“A-B-C-1-2-3 Healthy Kids in Tennessee:
Let’s Be Aware Every Day”
About This Module
o The Awareness module of the A-B-C-1-2-3
Healthy Kids in Tennessee: Let’s Eat Well,
Play, and Be Aware Every Day program
focuses on three components:
o Being aware of how we treat ourselves and others,
through compassion and respect, and treating
ourselves and others well
o Childhood cancer – awareness of signs and symptoms*
o Tobacco use and avoidance of secondhand smoke
*Parents and caregivers participate in the childhood cancer
component, but not children.
o To promote awareness of other components
of healthy living which includes childhood
cancer awareness (parents and caregivers),
compassion, respect, and treating others
well (children), and avoidance of tobacco
and secondhand smoke (parents and
caregivers and children).
Objectives for each participant
o For children, to learn about compassion and respect for
people who appear different from themselves, and to treat
themselves and others well, by listening to the Zink the
Zebra story and participating in selected activities; to learn
about the dangers of tobacco and secondhand smoke by
participating in selected activities.
o For parents, to explore Zink the Zebra activities that can
be done with children at home; to learn about the dangers of
tobacco and secondhand smoke.
o For parents and teachers, to increase awareness of
childhood cancer and possible signs for which they should be
alert and provide resources to communicate this information
to parents and caregivers; to learn about the dangers of
tobacco and secondhand smoke.
“Zink the Zebra” –
Treating Ourselves and
Zink’s Overall Message?
“Together, we need to help produce
generations of students, parents,
and adults who will have respect
for themselves and for other people
who are perceived as different.”
- Zink The Zebra Foundation Inc. 2000
Zink’s Message to
Parents and Childcare Providers
All of us face cancer in our communities.
Raising awareness of adult and childhood
cancers will help to save lives.
Zink’s Message to Children
We all may be different on the outside, but we
are the same on the inside. We should treat
ourselves and others well and with
compassion and respect!
o Teacher reads Zink the Zebra and completes several
lesson plans from the curriculum (see next slide). The
program is best completed within one week.
o The story communicates a powerful message of
“differences,” whether due to illness, handicaps, size,
beliefs, or any other defining characteristic.
o The Zink story and activities will teach compassion
and understanding and to treat oneself and others
Lessons with Zink the Zebra
Four lesson plans are included:
o Lesson 1: Meeting Zink the Zebra
o Lesson 2: Kindness Comes from Within
o Lesson 3: The Zebra In Me
o Lesson 4: Re-enact the Story
from Zink the Zebra
o Expand on Zink lessons at home with
take-home activities provided
o Enjoy other suggested stories with similar
themes (such as The Little Engine That
Childhood Cancer –
Signs and Symptoms
How Does Zink the Zebra relate to Childhood Cancer?
o Kelly Weil wrote Zink the Zebra when she
was 11 years old and undergoing treatment
o Kelly wanted to tell others how it feels to be
different and emphasized the importance of
kindness and sensitivity.
Sharing with Parents, Caregivers,
and Childcare Providers
o Kelly’s message leads us to a discussion among
adults regarding cancer in our community.
o The following handouts are included that may be
shared with parents and caregivers:
o Differences in Adult and Childhood Cancers
o Possible Signs of Childhood Cancer
o Important Points
o Did You Know?
o Did You Know You Can Help?
Differences between Adult and Childhood Cancers
Prevention/Early Detection No tobacco use; None–causes of childhood
Diet/exercise; cancer are unknown.
Sun safety; and However, good habits to
Screening tests prevent adult cancers start
(mammogram, at birth.
Frequent Types Lung, Breast, Colon, Leukemia, Lymphoma,
Prostate, Skin Brain, Bone
Incidence Per Year 1,000,000 12,500
~ 5-Year Survival Rate 68% 81%
% of Patients in Clinical Trials 3% 70%
~ Length of Treatment 6 months to 1 year Up to three years
Long Term Effects of Typically less severe; 70% of survivors suffer
Treatment varies based on serious long-term effects
treatment (heart failure, learning
disabilities, increased risk
of other cancers)
Citations listed on next slide.
Differences in Adult and Childhood Cancers
Possible Signs of Childhood Cancer
Continued weight loss
Increased swelling or pain in bones, joints, etc.
Lump in abdomen, neck, chest, pelvis, or armpits
Development of excessive bruising, bleeding, or rash
A whitish color in the pupil (middle, dark area of the eye)
Constant tiredness or paleness
Eye or vision changes
Recurrent or persistent fevers
Source: Ped-Onc Resource Center. Available at www.acor.org/ped-onc/diseases/SOCC.html (accessed June 28, 2011).
o Childhood cancer is rare.1,2
o It is unlikely that a child will develop
o As a parent or teacher, being aware of
possible signs can result in a faster
o Children need regularly scheduled well-
baby/well-child check ups.
1 University of Texas MD Anderson Cancer Center. Newswise. Parents Update: Pediatric Cancer Myths and Facts. Available
at www.newswise.com/articles/parents-update-pediatric-cancer-myths-facts (accessed June 28, 2011).
