Addressing Tobacco Addiction by mehmete


									                             Addressing Tobacco Use
                                  & Addiction
                               CDC’s Division of Adolescent & School Health

Mission                                           Data Collection                      Coordinated School Health
The mission of the Division of                                                         Program (CSHP)
Adolescent and School Health (DASH)               and Analysis                         A CSHP consists of eight interrelated
is to prevent the most serious health                                                  components: health education;
risks among children, adolescents, and   Youth Risk Behavior                           physical education; health services;
young adults.                            Surveillance System (YRBSS)                   nutrition services; counseling,
                                         The YRBSS consists of national,               psychological, and social
Goal                                     state, and large urban school district
                                         surveys of representative samples of
                                                                                       services; healthy and safe school
                                                                                       environments; health promotion
To prevent tobacco use and addiction     high school students. Conducted               for staff members; and family and
among young people by increasing         every two years, these surveys monitor        community involvement. CSHPs
the capacity of the nation’s schools     health-risk behaviors among young             focus on improving the quality of
to address tobacco use through           people so that health and education           each of these components and
coordinated school health programs.      agencies can more effectively target and      expanding collaboration among the
                                         improve programs. These behaviors,            people responsible for them. This
Strategies                               often established during childhood and
                                         early adolescence, include tobacco use;
                                                                                       coordination results in a planned,
                                                                                       organized, and comprehensive set
  1	 Data	collection	and	analysis.       unhealthy dietary choices; inadequate         of courses, services, policies, and
                                         physical activity; alcohol and other          interventions that meet the health
  2	 Science-based	guidance.             drug use; sexual behaviors that can lead      and safety needs of all students
                                         to unintended pregnancy or sexually           from kindergarten through grade
  3	 Funding	to	state	departments	                                                     12. Effective CSHPs can increase
                                         transmitted disease, including HIV
     of	education	and	health	and	        infection; and behaviors that contribute      the adoption of health-enhancing
     national	nongovernmental	           to unintentional injuries and violence.       behaviors, improve student and
     organizations	for	program	                                                        staff health, and use resources more
     and	policy	development.             Specific data collected on tobacco-use
                                         behaviors include
  4	 Evaluation.                           Age at initiation of cigarette use.        activity; health services; mental health
                                           Lifetime, lifetime daily, current, and     and social services; nutrition services;
  5	 Integration	with	other	federal	                                                  healthy and safe school environment;
                                           current frequent cigarette use.
     efforts.                                                                         faculty and staff health promotion; and
                                           Current smokeless tobacco, cigar, and
                                           tobacco use.                               family and community involvement.
                                           Cigarette and smokeless tobacco use        SHPPS monitors policies and practices
                                           on school property.                        related to tobacco use, such as
                                           Access to cigarettes.                         Prohibiting all forms of tobacco use
                                                               by students, staff, and visitors, on
                                                                                         school property, in school vehicles,
                                             School Health Policies and                  and at school-sponsored events not
                                              Programs Study (SHPPS)                     on school property.
                                                                                         Prohibiting various forms of tobacco
                                                Conducted every six years, SHPPS
                                                is the most comprehensive study
                                                of U.S. school health policies and       Providing funding for staff
                                                programs. SHPPS assesses the             development or offering staff
                                               characteristics of school health          development on tobacco-use
                                              policies and programs at the state,        prevention education to health
                                             district, school, and classroom levels      education teachers.
                                            nationwide across all eight school           Requiring tobacco-use prevention
                                          health program components: health              education.
                                         education; physical education and  
School Health Profiles (Profiles)                                                          School Health Index (SHI):
Profiles, a biennial survey conducted                  Science-Based                       A Self-Assessment and
by state and local education and health
agencies, provides data on school health
