Impact of the Life Skills Training Curriculum on Middle School Students Tobacco Use in Marion County, Indiana, 1997-2000

By Zollinger, Terrell W.; Saywell, Robert M., Jr. et al. | Journal of School Health, November 2003 | Go to article overview

Impact of the Life Skills Training Curriculum on Middle School Students Tobacco Use in Marion County, Indiana, 1997-2000


Zollinger, Terrell W., Saywell, Robert M., Jr., Muegge, Carolyn M., Wooldridge, J. Scott, Cummings, Sandra F., Caine, Virginia A., Journal of School Health


Tobacco use represents a significant cause of death and disease in the United States. (1-4) Most smokers begin smoking before age 18, and addiction to tobacco occurs in the first few years of tobacco use. (5,6) Relationships also exist between high school students' tobacco use and other health-risk behaviors, such as other substances, sexual risk behaviors, and intentional injury risk behaviors. (7)

The 1999 American Legacy Foundation national youth tobacco survey found that 12.8% of middle school students (grades 6-8), and 34.8% of high school students (grades 9-12), used some form of tobacco products in the past 30 days, with cigarette smoking the most commonly used form of tobacco. (8) Surveillance of high school students' health-risk behavior shows that tobacco use among high school students increased the first two-thirds of the 1990s, then slowly declined. (9) The serious impact of tobacco use by youth and adults led the US Dept. of Health and Human Services to identify tobacco use as a leading health indicator in Healthy People 2010. (10)

Best practices for strengthening school programs to prevent or cease tobacco use derive from evidence-based curricula that rely on improving social-cognitive life skills to enhance knowledge, affect attitudes, and promote refusal skills. (11) Guidelines for school health programs to prevent tobacco use and addiction recommend that programs address multiple factors, including undesirable consequences of tobacco use, social norms and influences regarding tobacco use, and behavioral and social skills for resisting influences that promote tobacco use. (12) Evaluations of school-based interventions produced mixed findings. Where a reduction in smoking occurred, the average affect was modest. Interventions with multiple components such as age restrictions for tobacco purchase, tobacco-free public places, anti-tobacco mass media campaigns, and special school programs often are combined on a communitywide level to deter young people from using tobacco. (13)

In a review of nine community interventions with school-based programs, only two reported reductions in smoking prevalence in the intervention community, compared to the no intervention control community. (14) Both of the successful programs (15,16) were designed as large-scale, population-focused cardiovascular disease prevention programs with a smoking component that included a school-based intervention for young people. Seven studies reporting no effects on smoking prevalence involved a mixture of different community programs. (17-23)

Botvin et al (24,25) report that drug abuse prevention programs conducted during junior high school produce meaningful and durable reductions in tobacco, alcohol, and marijuana use. These interventions focused on social and psychological factors to develop skills for resisting drug use influences. Recommended curricula and guidelines have not been widely adopted in schools. Yet, where evidence-based school programs were coordinated with other community efforts, some significant decreases in prevalence of tobacco use occurred. (14,26)

This study assessed the impact of the Life Skills Training curriculum (27) on participating Indianapolis Public School (IPS) students' ability to make good lifestyle decisions, particularly related to tobacco use. The premise was that school-based smoking prevention and intervention programs would produce a measurable reduction in smoking, and that repeated exposure to Life Skills Training would produce a greater positive change in tobacco use, attitudes, and knowledge.

METHODS

The Marion County (Indiana) Tobacco-Free Youth Initiative was developed by the Healthy Indy Partnership to address tobacco use among youth in Marion County (Indianapolis), Indiana. The Tobacco-Free Youth Initiative sought to reduce the prevalence of tobacco use among youth through smoking prevention and intervention programs using the Life Skills Training curriculum, in which students learn about self-image, influence of media, and peer pressure. …

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