2 Ped-Onc Resource Center. Available at http://www.acor.org/ped-onc/diseases/SOCC.html (accessed June 28, 2011).
Did You Know That. . .
o … childhood cancer is the number one cause of
death by disease in children and causes more
deaths than cystic fibrosis, muscular dystrophy,
diabetes, asthma, and AIDS, combined?1
o … 46 children (equal to two classrooms) per day
are diagnosed with childhood cancer.2
o … 40,000 thousand children are currently being
treated for cancer.2
o … over the past 20 years, increasing numbers of
children have been diagnosed with cancer.3 The
causes are still unknown.
1 University of Texas MD Anderson Cancer Center. Newswise. Parents Update: Pediatric Cancer Myths and Facts.
Available at www.newswise.com/articles/parents-update-pediatric-cancer-myths-facts (accessed June 28, 2011 ).
2 Cure Search/Children’s Oncology Group (COG). Fact Sheet. Available at www.cursearch.org (accessed June 2782011).
3 National Cancer Institute Fact Sheet. Available at www.cancer.gov(accessed July 6, 2011).
Did You Know You Can Help?
o By being aware, you could be
the person who identifies a
child in need.
o You can be a leader in your
community for cancer issues
o You can help neighbors and
families facing cancer.
o You can promote
compassion, as illustrated in
Zink the Zebra.
Objectives for the Tobacco and Secondhand
Smoke section of the Awareness module:
Tounderstand the health risks of tobacco
use and secondhand smoke
Tobe able to implement learning
activities for preschool children about the
dangers of tobacco and secondhand smoke
Tobe prepared to share information to
educate parents, caregivers, and childcare
teachers and staff about the dangers of
tobacco use and of secondhand smoke
Why Focus on Tobacco Use
and Secondhand Smoke?
Improving the health of children ages 3–5 enrolled
in child care facilities in Tennessee and their
families is a goal of the A-B-C-1-2-3 Healthy Kids
in Tennessee: Let’s Eat Well, Play, and Be Aware
Every Day program.
Cigarette smoking is the leading preventable cause
of death in the U.S.1
Tobacco smoke contains chemicals that are
harmful to both smokers and nonsmokers.
Breathing even a little tobacco smoke can be
Source: 1 National Cancer Institute, Harms of Smoking and Health Benefits of Quitting. Accessed 6/30/2011
Why Focus on Tobacco Use
and Secondhand Smoke?
There are over 7,000 chemicals in tobacco smoke,
and at least 69 have been known to cause cancer.1
Children aren’t able to make the decision to not
breathe in smoke—it’s up to the parents and
caregivers to maintain a smoke-free environment.
When YOU smoke, your child smokes, too!
The U.S. Surgeon General estimates that living with
a smoker increases a nonsmoker’s chances of
developing lung cancer by 20 to 30 percent. Keep a
smoke-free environment for the health of everyone!1
Source: 1National Cancer Institute, Harms of Smoking and Health Benefits of Quitting. Accessed 6/30/2011
Terms You May Hear
“Secondhand smoke is the combination of smoke from
the burning end of the cigarette and the smoke breathed
out by smokers.”
“When you breathe secondhand smoke, it is like you are
“It hurts you.
It doesn’t take much.
It doesn’t take long.”
Source: The Health Consequences of Involuntary Exposure to Tobacco Smoke: A R e p o r t o f t h e S u r g e o n G e n e r a l, 2006. youwww.surgeongeneral.gov; accessed
June 30, 2011.
Terms You May Hear
o Particles from secondhand tobacco smoke that may
settle onto hair, clothing, and other surfaces and
remain there long after the smoke is gone.
o Researchers have proven that these particles can form
more cancer-causing compounds.
o This is a concern for everyone, but particularly for
children who are on the floor playing, crawling, etc.
Health Risks of Tobacco Use
Smoking harms nearly every organ of the body and
diminishes a person’s overall health.
Smoking is a leading cause of cancer and death from
cancer. It causes cancers of the lung, esophagus,
larynx, mouth, throat, kidney, bladder, pancreas,
stomach, and cervix, as well as acute myeloid
Smoking causes heart disease, stroke, aortic
aneurysm (a balloon-like bulge in an artery in the
chest), chronic obstructive pulmonary disease (COPD)
(chronic bronchitis and emphysema), asthma, hip
fractures, and cataracts.
Smokers are at higher risk of developing pneumonia
and other airway infections.
Source: National Cancer Institute, Harms of Smoking and Health Benefits of Quitting. Accessed 6/30/2011
Benefits of Quitting Smoking
20 minutes after quitting your heart rate drops to a
more normal state.
12 hours after quitting the carbon monoxide level in
your blood drops to normal.
2 weeks to 3 months after quitting your heart attack
rate begins to drop. Your lung function begins a
series of changes to improve.
1 to 9 months after quitting your cough and
shortness of breath decrease.
Source: Centers for Disease Control and Prevention. Surgeon General’s Report: Within 20 Minutes of Quitting, 2004. www.cdc/.gov. Accessed June 30, 2011.
