School, parent, and student perspectives of school drug policies

BACKGROUND: Schools use a number of measures to reduce harmful tobacco, alcohol, and drug use by students. One important component is the school's drug policy, which serves to set normative values and expectations for student behavior as well as to document procedures for dealing with drug-related incidents. There is little empirical evidence of how policy directly or indirectly influence students' drug taking. This study compares how effectively schools communicate school drug policies to parents and students, how they are implemented, and what policy variables impact students' drug use at school and their perceptions of other students' drug use at school. METHODS: Data were obtained from 3876 students attending 205 schools from 2 states in the United States and Australia, countries with contrasting national drug policy frameworks. School policy data were collected from school personnel, parents, and students. RESULTS: Schools' policies and enforcement procedures reflected national policy approaches. Parents and students were knowledgeable of their school's policy orientation. CONCLUSIONS: When delivered effectively, policy messages are associated with reduced student drug use at school. Abstinence messages and harsh penalties convey a coherent message to students. Strong harm-minimization messages are also associated with reduced drug use at school, but effects are weaker than those for abstinence messages. This smaller effect may be acceptable if, in the longer term, it leads to a reduction in harmful use and school dropout within the student population.     

A cross-national comparison of school drug policies in Washington State, United States, and Victoria, Australia

Using mail survey data collected from primary and secondary school administrators in Washington State, United States, and in Victoria, Australia, this study compared aspects of the school drug policy environment in the 2 states. Documented substance-use policies were prevalent in Washington and Victoria but less prevalent.in primary schools, especially in Victoria. Victorian school policy-setting processes were significantly more likely to involve teachers, parents, and students than processes in Washington schools. Consistent with expectations based on their respective national drug policy frameworks, school drug policies in Washington schools were more oriented toward total abstinence and more frequently enforced with harsh punishment (such as expulsion or calling law enforcement), whereas policies in Victorian schools were more reflective of harm-minimization principles. Within both states, however, schools more regularly used harsh punishment and remediation consequences for alcohol and illicit-drug violations compared to tobacco policy violations, which were treated more leniently.     

Longitudinal Effects of School Drug Policies on Student Marijuana Use in Washington State and Victoria,Australia

