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Healthy Tobacco-Free Schools CDC’s Division of Adolescent and School Health (DASH). DASH’s Mission. To promote the health and well being of children and adolescents so they become healthy and well-functioning adults. 3/10/2014. Key Health Issues for Young People.

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Healthy Tobacco-Free Schools

CDC’s Division of Adolescent and School Health (DASH)

dash s mission
DASH’s Mission

To promote the health and well being of children and adolescents so they become healthy and well-functioning adults.


key health issues for young people
Key Health Issues for Young People

Intentional and unintentional injuries

Alcohol/drug use

Sexual risk behaviors

Tobacco use

Physical inactivity

Poor eating habits


Mental health

coordinated school health programs
Coordinated School Health Programs

Health Education

Physical Education

Family and Community Involvement

Health Services



for Staff



Healthy and Safe School Environment

Counseling, Psychological, and Social Services

cdc dash funded coordinated school health programs
CDC/DASH-Funded Coordinated School Health Programs




Nez Perce Tribe




















Funded States

guidelines review process
Guidelines Review Process
  • Literature search
  • Convene DASH workgroup
  • Code articles (approx. 500)
  • Copies stored in hard copy and Ref. Mgr.
  • Draft list of strategies
  • Convene experts/partner panel
  • Draft for CDC internal review/partner review
  • CDC clearance process
1994 guidelines for school health programs to prevent tobacco use and addiction
1994 Guidelines for School Health Programs to Prevent Tobacco Use and Addiction

1. Policy

2. Instruction

3. Curriculum

4. Training

5. Family




7. Evaluation

2010 guidelines revisions
2010 Guidelines Revisions
  • Health Services: school health nurses, health care providers, counselors; cessation programs
  • Community + School Efforts
  • Parental Involvement
  • School Staff Involvement
  • After School/Advocacy Programs
  • Tobacco Awareness Events
  • Media/Advertising
  • Effects of Secondhand Smoke
comprehensive school tobacco free environment
Comprehensive School Tobacco-Free Environment
  • Creation of a strong tobacco-free policy
  • Communication of the policy
  • Enforcement of the policy
  • Prohibiting advertising and promotion
  • Tobacco-use cessation advice and referral
  • Tobacco-use prevention instruction
tobacco free environment
Tobacco-Free Environment
  • Emphasis on total tobacco-free environment at all times (24/7)
  • New research on secondhand smoke’s lingering effects in buildings
  • Secondhand smoke and asthma
  • Influence of role modeling by teachers, staff, visitors, and parents
exposure to secondhand smoke
Exposure to Secondhand Smoke

2006 Surgeon General’s Report:

  • There is no “risk-free” level of exposure to secondhand smoke.
  • Only eliminating smoking in indoor spaces fully protects non-smokers from exposure to secondhand smoke. Separating smokers from non-smokers, cleaning the air, and ventilating buildings cannot eliminate exposure.
exposure to secondhand smoke sgr 2006 continued
Exposure to Secondhand SmokeSGR, 2006, continued
  • Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke.
  • Children exposed to secondhand smoke are at increased risk for SIDS, acute respiratory infections, ear problems, and more severe asthma.
guidelines also cover
Guidelines also cover…

Effects on students from :

- Attitudes of teachers and parents

toward school tobacco-free policies

- Harmful effects of minimal

exposure to secondhand smoke

- Secondhand smoke and impaired


- Schools and students raising

tobacco crops

tobacco free policy cornerstone
Tobacco-Free Policy: Cornerstone
  • Prohibit all tobacco use on all school property, in school vehicles, at school- sponsored events (on and off school property) for students, staff, and visitors 24/7.
school district and state tobacco use prevention policies
School, District, and State Tobacco-Use Prevention Policies
  • Schools: 64%
  • Districts: 55%
  • States: 38%
  • Policies are least likely to address smokeless tobacco use and tobacco use among visitors

Source: CDC, School Health Policies and Programs Study 2006

school policies prohibiting tobacco advertisements
School Policies Prohibiting Tobacco Advertisements
  • In school buildings, outside on school grounds, on school buses or other vehicles, in school
  • publications, through sponsorship of school events
  • Source: CDC, School Health Policies and Programs Study 2006
communication and enforcement of the policy
Communication and Enforcement of the Policy
  • Clear communication to students, staff, visitors, contractors, and the community
  • Remedial* sanctions work best for students.

*Remedial = counseling, alternatives to suspension programs instead of suspension or expulsion, cessation programs, etc.

Recommendations for School-based Tobacco-Use PreventionEducationCommunity Guide to Preventive Services, 2004
  • The Task Force recommends use of school-based interventions when combined or coordinated with mass media campaigns and community education activities based on strong evidence of effectiveness in reducing tobacco use by students.
  • There is insufficient evidence to determine the effectiveness of school-based education (classroom programs) and other activities when implemented without additional community activities.
tobacco use prevention education
Tobacco-Use Prevention Education

Classroom programs should be delivered in conjunction with community and media messages.

Instruction should be K-12 and include:

  • Short- and long-term health consequences
  • Social influences
  • Peer norms
  • Refusal skills
  • Life and decision-making skills
  • Emphasis during middle and high school
Guidance, tools, and resources for a clear, complete, and consistent analysis of health education curricula
  • Based on CDC School Health Guidelines and National Health Education Standards
  • Identifies common characteristics of effective health education curricula
  • Higher expectations for and greater rigor in curriculum development and selection
  • Improved health education
tobacco use cessation for students and staff
Tobacco-Use Cessation for Students and Staff
  • Schools should identify students and staff who need assistance
  • Schools should give “brief advice” on quitting to students and staff
  • Schools should refer students and staff to outside providers
  • Schools should refer to the CDC guidance document if adopting an evaluated program or if developing its own program
cdc s guidance tool
CDC’s Guidance Tool

“Youth Tobacco Cessation: A Guide to Making Informed Decisions” (2004)


Youth Tobacco Cessation Collaborative

American Legacy Foundation

National Cancer Institute

Canadian Tobacco Control Research Initiative

parent involvement
Parent Involvement
  • Program planning
  • Reinforcing messages
  • Role modeling
  • Garner community support for tobacco-free policies and programs
  • Encourage smoke-free homes and cars
school community model








Student Led Programs

School + Community Model
Enables schools to identify strengths and weaknesses of health policies and programs
  • Enables schools to develop an action plan for improving student health
  • Engages teachers, parents, students, and the community in promoting health enhancing behaviors and better health

school health index topics
School Health Index Topics
  • Physical activity
  • Healthy eating
  • Tobacco use prevention
  • Unintentional injuries and violence prevention (safety)
  • Asthma



(National School Boards Association)


(National Association of State Boards of Education)

Linda Crossett: