Academic journal article Journal of School Health

Tobacco Prevention in Tobacco-Raising Areas: Lessons from the Lion's Den

Academic journal article Journal of School Health

Tobacco Prevention in Tobacco-Raising Areas: Lessons from the Lion's Den

Article excerpt

Health educators often face the challenge of delivering messages about health that are controversial. Opposition to the health message may be based on values, morals, economics, lack of curricular time, or other reasons. Regardless of the reason, health educators have the responsibility of attempting to deliver useful health information, even when some opposition exists. In this commentary, issues of delivering messages about tobacco in a tobacco-producing area are discussed. While students who live in these areas most need effective tobacco prevention, they probably are least likely to receive it due to the many barriers to tobacco prevention. Tobacco prevention is a challenge in any locale, but it is even more of a challenge in tobacco-raising areas where tobacco use and tobacco growing are-an integral part of the culture.

This commentary describes why students living in tobacco-raising areas are at high-risk for tobacco use and why they should be targeted for prevention efforts; makes recommendations for appropriate tobacco prevention with students exposed to a tobacco-growing culture; and, gives suggestions for obtaining access to teach tobacco prevention in tobacco-raising areas. While policy and community prevention efforts are mentioned, the focus of the commentary is on the curriculum as well as the efforts that the individual teacher can make to address tobacco prevention in tobacco-growing areas.

While tobacco-growing is concentrated in a few U.S. states, 18 states including Georgia, Indiana, North Carolina, Kentucky, Tennessee, Ohio, Virginia, South Carolina, Wisconsin, and others produce some tobacco.[1] Although the number of children actually exposed to tobacco-growing may appear small outside of a few states, health educators must be aware of even one child in the classroom who is at risk due to multiple influences to use tobacco and attempt to provide appropriate prevention education for that child.

FACTORS PROMOTING INCREASED RISK

Students living in a tobacco-raising area are exposed to many influences to use tobacco. The family influence to use is strong. In a survey of 19 middle schools in central Kentucky,[2] students reported that 45% of their fathers and 38% of their mothers smoked. In the same study, students listed their family as a source of cigarettes, and boys who personally raised tobacco reported that one of their sources of smokeless tobacco was that it was "given to me by parents."[2] Students' parents often grow tobacco and involve the children in the planting and harvesting process. The extended family also frequently is involved in tobacco raising. School board members, principals, and teachers often grow tobacco and receive income from it. As part of the agriculture program in public schools, students are taught how to grow tobacco and some schools have a tobacco barn on the school campus.

School policies in high school until recently, allowed students to smoke (with parent permission) in a designated area at school. School policies sometimes are lax and tobacco use at school, particularly smokeless (spitting) tobacco, often is overlooked. Tobacco use in school-sponsored athletic programs is widespread. Data collected in tobacco-producing areas confirm that these tobacco influences have had an impact on tobacco use by adolescents.

A group of researchers in Kentucky has been conducting research related to use of tobacco by adolescents in tobacco-raising areas for approximately nine years. This research, in the form of several studies, with other research studies, shows that students in tobacco-raising areas are at high-risk for tobacco use.[3,4] In a subsequent study of 3,851 seventh grade students in 19 middle schools, Noland et al[2] found that cigarette use was higher when at least one parent smoked, and/or the student personally raised tobacco. A boy who personally raised tobacco and had at least one parent who smoked was 10.2 times more likely to have smoked in the past seven days than a boy from a nonraising household in which neither parent smoked. …

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