Objectives. We examined the longitudinal effect of schools’ drug policies on student marijuana use.Methods. We used data from the International Youth Development Study, which surveyed state-representative samples of students from Victoria, Australia, and Washington State. In wave 1 (2002), students in grades 7 and 9 (n = 3264) and a school administrator from each participating school (n = 188) reported on school drug policies. In wave 2 (2003), students reported on their marijuana use. We assessed associations between student-reported and administrator-reported policy and student self-reported marijuana use 1 year later.Results. Likelihood of student marijuana use was higher in schools in which administrators reported using out-of-school suspension and students reported low policy enforcement. Student marijuana use was less likely where students reported receiving abstinence messages at school and students violating school policy were counseled about the dangers of marijuana use.Conclusions. Schools may reduce student marijuana use by delivering abstinence messages, enforcing nonuse policies, and adopting a remedial approach to policy violations rather than use of suspensions.Marijuana is the most widely used illicit drug worldwide,1,2 with an estimated 181 million (3.9%) of the world’s adults using it in 2011.3 Surveys in the United States and Australia have shown that marijuana use is particularly high among adolescents.4,5 Concern about marijuana use has increased in recent years as a result of improved understanding of the harmful health and psychological effects of frequent use, especially among adolescents and young adults.6,7 At the same time, many US states have passed marijuana laws making it legal for adults older than 21 years to possess small amounts of marijuana for medical purposes. Two states—Colorado and Washington—have legalized marijuana for recreational use by adults. Studies on the impact of marijuana legislation on marijuana use by US adolescents have yielded mixed results, with some pointing to an increase in use and others to no change or to a decrease in marijuana use.8–13 Marijuana use is illegal in Australia.14School-based prevention programs and policies have become the dominant mode of drug prevention for adolescents.15 School drug policies aim to reduce levels of adolescent substance use by restricting access to drugs and exposure to drug use during school hours. Studies measuring access to marijuana at the individual, school, and country levels have shown consistent associations between increased access and higher rates of self-reported use by adolescents.16–18 An Australian study showed that high rates of school-level marijuana use (an indirect measure of exposure) are associated with increased risk of use by secondary students.19 In addition, students in Swiss schools with more incidents of marijuana intoxication (as reported by teachers) were more likely to report marijuana use, regardless of peer use,20,21 itself a salient risk factor.19,22 Even in the absence of direct exposure to others’ marijuana use, students may be influenced by the general level of acceptability or disapproval of marijuana use in the broader school environment.23,24 Thus, school drug policy may have a further potentially important function in addressing marijuana social norms in the school context.Although almost all secondary schools in the United States and Australia have illicit drug policies, school-to-school variation in policy content exists.25–27 Schools differ in how they develop, communicate, and enforce their policies as well as in policy intent (e.g., goals of abstinence vs harm minimization). In addition, schools vary with respect to their responses to incidents of student drug use, which range from highly punitive approaches such as expulsion and suspension to remedial responses such as counseling.25–27 Despite calls from leading government agencies for schools to implement evidence-based, whole-school drug education policies and programs,28,29 empirical evidence of effective policy effects is relatively scarce. Studies examining the effectiveness of school drug policies in reducing student drug use have demonstrated mixed results, although there is some evidence of the importance of policy enforcement.30The majority of studies have focused on the impact of tobacco policy on student smoking.31–42 Fewer studies have investigated the impact of policies on student alcohol43–46 and illicit drug use.47,48 With 1 exception,45 none of these studies has demonstrated a longitudinal relationship between school policy and subsequent drug use. Further research is required to understand how these policies affect student drug use. Particularly needed are studies addressing the predictive impact of various elements of school policy, including punitive versus remedial policies and responses, policy enforcement, and exposure to abstinence and harm minimization messages related to substance use in the school context.We aimed to fill the existing knowledge gap by assessing the longitudinal impact of school illicit drug policies on student marijuana use. We maximized variation in the measured policy components by using data from the International Youth Development Study (IYDS), an ongoing longitudinal cross-national study of schools and adolescents in Washington State and Victoria, Australia, which have been shown to differ in their approach to school policy elements. Washington school policies have been more oriented toward total abstinence and more frequently enforced with harsh punishment (such as expulsion or calling law enforcement), whereas policies in Victoria schools have been more reflective of harm minimization principles.25Previous studies investigating the validity of the IYDS school policy survey tools have shown that reports from school officials and students in the United States are significantly different from those in Australia and accurately reflect their respective national policy approaches to youth alcohol and drug use.25,26 School official and student reports on IYDS school alcohol policy measures have longitudinally predicted student alcohol use.45 In this study, we used IYDS school policy information collected from both school officials and students and self-reported student marijuana use 1 year later to address the following research questions:

1. Is student marijuana use predicted by the level of enforcement of school illicit drug policies?
2. Is student marijuana use predicted by different types of school responses to illicit drug use at school?
3. Is student marijuana use predicted by the degree to which school illicit drug policy is based on abstinence and harm minimization principles?

     

Impact of a School Health Coordinator Intervention on Health-Related School Policies and Student Behavior

BACKGROUND: Health-related, school-based interventions may serve to prevent disease and improve academic performance. The Healthy Maine Partnerships (HMP) initiative funded local school health coordinators (SHCs) as a part of Maine's Coordinated School Health Program (CSHP) beginning in January 2001. SHCs established school health leadership teams and implemented annual work plans to address health risk behaviors. This study evaluates the impact of the Healthy Maine Partnerships SHC (HMPSHC) intervention on school policies and student risk behaviors after its first 5 years. METHODS: Data sources include the Maine School Health Profiles Survey and the Maine Youth Drug and Alcohol Use Survey/Youth Tobacco Survey. Cross-sectional analyses were performed on 2006 data to assess physical activity, nutrition, and tobacco-related policy associations with the HMPSHC intervention. Finally, policy and student behavior analyses were conducted to assess associations. RESULTS: Intervention schools were more likely to be associated with physical activity intramural offerings, improved nutritional offerings, and tobacco cessation programs. In intervention schools, supportive school policies were associated with decreased soda consumption, decreased inactivity, and decreased tobacco use. Required school health education curricula were more predictive of decreased risk behavior in intervention schools than in nonintervention schools. CONCLUSIONS: In schools with SHCs, there exists a stronger association with improved school programs. Improved policies and programs were associated with decreases in risk behavior among students in intervention schools. The HMPSHC intervention may be a viable CSHP model to replicate and evaluate in other settings.     