Benefits of Quitting Smoking
1 year after quitting your added risk of coronary
heart disease is half that of a smoker’s.
5 to 15 years after quitting your stroke risk is
reduced to that of a nonsmoker.
10 years after quitting your lung cancer death
rate is half that of a smoker’s. Your risk of
cancers of the mouth, throat, esophagus, bladder,
kidney and pancreas decreases.
15 years after quitting your risk of coronary
heart disease is back to that of a nonsmoker’s.
In 2006, Surgeon General Richard Carmona
stated that, at ANY amount, secondhand smoke
“There is no safe amount
of secondhand smoke.”
Source: The Health Consequences of Involuntary Exposure to Tobacco Smoke: A R e p o r t o f t h e S u r g e o n G e n e r a l, 2006. youwww.surgeongeneral.gov; accessed June 30, 2011
Children are Especially Vulnerable
The main place young children breathe
secondhand smoke is in their homes. Almost
three million children in the United States under
the age of six years old breathe secondhand
smoke at home at least four days per week.
Breathing secondhand smoke is a known cause
of sudden infant death syndrome (SIDS).
Children are more likely to have lung problems,
ear infections, and severe asthma from being
Children are Especially Vulnerable (continued)
Secondhand smoke contains more than 250 chemicals
known to be toxic or carcinogenic.
Because their bodies are still developing, infants and young
children are especially vulnerable to the poisons in
Source: Campaign for Tobacco-Free Kids: Facts & Information.www.tobaccofreekids.org. Retrieved June 23, 2011.
How Can Childcare Centers Make a Difference by
Addressing Tobacco Use and Secondhand Smoke?
Child care programs have the opportunity to contribute
dramatically to the improvement of the health of families they
providing education on the effects of secondhand smoke
on infants and children;
providing education on the effects of thirdhand smoke
on infants and children;
providing information on tobacco cessation and referral
services in the community; and
protecting children from the long term harmful effects
of secondhand and thirdhand smoke.
Hands-on activities are included in the A-B-C-1-2-3
Healthy Kids in Tennessee: Let’s Eat Well, Play, and
Be Aware Every Day curriculum package that teach
children about the dangers of tobacco use and
Include these and others in your classroom activities
as part of this program.
“Is Your Heart in the Right Place”
Science Project/”My Little Heart”
Smoke-free pledge take-home activity
Reach Out to Enhance
Your Tobacco Education Efforts
Partner with agencies and organizations who work
with tobacco control and prevention and/or other
health-related concerns to come and do classroom
activities with the children (local health departments,
hospitals, American Lung Association, American Heart
Association, American Cancer Society, and others).
Provide information on programs and resources to
staff and families.
See resources that follow for additional sources of
Incorporate classroom activities included in this
curriculum into your planned activities.
Resources for Parents, Caregivers,
and Childcare Teachers and Staff
Breathe Free Tennessee
strives to eliminate children's exposure to
secondhand smoke by promoting the adoption
of voluntary smoke-free home and car policies
in communities across Tennessee.
Resources for Parents, Caregivers, and
Childcare Teachers and Staff (continued)
Tennessee Tobacco Quitline
1-800- QUIT NOW
o It’s free.
o Callers are assigned a personal “quit coach.”
o It is a wonderful resource to share with parents,
caregivers, and childcare teachers and staff.
Please share available handouts with parents
and caregivers with information on the
Tennessee Tobacco Quitline!
Tennessee Tobacco QUITLINE:
1-800-QUIT-NOW or 1-800-784-8669
(funded by the Tennessee Department of Health)
EX, interactive website by the American Legacy
Foundation to help smokers quit.
National Cancer Institute Smoking Quitline
Breathe Free Tennessee www.breathefreetn.com
American Lung Association, www.lungusa.org
American Cancer Society, www.cancer.org
Nicotine Anonymous World Services,
Campaign for Tobacco-Free Kids
Want to Take It to the Next Level?
Want to take A-B-C-1-2-3 Healthy Kids in
Tennessee: Let’s Eat Well, Play, and Be Aware
Every Day to the next level?
Now that you have the tools to implement
healthy living education in your classrooms and
with parents and families, what’s next?
Consider participating in the “Gold Sneakers”
program, which helps you develop policy
guidelines for your facility. Both programs
complement each other extremely well, providing
your facility with a well-rounded approach to
Want to Take It to the Next Level? (continued)
To learn more about Gold Sneakers contact:
Tennessee Department of Health
Gold Sneaker Initiative
For more information or questions, please contact:
Cynthia Chafin, M.Ed., CHES
The MTSU Adams Chair of Excellence in Health Care Services
and Center for Health and Human Services
Tennessee Cancer Coalition coordinator
email@example.com or firstname.lastname@example.org
Phase III of the A-B-C-1-2-3 Healthy Kids in Tennessee: Let’s Eat Well, Play,
and Be Aware Every Day project supported in part by funding
from the MTSU Center for Physical Activity and Health in Youth and the Tennessee Cancer
Coalition, with support of the MTSU Center for Health and Human Services.