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School Policies and Programs on
Smoking and Health -- United States, 1988
In 1988, the National School Boards Association (NSBA), in
collaboration with the American Cancer Society, the American Heart
Association, and the American Lung Association, conducted a random
sample mail survey of 2000 of the more than 15,000 public school
districts in the United States to gather information on school
smoking
policies and programs (1); 1310 (66%) of the districts responded. A
similar study was done in 1986 (2). Topics covered in the survey
were
districts' policies on tobacco smoking, development of school
smoking
policies, antismoking education programs in schools, assistance
given
to districts by voluntary health organizations, and demographics of
each school district. Two hundred of the 690 nonrespondents were
contacted and questioned by telephone; they were similar to
respondents
demographically and in their responses. Not all respondents
answered
all questions.
In 1988, 1239 (95%) of all responding school districts had a
written
policy or regulation on tobacco smoking in schools; in 1986, 622
(87%)
of 714 school districts had a written policy or regulation. All the
written policies addressed smoking by students, 1189 (96%)
addressed
smoking by faculty/staff/administration, and 1140 (92%) addressed
smoking by other adults (e.g., parents, school visitors). Of the 71
(5%) responding districts with no written policy, 31 (44%) are
considering developing such policies. Of the 1310 districts
responding,
226 (17%) totally banned smoking (no smoking allowed by anyone on
school premises or at school functions). From 1986 to 1988, the
proportion of districts prohibiting adults from smoking in school
buildings, on school grounds, and at school-related functions more
than
doubled. For example, the proportion prohibiting smoking by
faculty/staff/administrators in school buildings increased from 11%
in
1986 to 289 (24%) of 1188 in 1988.
Of the 1169 districts with written policies, 802 (69%) had enacted
these policies within the last 6 years. Health hazards of tobacco
use
continued to be the reason most respondents (914/1188 (77%)) cited
for
instituting a nonsmoking policy, followed by belief in adult role
models (574/1188 (48%)) and state or local antismoking legislation
(525/1188 (44%)). Smoking policies were initiated by school boards
(307/1203 (26%)), district administrations (226/1203 (19%)),
teachers
(156/1203 (13%)), building administration staff (143/1203 (12%)),
parents (69/1203 (6%)), community (69/1203 (6%)), students (63/1203
(5%)), and other (48/1203 (4%)).
Most districts (1078/1239 (87%)) reported excellent or good
compliance
among faculty, and 1062 (86%) of 1239 reported similar compliance
among
students. Re- ported compliance was much higher in districts with
total
smoking bans than in districts with some restrictions.
In 1988, 942 (75%) of 1254 school districts had antismoking
educational programs at the elementary school level, 1016 (81%) at
the
middle school level, and 982 (78%) at the high school level; in
1986,
the corresponding proportions were 61% for ele- mentary schools,
64%
for middle schools, and 62% for high schools. Voluntary health
organizations were involved in providing antismoking education in
74%
of the school districts.
Reported by: P Smith, Dept of Communications, National School
Boards
Association, Alexandria, Virginia. Epidemiology Br, Office on
Smoking
and Health and Div of Adolescent and School Health, Center for
Chronic
Disease Prevention and Health Promotion, CDC. Editorial Note
Editorial Note: Tobacco use by students remains a major public
health
problem. Approximately 3000 persons--most less than 21 years of
age--begin to smoke each day in the United States (3,4). The
findings
that 95% of school districts now have a written policy regarding
smoking and that this proportion has been increasing are
encouraging.
Smoking bans in schools accomplish several goals: 1) they
discourage
students from starting to smoke; 2) they reinforce knowledge of the
health hazards of cigarette smoking and exposure to environmental
tobacco smoke; and 3) they promote a smoke-free environment as the
norm. It is particularly important that smoking policies are now
directed at adults as well as students. School policies that
restrict
smoking have always applied to the students, but from 1986 to 1988,
the
proportion of districts having smoking restrictions for
faculty/staff/administrators and other adults attending school
functions increased substantially.
The 1990 health objectives for the nation include as a target that
all
50 states enact laws that prohibit smoking in enclosed public
places
(5). Based on the present survey, a completely smoke-free
environment
for schools has been achieved in 17% of school districts. In
accordance
with its goal of eliminating smoking in the public schools, NSBA
has
published No Smoking:
A Board Member's Guide to Nonsmoking Policies for the Schools (2),
which includes the entire 1986 survey report, outlines
implementation
steps and guidelines concerning nonsmoking policies, and describes
several antismoking school programs across the country.
The increase in antismoking instruction in schools is also
encouraging. Studies show that such instruction, as part of a
comprehensive school health education curriculum, is effective in
preventing initiation of smoking among children and adolescents
(6). A
National Cancer Institute advisory panel on smoking and school
health
has developed recommendations for the essential elements of a
school-based smoking prevention program (7). These elements
include:
emphasizing the social and short-term physiologic consequences of
tobacco use; training students in refusal skills; involving
parents,
trained teachers, and peers in smoking-prevention activities; and
designing a curriculum that reflects the needs of the community.
The
public health community has also identified the need to develop
cessation programs for children and adolescents addicted to
nicotine
(4).
References
National School Boards Association. Smoke-free schools: a
progress
report. Alexandria, Virginia: National School Boards Association,
1989.
2.National School Boards Association. No smoking: a board member's
guide to nonsmoking policies for the schools. Alexandria, Virginia:
National School Boards Association, 1987.
3.Pierce JP, Fiore MC, Novotny TE, Hatziandreu EJ, Davis RM. Trends
in
cigarette smoking in the United States: projections to the year
2000.
JAMA 1989;261:61-5.
4.CDC. Reducing the health consequences of smoking: 25 years of
progress--a report of the Surgeon General, 1989. Rockville,
Maryland:
US Department of Health and Human Services, Public Health Service,
1989; DHHS publication no. (CDC)89-8411.
5.Public Health Service. Promoting health/preventing disease:
objectives for the nation. Washington, DC: US Department of Health
and
Human Services, Public Health Service, 1980.
6.Christenson GM, Gold RS, Katz M, Kreuter MW. Results of the
School
Health Education Evaluation: preface. J School Health
1985;55:295-6.
7.Glynn TJ. Essential elements of school-based smoking prevention
programs. J School Health 1989;59 (in press).
Disclaimer
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