The constitutionality of random drug and alcohol testing of students in secondary schools

Adolescent drug and alcohol use is a major public health problem. Multiple studies indicate that substance use is a risk factor for physical and mental disorders in adolescents. Secondary schools and the communities they serve have been facing a long-standing problem of substance abuse. American adolescents have become quite accustomed to drug prevention being a part of their curriculum. However, some policy decisions made by school administrators have been legally challenged. In 1989, Vernonia School District serving a small community in Oregon, instituted a random drug testing policy of its athletes. In 1991, the parents of a seventh grader refused to give their consent for random drug testing. The seventh grader was denied participation in the sport and sued the School District arguing that the school policy violated the Fourth and Fourteenth Amendments to the United States Constitution, and Article I, Section 9 of the Oregon Constitution. In 1995, on appeal to the Supreme Court of the United States, the School District won the case. The Vernonia School District versus Acton case became a landmark case, but random drug and alcohol testing in secondary schools has been a subject of multiple court cases. The authors discuss three of them. Both Federal and State Courts have recognized that a secondary school environment in itself represents "a special need," for which suspicionless searches are sometimes necessary to maintain order, safety, and discipline. Drug and alcohol testing programs in secondary schools may still be challenged on its legality. Therefore, examining court sanctioned programs and their long-term efficacy statistics is recommended.     

A cross-national comparison of risk and protective factors for adolescent substance use: the United States and Australia.

PURPOSE: To compare risk and protective factors that influence youth substance use in Australia and the United States. The two countries have different policy orientations toward substance use: Australia has adopted harm-reduction policies, and the United States has adopted abstinence-focused policies. METHODS: Cross-sectional survey data were collected from independent samples of adolescents in the states of Maine (N = 16,861; 53% female, 7% Non-white) and Oregon (N = 15,542; 51% female, 24% Non-white) in the United States and Victoria in Australia (N = 8442; 54% Female, 11% Non-white) in 1998 (Maine and Oregon) and 1999 (Victoria). Chi-square tests, t-tests, effect size comparisons, and logistic regression analyses that accounted for age and gender were used to investigate cross-national similarities and differences in: (a) rates of cigarette, alcohol, and marijuana use; (b) levels of risk and protective factors; and (c) magnitudes of associations between risk and protective factors and substance use. RESULTS: More adolescents in Victoria reported using cigarettes and alcohol, whereas more of the U.S. adolescents reported using marijuana. Exposure to risk and protective factors was generally similar in the cross-national samples. However, adolescents in Maine and Oregon perceived handguns to be more readily available, reported more participation in religious activities, and were higher in sensation-seeking and social skills; and adolescents in Victoria had more favorable attitudes toward drug use and reported community norms and parental attitudes more favorable to drug use. Most of the risk and protective factors were strongly associated with substance use to a similar degree in Victoria, Maine, and Oregon. However, among adolescents in Maine and Oregon peer/individual risk and protective factors associated with social detachment were more strongly related to substance use, and among adolescents in Victoria, family protective factors were less strongly related to alcohol use. CONCLUSIONS: Inter-country influences on youth substance use are generally similar despite different policy directions. Existing differences suggest that the abstinence policy context is associated with higher levels of illicit drug use and stronger relations between individual indicators of social detachment and substance use, whereas the harm reduction policy context is related to more cigarette and alcohol use, possibly from exposure to normative influences that are more tolerant of youth drug use.     

School Policy in COMMIT: A Promising Strategy to Reduce Smoking by Youth

ABSTRACT: Organizational smoking policy has been identified as a potentially effective way to influence health behavior, particularly in worksites. Examining the elements of existing school smoking policies for both students and employees can provide insight into the potential effectiveness of these policies in changing young people's smoking behavior. This paper examines selected components of existing school smoking policies in a national sample of schools at all levels of education as part of the Community Intervention Trial for Smoking Cessation. Schools were questioned about their school smoking policies, related resources, and compliance. The data show much variation in the elements of school tobacco use policy to change smoking behavior. Existing policies in schools differ among grade levels, thus providing different messages about the appropriateness of smoking. Policies differ for students and adults, providing another opportunity for confusion about the messages that policy can deliver.
In general, resources available to support existing policies are lacking. Many schools offer classes on knowledge of negative health effects of smoking but do not teach the psychosocial skills necessary to resist tobacco use. In its present forms, school policy has great potential for an effective tool for health promotion, but considerable reform is needed to overcome current barriers.     

