An Innovative and Interactive Supplemental Tobacco Curriculum for Native Youth

Pilot Abstract

Tobacco use is the leading preventable cause of premature morbidity and mortality in the U.S. and is the leading cause of cancer risk. Prevention and cessation efforts are undoubtedly the key to reducing the enormous toll tobacco use takes in terms of premature death, disease, and health care resources and dollars. The vast majority of smokers in the U.S. begin their tobacco use during the adolescent years, and the majority of those who will eventually become regular smokers do so by age 18. Although considerable strides have been made in reducing the prevalence of smoking among adolescents, rates of cigarette smoking remain unacceptably high. Because American Indian lands are not subject to state laws prohibiting the sale and promotion of tobacco products to minors, American Indian youth have access to tobacco products at a very early age, and show particularly high smoking rates compared to their peers in other racial/ethnic groups. Further, smoking prevalence among American Indians has not followed the downward trend seen over the past decade in the general U.S. population. Public school-based surveys in Washington State showed that, in 2002, -18% of American Indian youth in 8th grade, 31% in 10th grade, and 44% in 12th grade reported smoking at least 1 cigarette during the past 30 days. These high rates are occurring in spite of regulations in Washington State requiring all middle and high schools to provide some form of tobacco education to students. Social development models and skill-based approaches hold special promise to help American Indian youth recognize and avoid unhealthy behaviors and promote their health through skill building, problem solving, coping, and communication skills. In this project, we will incorporate such a theory-driven strategy into a supplemental, innovative, interactive school-based curriculum to reduce tobacco use. Our specific aims are to 1) develop and pilot-test a cultural and age appropriate 8th grade supplemental curriculum using focusing on tobacco use for American Indian youth; 2) estimate baseline rates of tobacco use and initiation; and 3) compare knowledge and attitudes about tobacco use in a pre- and post curriculum design. The project will feature videos focusing on tobacco information, media skill building, and portrayal of positive role models engaged in activism, accompanied by corresponding lesson plans. This project will be conducted in the Toppenish School district on the Yakima Indian reservation in the 8th grade classes. The supplemental curriculum will be integrated into existing science, social studies, and other mandated classes. This project is consistent with the Healthy People 2010 objective of reducing smoking among adolescents to 16% and with the mandate of the Indian Health Service, Tribal governments, Indian health boards, CDC, NIH, American Heart Association, and the American Diabetes Association to develop a school-based education and awareness initiative for Indian youth that focuses on reducing risk factors such as tobacco use.