Tobacco Control Programs
1999 Fact Sheet/Executive Summary
There is an ongoing commitment by the Massachusetts Department of Elementary and Secondary Education to help prevent and decrease tobacco use by students. Research shows that tobacco use is the leading preventable cause of death in the United States, and is responsible for one in every five deaths. Tobacco use among young people poses especially serious risks. Adolescent tobacco use not only threatens health, but it is also associated with alcohol and illicit drug use and with poor school performance. Every year in the United States over one million adolescents begin smoking. Four out of every five current adult smokers tried their first cigarette before age 18, and half of these became regular smokers by age 18.
Current Rates of Tobacco Use
The Massachusetts Department of Elementary and Secondary Education conducts the Youth Risk Behavior Survey (YRBS), a large, confidential, random survey of student-based behavior every two years. The most recent YRBS revealed some progress in the Commonwealth around tobacco use by students. According to the most recent Massachusetts Youth Risk Behavior Survey (1997):
- Overall, lifetime cigarette smoking, which had risen sharply from 1993 to 1995, has decreased slightly since then, from 72% (1995) to 69% (1997).
- Students in the 9th grade in 1997 had notably lower rates of lifetime smoking (62%) than did their 1995 counterparts (69%).
Recent cigarette smoking, which had risen significantly from 1993 to 1995, has decreased slightly since then, from 36% (1995) to 34% (1997).
- Recent smoking declined most notably among 9th grade students, from 32% (1995) to 28% (1997).
- Recent smoking stayed level for female students from 1995 to 1997 (36% for both years), but dropped slightly for males (35% to 33%).
- In 1995, rates of recent smoking among Massachusetts students were slightly above those reported by the national YRBS (35.7% vs. 34.8%). Due to slight increases nationally and slight decreases in Massachusetts, the 1997 rates of recent smoking among Massachusetts adolescents dropped below national rates (34.4% vs. 36.4%).9
The percentage of students who reported smoking cigarettes every day in the month prior to the survey (daily smoking) rose from 1993 to 1995, but has remained level since then at 15%.
- Among students who smoked every day, the proportion of those who smoked more than a half a pack a day (11 or more cigarettes) dropped slightly, from 46% (1995) to 42% (1997).
Health Protection Fund Grant Program
In accordance with the Massachusetts Department of Elementary and Secondary Education Health Protection Fund grant, school districts provide:
- The maintenance of a healthy school climate and environment, with special emphasis on enforcement of an effective tobacco free schools policy. There is to be equitable enforcement of the policy and consequences for students and staff and the provision of cessation programs.
- Tobacco prevention education for all students, including smoking cessation programs.
- 100% of districts reported that they have a tobacco free schools policy for students and staff as mandated by the Education Reform Act of 1993.
- The districts' tobacco-free schools policy included the following consequences for student violation:
92% include that students are suspended or expelled,
72% require students' parents/guardians to meet with school officials,
48% include that students must participate in prevention education,
29% include that students must participate in a cessation program, and
14% include that students are fined.
- 91% of districts include consequences for teachers in the policy.
- 95% of districts enforce the policy during athletic and other special school events.
Tobacco Prevention Education Instruction
- 98% of middle and high schools teach tobacco use prevention.
- Of these, 100% have a tobacco education curriculum that includes refusal skills.
- 63% of districts offered cessation programs for students.
Districts report that the average annual number of hours for cessation programs was:
- 10 hours for students.
The number of participants within the last 12 months in districts with a cessation program was:
- 13% of districts reported no participation. Between 1 and 38 students participating was reported by 72% of districts. The remaining 15% of districts reported that the number of participants ranged from 40 to 157 students.
Of those students participating in cessation programs:
- 61% of students completed the cessation program.
Effective Comprehensive School Health Education Program Practices
It can be useful to know which program practices as a group are related to decreases in tobacco use and to know the extent to which the decreases can be understood in terms of these groups of program practices. The information presented below is from the Year V Evaluation of the Health Protection Fund Grant program and reflect differences in current tobacco use from the first year and from the fifth year of the Health Protection Fund. The program practices are listed in order of their explanatory strength.
High School Tobacco Use
25% of the decrease that occurred from Year I (1993) to Year V (1997) in high school tobacco use can be accounted for by the program practices of:
- Parents being represented on the school health advisory council,
- Peer health educators working with students in discussion/support groups, and
- Training provided to teachers on matching the district's current health curriculum with the Health Curriculum Framework.
Middle School Tobacco Use
28% of the decrease that occurred from Year I (1993) to Year V (1997) in middle school tobacco use can be accounted for by the program practices of:
- A formally documented local evaluation of written goals, objectives, and/or outcomes in health education,
- Peer health educators working with students in health education courses/classes, and
- A greater frequency of interdisciplinary instruction between health education and family and consumer sciences education.
This fact sheet is part of a more conclusive report. Complete references for cited research are available in the full report. The findings presented in this fact sheet are compiled from the following Massachusetts Department of Elementary and Secondary Education reports: 1997 Comprehensive School Health Education Tobacco Control Programs Status Report, 1996 Massachusetts School Health Education Profile, 1998 Massachusetts School Health Education Profile (1999), 1998 Year IV Evaluation of the Health Protection Fund, and the 1999 Year V Evaluation of the Health Protection Fund (1999).
For more information, contact the Massachusetts Department of Elementary and Secondary Education, Health, Safety and Student Support Services Unit, 75 Pleasant Street, Malden, MA, 02148; 781-338-3000.
View the School Health Education Tobacco Control Programs Status Report