Effect of school policy on tobacco use by school personnel in Bihar, India

This study examined the relationship between school tobacco policies and tobacco use prevalence among school personnel. Two subsets of schools were identified in Bihar, India: Federal Schools (with a tobacco policy), and State schools (without a tobacco policy). Stratified probability samples of 50 schools each were selected. The survey was conducted through an anonymous, self-administered questionnaire. School personnel from State Schools (non-policy schools) reported significantly higher daily cigarette smoking and daily current smokeless tobacco use compared to personnel in Federal schools (policy schools). Teachers in State schools did not teach about health consequences of tobacco, and they had not received training for such teaching. Extent of teaching about health consequences of tobacco varied across topics for teachers in Federal schools. They received negligible training, but more than 35% reported access to teaching materials. More than one-half the personnel from Federal schools knew about their school's policy prohibiting tobacco use among students and school personnel, and about policy enforcement. Personnel in State schools did not know about tobacco control policy in their schools. All school personnel in both types of schools were near unanimous in supporting policy prohibiting tobacco use in schools. The study demonstrated an association between enacting a school policy regarding tobacco use and school personnel's use of tobacco, curricular teaching, and practical training of students. Findings suggest that more extensive introduction of comprehensive school policies may help reduce tobacco use among school personnel.     

Is there a relation between school smoking policies and youth cigarette smoking knowledge and behaviors?

To comply with workplace legislation, New Zealand schools are required to have policies regarding tobacco smoking. Many schools also have policies to prevent tobacco use by students, including education programmes, cessation support and punishment for students found smoking. This paper investigated the associations between school policies and the prevalence of students' cigarette smoking. Furthermore, we investigated the association between school policy and students' tobacco purchasing behavior, knowledge of health effects from tobacco use and likelihood of influencing others not to smoke. Data were obtained from a self-report survey administered to 2,658 New Zealand secondary school students and staff from 63 schools selected using a multi-stage sampling procedure. Components of school policy were not significantly associated with smoking outcomes, health knowledge or health behavior, and weakly related to a punishment emphasis and students advising others to not smoke. Similarly, weak associations were found between not advising others to not smoke and policies with a punishment emphasis as well as smoke-free environments. The results suggest that having a school tobacco policy was unrelated to the prevalence of tobacco use among students, tobacco purchasing behavior and knowledge of the negative health effects of tobacco.     

Rural adolescent alcohol, tobacco, and illicit drug use: a comparison of students in Victoria, Australia, and Washington State, United States

Purpose: There are inconsistent research findings regarding the impact of rurality on adolescent alcohol, tobacco, and illicit substance use. Therefore, the current study reports on the effect of rurality on alcohol, tobacco, and illicit drug use among adolescents in 2 state representative samples in 2 countries, Washington State (WA) in the United States and Victoria (VIC) in Australia. Participants: The International Youth Development Study (IYDS) recruited representative samples of students from Grade 7 (aged 12 to 13 years) and Grade 9 (aged 14 to 15) in both states. A total of 3,729 students responded to questions about alcohol, tobacco, cannabis, and other illicit substance use (n_VIC= 1,852; n_WA= 1,877). In each state, males and females were equally represented and ages ranged from 12 to 15 years. Methods: Data were analyzed to compare lifetime and current (past 30 days) substance use for students located in census areas classified as urban, large or small town, and rural. Findings were adjusted for school clustering and weighted to compare prevalence at median age 14 years. Findings: Rates of lifetime and current alcohol, tobacco, and cannabis use were significantly higher in rural compared to urban students in both states (odds ratio for current substance use = 1.31). Conclusions: In both Washington State and Victoria, early adolescent rural students use substances more frequently than their urban counterparts. Future studies should examine factors that place rural adolescents at risk for alcohol, tobacco, and illicit drug use.     

