlstrom, A. (2000). Investing in youth tobacco control: a review of smoking prevention and control strategies. Tobacco Control, 9, 47-63.

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