                                                       Guidance                            Planning Guide
                                                                                           The SHI helps schools implement
policies and practices in states and large
urban school districts. It monitors and
                                             Guidelines for School Health                  evidence-based policies and practices
                                             Programs to Prevent Tobacco                   that promote a tobacco-free lifestyle and
assesses characteristics of, and trends
                                                                                           other healthy behaviors. SHI provides
in, health and physical education and        Use and Addiction                             the tools and resources needed to assist
activity, tobacco-use prevention policies,   Developed in collaboration with               stakeholders (e.g., teachers, parents,
nutrition-related policies and practices,    tobacco-use prevention experts across         students, and community members) in
health services, collaboration, and          the nation, the guidelines identify the       assessing health policies and programs
family and community involvement in          most effective policies and practices         and developing an improvement plan
school health programs. States and large     schools can implement to prevent              based on assessment results. Both print
urban school districts can use Profiles      tobacco use and addiction among               and interactive online versions of the
data to plan and allocate resources,         young people and create a tobacco-free        SHI are available.
guide professional development,              environment in which students can
advocate for policy improvement                                                  
                                             learn. According to these guidelines–
and resources, and describe the status       which are based on an extensive review
of school health programs in their           of research, theory, and current practice     Promising Practices in
jurisdictions.                               in tobacco-use prevention, cessation,         Chronic Disease Prevention
Data collected in Profiles include the       health education, and public health–          and Control: A Public Health
percentages of schools in participating      tobacco-use prevention programs are
                                             most likely to be effective when schools      Framework for Action
states and large urban school districts
that                                                                                       This publication provides a framework
                                                Develop and enforce a school policy        to help public health officials establish
  Prohibit all forms of tobacco use by          on tobacco use that establishes            comprehensive chronic disease
  students, staff, and visitors, on school      environments that are tobacco-free         prevention and control programs that
  property, in school vehicles, and             at all times, including off-site school    target limited resources where they are
  at school-sponsored events not on             events.                                    most needed and can be most effective.
  school property.                              Provide a sequential tobacco-use           The chapter on school health programs
  Teach specific topics related to              prevention curriculum during grades        describes promising practices that
  tobacco-use prevention.                       K–12, with intensive delivery in           states should consider when planning
                                                junior high or middle school, and          school-based policies and programs to
  Have a lead health education teacher
                                                with reinforcement in high school.         help young people avoid behaviors that
  who has recieved staff development
  on tobacco-use prevention.                    Provide instruction that covers the        increase their risk for tobacco addiction
                                                physiologic and social consequences        and tobacco-related diseases, and                                                          promote a tobacco-free environment. In
                                                of tobacco use, social influences on
                                                tobacco use, peer norms regarding          addition, the tobacco chapter describes
Healthy Passages                                tobacco use, and skills that promote a     proven, effective interventions that state
Healthy Passages is a multi-year study          tobacco-free lifestyle.                    and local public health officials and
that follows a group of fifth-grade             Provide program-specific training for      their partners can implement to address
students through age 20 to improve              teachers.                                  tobacco use on a state or community
our understanding of what factors help                                                     level.
                                                Involve parents, families, and the
keep children healthy. The results will                                          
                                                community in support of school-
provide information that can be used to                                                    Ch9.pdf
                                                based programs to prevent tobacco
develop effective policies and programs         use.
to improve the health and development
of children, adolescents, and adults.           Provide support for tobacco-use
Healthy Passages collects data on               cessation efforts among students and
cigarette and smokeless tobacco use,            school staff who use tobacco.
other substance use, and peer tobacco           Assess the tobacco-use prevention
use, as well as data on physical activity,      program at regular intervals.
diet, physical and mental health, injuries
and violence, sexual behavior, family        An updated version of the guidelines is
and peer relationships, and media            scheduled for release in 2008.
     Funding to State
     Departments                                  Welcome to our
of Education and                                       tobacco-free school!
Health and National                                                               State law prohibits tobacco use on all school property.
Nongovernmental                                                                   Violators are subject to penalty.