Tobacco, alcohol, and other drug use among high school students in Bureau of Indian Affairs-funded schools--United States, 2001

In the United States, use of alcohol and other drugs is associated with the three leading causes of death and disability (i.e., unintentional injuries, primarily from motor vehicle crashes; suicide; and homicide) among American Indian/Alaska Native (AI/AN) persons aged 15-24 years, and tobacco use is associated with the two leading causes of death (i.e., heart disease and cancer) among AI/AN adults. This report presents data about the prevalence of tobacco, alcohol, and other drug use among high school students at schools funded by the Bureau of Indian Affairs (BIA). The findings indicate that a substantial number of these students engage in behaviors that put them at risk for premature death and disability and underscore the need for expanded health education and counseling programs and policies in AI communities and BIA-funded schools.     

Passage of 100% tobacco-free school policies in 14 North Carolina school districts

Though comprehensive tobacco-free school policies constitute an important component of state tobacco control efforts, little research exists about their adoption process. In the past two years, efforts occurred in North Carolina to increase the number of school districts adopting 100% tobacco-free school policies. As part of the North Carolina Youth Empowerment Study (NC-YES), researchers developed a school tobacco policy interview guide to conduct interviews with 40 key people (e.g., school board member, principal, etc.) in each of 14 school districts that adopted a 100% tobacco-free school policy by the end of 2001. Results showed seven districts adopted their school policy in the past two years. Seven themes emerged: 1) Catalysts: Local adult and youth "champions" facilitated policy change; 2) Process of Adoption: Most school policies were adopted with an administrator or other adult initiating the change, but youth involvement increased in recent years; 3) Methods of Adoption: Advocates personalized health concerns by focusing on children and role modeling by adults; 4) Political Leadership: Governors of North Carolina, through letters to school districts and a policy summit, played an important role in stimulating policy change; 5) Barriers to Adoption: Concerns expressed before policy adoption, about teacher attrition or inability to enforce the policy, did not occur as feared; 6) Enforcement Issues: A key to policy enforcement involved being consistent, supportive, and firm; and 7) Economics of Tobacco Farming/Manufacturing: Though a local tobacco economy did little to influence policy adoption, districts that adopted policies were not located in counties with heavy tobacco production. Public health advocates may use this information to encourage school districts to adopt 100% tobacco-free school policies.     

Peer Reviewed: The Influence of School Policies on Smoking Prevalence Among Students in Grades 5-9, Canada, 2004-2005

Introduction

School characteristics may account for some of the variation in smoking prevalence among schools. The purpose of this study was to investigate the relationships between characteristics of school tobacco policies and school smoking prevalence. We also examined the relationship between these characteristics and individual smoking status.

Methods

Tobacco policy data were collected from schools in 10 Canadian provinces during the 2004-2005 school year. Written tobacco policies were collected from each school to examine policy intent, and school administrators were surveyed to assess policy enforcement. Students in grades 5 through 9 completed the Youth Smoking Survey to assess smoking behaviors and attitudes. We used negative binomial regression and multilevel logistic regression to predict the influence of school policies on smoking behavior at the school and student levels.

Results

School policies that explicitly stated purpose and goals predicted lower prevalence of smoking at the school and individual levels. Policies that prohibited smoking on school grounds at all times predicted lower smoking prevalence at the school level but not at the individual level.

Conclusions

For maximum effectiveness, school smoking policies should clearly state a purpose and goals and should emphasize smoking prohibition. These policies can help reduce smoking prevalence among youths and are part of a comprehensive school approach to tobacco control.     

