Reprinted from the "Tobacco" issue of Visions Journal, 2007, 3 (4), p. 20
Chances are, when you think of preventing smoking, you think of education programs in school. But, as a recent Ministry of Health document shows, prevention is much more than education.1 Schools are also being asked to develop policies to respond to tobacco and other drug use by students, not just prevent it. This article explores briefly the complex role of schools in tobacco control.
Impact of school-based drug education programs
School-based drug education can have a modest impact in reducing or delaying alcohol and tobacco use.2 Mixed results in the research, however, suggest caution in assuming that any education program will have a positive impact. Delivering such programs within health education at key stages in youth development improves effectiveness.
In-school education should seek to influence behaviour in the short term. Since early substance use predicts later problems, delaying use can have a significant positive impact.
The best programs are interactive and provide information that students can readily put into use. They focus on developing practical skills—how to negotiate social situations or deal with stress, for example—reinforced across a period of years.1
Challenges of drug education programs
Even though education programs can have some positive impact, schools have very few learning resources or curriculum supports from which to choose. Even fewer of these resources have been properly evaluated. BC Tobacco Facts is a learning resource developed in BC several years ago.3 It meets many of the criteria of effective programs, but lacks a full evaluation.
BC Partners for Mental Health and Addictions Information and other partners are working with the Centre for Addictions Research of BC to develop classroom resources. These will address tobacco use along with other substances and mental health issues. Some of these resources will be piloted in selected school districts this spring. Work on developing and testing these resources will need to continue over the next several years to ensure effectiveness.
Other ways schools can promote prevention
Preventing tobacco use is not only about education; schools can also contribute to prevention in other ways. Smoking bans in public places are effective in preventing tobacco use. Some evidence suggests that school-based bans can also be effective when strongly enforced.4 Such policies should be part of a community-wide strategy, rather than being isolated to the school.
Schools can also play a role in other aspects of tobacco control. They can promote messages and programs that support students who want to quit smoking. This can be as simple as providing highly visible information about resources that assist students to quit.
BC schools can participate in the Tobacco-Free Sports program, which supports both prevention and cessation. Alternatively, they can offer cessation support at school through a program like Kick the Nic.5
Why tobacco use prevention is really a community concern
The BC Ministry of Health estimates that 12% of premature death and disability in BC is the result of tobacco use.6 Smoking by school-aged children is of particular concern, so it is natural to think of addressing the issue in the schools. As noted, schools can help prevent and reduce smoking, thereby reducing death and disability, as well as health care costs. But it is both unfair and unwise to expect schools to carry the burden of tobacco use prevention.
School-based strategies have more impact when linked to effective policies and programs in the community. Taxation and retail regulations that increase the cost of tobacco are very effective. Social marketing campaigns that reinforce the messages presented at school are vital.
Attention needs to be given to factors that influence early childhood development. This should involve programs to decrease the use of tobacco during pregnancy, as well as programs for parental education and support. Early school adjustment, in particular, deserves careful attention—which brings us back to schools.
Schools, though important institutions within all communities, are not the community. And it takes a community to prevent and reduce tobacco use.
About the authorDan is Director of the Communication and Resource Unit for the Centre for Addictions Research of BC at the University of Victoria
Centre for Addictions Research of BC. (2006). Following the evidence: Preventing harms from substance use in BC. Victoria: Ministry of Health.
McBride, N. (2005). The evidence base for school drug education interventions. In T. Stockwell et al (Eds.), Preventing harmful substance use: The evidence base for policy and practice (pp.101-112). Chichester, UK: John Wiley & Sons.
BC Ministry of Health. (n.d.). bc.tobaccofacts: A tobacco prevention resource for teachers. www.silink.ca.
Wakefield, M.J., Chaloupka, F.J., Kaufman, N.J. et al. (2000). Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: Cross sectional study. British Medical Journal, 321(7257), 333-337.
Information about these programs is available on www.carbc.ca