Organizations for                                                    provided by the Colorado Department of Public Health and Environment, State Tobacco Education and Prevention Partnership (STEPP) 11/00

Program and Policy
                                             DASH funds national NGOs to                                               state education and health agencies
Development.                                  Assess needs for training, technical                                     to advance the understanding and
                                              assistance, materials, and other                                         implementation of CSHPs, including
State Programs to Reduce                      resources.                                                               tobacco-use prevention, within
Tobacco Use and Addiction                     Build capacity of other funded
                                                                                                                       schools. In addition to training, the
DASH supports efforts to reduce tobacco                                                                                Collaborative provides ongoing support
                                              partners and constituents through
use through Coordinated School                                                                                         to trainees by hosting CSHP-related
                                              training and technical assistance
Health Programs (CSHPs) by providing                                                                                   conference calls, supplying Website
technical assistance and financial                                                                                     assistance, identifying and promoting
                                              Identify, develop, and disseminate                                       additional resources, and conducting
support to state education and health
                                              model strategies, guidelines, program                                    follow-up site visits.
agencies in 23 states. As a result of this
                                              materials, and other resources.
assistance, states are able to                                                                                         The Society and the Association of
                                              Assist constituents and other funded
  Implement effective tobacco-use                                                                                      State and Territorial Health Officials
                                              partners in developing
  prevention policies, programs,                                                                                       (ASTHO) developed Making the
  curricula, and standards.                                                                                            Connection: Health and Student
                                              Encourage constituents and other                                         Achievement –a presentation for state
  Provide professional development,           funded partners to collaborate with                                      and local education decision makers,
  consultation, and technical assistance      state departments of education and                                       parents, teachers, and administrators
  to schools and school districts.            health and community-based                                               that summarizes research linking health
  Implement strategies to reduce health       organizations.                                                           status, health behavior, and academic
  disparities.                                                                                                         achievement.
  Collaborate with local health and          For example, the National Association                           
  education departments, community           of State Boards of Education developed
  planning groups, parents, students,        Fit, Healthy and Ready to Learn: A                                        The National School Boards
  and other groups or coalitions.            School Health Policy Guide to provide                                     Association (NSBA) convenes a
                                             science-based information to help state,                                  consortium of national organizations
                                             local, and territorial education agencies                                 and state School Boards Associations
National Nongovernmental                     develop and implement the policies                                        to promote strategies for preventing
Organization (NGO) Programs                  needed to ensure support for school                                       youth tobacco use and strengthening
to Reduce Tobacco Use and                    health. The tobacco prevention chapter                                    tobacco-free school policies. To
Addiction                                    provides guidance on developing a                                         support this effort, they are currently
                                             comprehensive, integrated policy aimed                                    assessing model policies of state school
National NGOs support state and                                                                                        boards associations for alignment
                                             at reducing tobacco use and promoting
local health and education agencies                                                                                    with established tobacco policy
                                             a tobacco-free lifestyle among students
in preventing tobacco use and                                                                                          recommendations and standards.
                                             and school staff. An updated version
addiction. NGOs can effectively                                                                                        Additionally, NSBA provides technical
                                             will be released in 2007.
reach target audiences with resources,                                                                                 assistance, information, and resources
guidance, training, and technical  
                                                                                                                       to school boards to help them establish
assistance to develop, implement,            The CSHP Collaborative includes the                                       and strengthen policies and practices to
and promote tobacco-use prevention           Society of State Directors of Health,                                     support tobacco-free schools.
programs, policies, and practices.           Physical Education, and Recreation
Through extensive coordination and           (The Society); the National Association
collaboration, NGOs promote better           of Chronic Disease Directors; and the
health for all students and put research     Directors of Health Promotion and
findings into action to support healthier    Education. The CSHP Collaborative
youth.                                       conducts trainings that bring together
         Evaluation                             TOBACCO-FREE                                                                                                                                      Integration with
                                                                                                                                                                                                  Other Federal Efforts
         Technical Assistance
DASH provides evaluation support to                 ZONE                                                                                                                                  DASH collaborates closely with CDC’s
its funded partners through individual                                                                                                                                                    Office on Smoking and Health (OSH),
technical assistance and professional                                                                                                                                                     other CDC partners, and other federal
development. Technical assistance                                                                                                                                                         agencies to address issues related to tobacco-
increases the capacity of funded                                                                                                                                                          use prevention and cessation in schools.