Implementation of school policies to prevent youth tobacco use in Alabama

BACKGROUND: Public health professionals must monitor the effectiveness of school policies and programs to prevent youth initiation, promote quitting, and eliminate secondhand smoke. This analysis of school tobacco policies was preliminary to release of a state tobacco prevention and control plan for 2010‐2015. METHODS: University health educators collaborated with the state health agency to review policies of 33 school systems in 5 Metropolitan Statistical Areas and 9 public health areas. Authors developed a systematic approach of 8 steps useful to rate implementation of school tobacco control and prevention policies and discuss implications for health education program planning. RESULTS: Thirty school policies prohibited possession and use of tobacco by students, faculty and campus visitors, and 26 of 33 specified disciplinary measures following violations. Only 4 public education agencies included 3 of the 6 elements of a model tobacco prevention and control policy as suggested by the state public health agency. None featured all 6 elements. None specified establishing school‐community partnerships for tobacco prevention and control. CONCLUSIONS: Preparing smoke‐free youth requires implementing and evaluating tobacco education in grades K‐12 including use of model guidelines from federal agencies and professional organizations. Determining the focus of existing school tobacco policies is an initial step to encourage adoption of comprehensive policies to reduce youth use of tobacco. Youth health advocates may act together with school administrators and legislators to strengthen policies to be consistent with model guidelines for tobacco prevention and control.     

Enabling the nation's schools to help prevent heart disease, stroke, cancer, COPD, diabetes, and other serious health problems

In the United States, more than 53 million young people attend nearly 120,000 schools, usually for 13 of their most formative years. Modern school health programs--if appropriately designed and implemented--could become one of the most efficient means the nation might employ to reduce the establishment of four main chronic disease risks: tobacco use, unhealthy eating patterns, inadequate physical activity, and obesity. The U.S. Centers for Disease Control and Prevention and its partners have developed four integrated strategies to help the nation's schools reduce these risks. Participating national, state, and local agencies (1) monitor critical health risks among students, and monitor school policies and programs to reduce those risks; (2) synthesize and apply research to identify, and to provide information about, effective school policies and programs; (3) enable state, large city, and national education and health agencies to jointly help local schools implement effective policies and programs; and (4) evaluate implemented policies and programs to iteratively assess and improve their effectiveness.     

Canada moving backwards on illegal drugs

Internationally, illegal drug use remains a major public health problem. In response, many countries have begun to shift their illegal drug policies away from enforcement and towards public health objectives. Recently, both the Global Commission on Drug Policy and the Supreme Court of Canada have endorsed this change in direction, supporting empirically sound illegal drug policies that reduce criminalization and stigmatization of drug users and bolster treatment and harm reduction efforts. Until recently, Canada was a participant in this growing movement towards rational drug policy. Unfortunately, in recent years, policy changes have made Canada one of the few remaining advocates of a "war-on-drugs" approach. Indeed, the current government has implemented a number of new illegal drug policies that contradict well-established scientific evidence from public health, criminology and other fields. As such, their approach is expected to do little to reduce the harms associated with substance use in Canada. The authors call on the current government to heed the recommendations of the Global Commission's report and learn from the many countries that are innovating in illegal drug policy by prioritizing evidence, human rights and public health.     

The influence of electronic cigarette age purchasing restrictions on adolescent tobacco and marijuana use

ObjectiveIn the United States, many states have established minimum legal purchase ages for electronic nicotine delivery systems (ENDS) to ban adolescent purchases, but these policies may also affect other related substance use. We explore whether ENDS are substitutes or complements for cigarettes, cigars, smokeless tobacco, and marijuana among adolescents by using variation in state-level implementation of ENDS age purchasing restrictions.MethodsWe linked data on ENDS age purchasing restrictions to state- and year-specific rates of adolescent tobacco and marijuana use in 2007–2013 from the Youth Risk Behavior Surveillance System. This data provides a nationally representative sample of adolescents who attend public and private schools. We performed a fixed effect regression analysis exploring the influence of ENDS age purchasing restrictions on outcomes of tobacco use and marijuana use, controlling for state and year fixed characteristics, age-race cohorts, cigarette excise taxes, and cigarette indoor use restrictions.ResultsFor cigarette use, we separate our results into cigarette use frequency. We found causal evidence that ENDS age purchasing restrictions increased adolescent regular cigarette use by 0.8 percentage points. ENDS age purchasing restrictions were not associated with cigar use, smokeless tobacco use, or marijuana use.ConclusionsWe document a concerning trend of cigarette smoking among adolescents increasing when ENDS become more difficult to purchase.     

School policy and tobacco use by students in Bihar, India

The association between school tobacco policies and tobacco use prevalence among students were examined. A two stage cluster sample design with probability proportional to the enrolment in grades VIII-X was used. Comparison was made between schools with a tobacco policy (Federal schools) and schools without a policy (State schools). Stratified probability samples of 50 schools each were selected. SUDAAN and the C-sample procedure in Epi-Info was used for statistical analysis. Students from State schools (without tobacco policy) reported significantly higher ever and current any tobacco use, current smokeless tobacco use and current smoking compared to Federal schools (with tobacco policy) both in rural and urban areas. Classroom teaching on the harmful effects of tobacco was significantly higher (17-24 times) in Federal schools than State schools both in rural and urban areas. Parental tobacco use was similar for students in Federal and State schools. Students attending state schools were more likely than students attending Federal schools to have friends who smoke or chew tobacco. These findings suggest that the wider introduction of comprehensive school policies may help to reduce adolescent tobacco use.     

School tobacco policies in a tobacco-growing state

This study examined factors associated with tobacco-free policies and tobacco cessation in schools serving children in grades 6 to 12 in a tobacco-growing state using a cross-sectional telephone survey of school administrators from public and private middle and high schools (N = 691), representing 117 of the 120 Kentucky counties. Trained health department staff contacted 1028 schools; 691 (67%) participated in a phone survey, which lasted an average of 19 minutes. Variables of interest were indoor and outdoor smoking policies, fund-raising in Bingo halls, provision of cessation and prevention programs, owning or leasing a tobacco base, if the school received money from tobacco companies, type of school (public vs private), and school setting (urban vs rural). Only 20% of Kentucky schools reported comprehensive tobacco-free policies. Urban area schools were nearly twice as likely to have a tobacco-free campus than rural schools. Schools that did fund-raising in smoky Bingo halls were 30% less likely to have tobacco-free school policies. While few schools had a tobacco affiliation, those that received money from tobacco companies or grew tobacco were nearly 3 times as likely to provide cessation resources, compared to schools without tobacco affiliation. Rural schools were less likely to be tobacco free and provide cessation services. School-related, off-campus, extracurricular events might be considered as an element of tobacco-free school policy. Schools with tobacco affiliation may provide more cessation resources due to the increased prevalence of tobacco use in these areas.     

Surveillance for characteristics of health education among secondary schools--school health education profiles, 1998.

PROBLEM/CONDITION: School health education (e.g., classroom instruction) is an essential component of school health programs; such education promotes the health of youth and improves overall public health. REPORTING PERIOD: February-May 1998. DESCRIPTION OF SYSTEM: The School Health Education Profiles monitor characteristics of health education in middle or junior high schools and senior high schools in the United States. The Profiles are school-based surveys conducted by state and local education agencies. This report summarizes results from 36 state surveys and 10 local surveys conducted among representative samples of school principals and lead health education teachers. The lead health education teacher coordinates health education policies and programs within a middle/junior high school or senior high school. RESULTS: During the study period, most schools in states and cities that conducted Profiles required health education in grades 6-12. Of these, a median of 91.0% of schools in states and 86.2% of schools in cities taught a separate health education course. The median percentage of schools in each state and city that tried to increase student knowledge in selected topics (i.e., prevention of tobacco use, alcohol and other drug use, pregnancy, human immunodeficiency virus [HIV] infection, other sexually transmitted diseases, violence, or suicide; dietary behaviors and nutrition; and physical activity and fitness) was >73% for each of these topics. The median percentage of schools with a health education teacher who coordinated health education was 38.7% across states and 37.6% across cities. A median of 41.8% of schools across states and a median of 31.0% of schools across cities had a lead health education teacher with professional preparation in health and physical education, whereas a median of 6.0% of schools across states and a median of 5.5% of schools across cities had a lead health education teacher with professional preparation in health education only. A median of 19.3% of schools across states and 21.2% of schools across cities had a school health advisory council. The median percentage of schools with a written school or school district policy on HIV-infected students or school staff members was 69.7% across states and 84.4% across cities. INTERPRETATION: Many middle/junior high schools and senior high schools require health education to help provide students with knowledge and skills needed for adoption of a healthy lifestyle. However, these schools might not be covering all important topic areas or skills sufficiently. The number of lead health education teachers who are academically prepared in health education and the number of schools with school health advisory councils needs to increase. PUBLIC HEALTH ACTION: The Profiles data are used by state and local education officials to improve school health education.