partners to evaluate and improve their
programs by describing their programs                                                                                                                                                        DASH collaborated with OSH
using a logic model, developing                 State law prohibits tobacco                                                                                                                  on the development of CDC’s Best
                                                                                                                                                                                             Practices for Comprehensive Tobacco
SMART objectives, and documenting               use on all school property.                                                                                                                  Control Programs, a guide for states on
what happened in their programs by
maintaining accurate and organized              Violators are subject to penalty.                                                                                                            establishing tobacco control programs
records on program activities and                                                                                                                                                            that are comprehensive, sustainable,
designating a person responsible for
                                                COLORADO REVISED STATUTE                                                                                                                     and accountable.
process evaluation data.                                                                                                                                                                     DASH staff members participate in
                                                 provided by the Colorado Department of Public Health and Environment, State Tobacco Education and Prevention Partnership (STEPP) 11/00

                                                                                                                                                                                             OSH’s Youth Initiation Work Group,
                                                                                                                                                                                             the Young Adult Tobacco Use Work
Evaluation Research                          and smoking rates among middle-                                                                                                                 Group, the Policy Team meetings, and
To help identify effective new               school students compared with a                                                                                                                 numerous school and youth-related
approaches for promoting the health of                                                                                                                                                       initiatives with OSH.
                                             control group. The evaluation found
young people, DASH provides technical                                                                                                                                                        DASH and OSH project officers
                                             that every dollar invested in TNT will
assistance to state and local agencies                                                                                                                                                       are cross-trained to assist states and
to evaluate innovative policies and          save society nearly 20 times as much in
                                                                                                                                                                                             collaborate in tobacco-use prevention
programs.                                    future medical care costs. The results of
                                                                                                                                                                                             in schools.
                                             the study were published in Archives of
Cost-Effectiveness Study of Project          Pediatric Medicine, 2001; 155 (9):1043-                                                                                                         DASH staff members regularly provide
Toward No Tobacco Use (TNT)                                                                                                                                                                  input on documents, toolkits, websites,
CDC conducted an economic                                                                                                                                                                    and other tools developed by CDC, the
evaluation using data from a 2-year          Linking Lives                                                                                                                                   National Cancer Institute, and other
                                             Linking Lives is a parent-based                                                                                                                 federal agencies related to tobacco-use
effectiveness study of the school-based
                                             intervention to prevent or reduce                                                                                                               prevention among young people.
tobacco-use prevention program,
TNT. The program had been found to           tobacco use and sexual risk behaviors in                                                                                                        DASH staff members participate
                                             young adolescents, and was developed                                                                                                            in the Healthy People 2010 Tobacco
significantly reduce smoking initiation
                                             for parents of Latino and African                                                                                                               Work Group.
                                             American middle school students in                                                                                                              DASH staff members serve on the
                                             the Bronx, New York. The evaluation                                                                                                             interagency Youth Tobacco Cessation
                                              focuses on the effectiveness of                                                                                                                Collaborative.
                                                 combining parents interventions                                                                                                             DASH and OSH have convened
                                                   with school-based curricula,                                                                                                              expert panels to explore strategies for
                                                    compared with curricula alone.                                                                                                           reducing tobacco use among college
                                                     The primary feature of the                                                                                                              students and young adults.
                                                     parent intervention is a set                                                                                                            DASH staff members help develop
                                                      of booklets (in English and                                                                                                            Guide to Community Preventive
                                                      Spanish) that teach parents how                                                                                                        Services reviews on school-related
                                                      to communicate effectively with                                                                                                        tobacco-use prevention.
                                                      their children about tobacco
                                                     and sexual risk behaviors. The                                                                                                        For additional information, contact
                                                    evaluation study is a randomized                                                                                                       DASH
                                                   controlled trial and includes about                                                                                                     4770 Buford Highway, NE, MS-K29
                                                 4,750 families. Data collection will                                                                                                      Atlanta, GA 30341-3717
                                               be completed in 2007.                                                                                                                       1-800-CDC-INFO

                               U.S. Department of HealtH anD HUman ServiceS
                                          Centers for Disease Control and Prevention

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