Sunday, October 03, 2004
Keeping kids from tobacco is an unending task
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Helton is prevention specialist for Prevention Plus at Blue Ridge Behavioral Healthcare.
Tobacco use remains the leading cause of preventable death in the United States, with more than 400,000 lives lost each year. Every year, tobacco use kills more Americans than AIDS, alcohol, car accidents, murders, suicides, drugs and fires combined. National survey data show more than $75 billion annually is spent on health care costs related to smoking, while costs in Virginia total more than $1.6 billion.
In 1998, Virginia and 45 other states reached a settlement to recover tobacco-related health-care costs annually and in perpetuity from the four largest tobacco manufacturers, estimated to total $246 billion over the first 25 years.
The states agreed to spend "a significant portion of the tobacco settlement funds on smoking cessation programs, health care, education and programs benefiting children." The settlement also imposed restrictions on the marketing of tobacco products to minimize exposure of youth to tobacco advertising campaigns.
While some states have not lived up to this promise, the General Assembly has allocated Virginia's portion of the tobacco settlement payments to decrease supply and demand, as well as the economic basis for tobacco's hold on Virginia.
Fifty percent goes to the Tobacco Indemnification and Community Revitalization Trust Fund for economic assistance to tobacco growers and revitalization of their communities. In part to subsidize Virginia's budget for declines in revenue from the tobacco industry, 40 percent is distributed to the state's general fund. The final 10 percent goes to the Tobacco Prevention Trust Fund administered by the Virginia Tobacco Settlement Foundation.
Tobacco companies spend more than $20 on marketing tobacco products for each dollar spent on tobacco prevention education. In spite of their significant investment in recruiting and retaining consumers of tobacco products, recently released data from the 2003 Virginia Youth Tobacco Survey show that tobacco prevention and cessation education funded by the foundation are having an impact on Virginia's youth.
Administered in 2003 by Virginia Commonwealth University and in 2001 by Area Health Education Centers Virginia, the survey was given to a random sampling of public school students in grades 6 through 12. Survey topics included tobacco use, availability of tobacco products, environmental tobacco smoke, tobacco use prevention education, tobacco advertisements and media depictions of tobacco.
Comparative data from the 2001 and 2003 surveys reveal dramatic declines in youth smoking rates. Results show a 28 percent decrease in smoking rates among high school students (from 29 percent to 21 percent) and a 45 percent decrease among middle school students (from 11 percent to 6 percent).
The widespread implementation of foundation-funded tobacco prevention and cessation education could account for these reductions in smoking rates among teens. Marty H. Kilgore, the foundation's executive director, says, "We are very happy with the results, but there is still a long way to go. A smoking rate of 21 percent among high school students and 6 percent among middle school students is still too high."
In the Roanoke Valley, foundation funds have been received by several organizations during the past few years to conduct tobacco prevention and cessation programs, including Blue Ridge Behavioral Healthcare Prevention Plus. In partnership with the Roanoke Adolescent Health Partnership and the Roanoke public schools' student assistance professionals, Blue Ridge Behavioral Healthcare implemented the smoking cessation program called Quitting Tobacco.
Also, Blue Ridge Behavioral Healthcare prevention specialists collaborated with teachers and guidance counselors in Roanoke and in Craig County schools to teach the Life Skills curriculum to all sixth-graders - specifically, lessons on developing a positive self-image, on making healthy decisions and considering consequences, and on smoking, alcohol, marijuana and techniques that advertisers use to entice consumers into buying products. In Craig, fifth-graders were also taught the Life Skills curriculum.
For the past six years, including the most recent two years funded by the foundation, approximately 1,300 youth have received Life Skills training. In this new school year, teachers in each middle school have the option of teaching the Life Skills curriculum on their own.
In the new school year, Blue Ridge Behavioral Healthcare prevention specialists will offer intensive educational programming to a more selective and potentially higher-risk group of teens. The Families in Action for Parents and Teens curriculum will be implemented with several local partners, including the Botetourt County and Roanoke city school systems.
The curriculum is designed to promote understanding between parents and teens and addresses such topics as drugs, sexuality, violence, family enrichment activities, behavior goals, problems and problem ownership, family guidelines, responsibility and discipline, mutual respect, understanding and accepting consequences, resisting negative peer pressure, communication, cooperation and school success.
Roanoke city will implement the program in seventh and eighth grades, because teens at this age often begin having difficulty talking to parents and relating to authority. Botetourt will implement the curriculum in these same grades plus ninth grade, to smooth the transition of freshmen to high school. For Botetourt ninth-graders, the program will address peer pressures and widespread beliefs that, in order to appear cool and grown-up, teens must engage in high-risk behaviors such as substance use and sexual activity.
Expected outcomes for parents and teens are increased family cohesion and fewer arguments among family members. It is also expected that teens will demonstrate greater school attachment and increased attendance, as well as development of unfavorable attitudes toward consumption of alcohol and tobacco by youth.
Despite successes shown in recent surveys, we cannot relax our efforts in Virginia as some other states have done recently. The wildly successful tobacco-prevention program in Florida was virtually eviscerated by the governor and the legislature with a subsequent and predictable rise in smoking rates. Similarly, other established and successful programs in Massachusetts and Oregon have been decimated recently by funding cuts, as have newer efforts in Indiana, Minnesota, Maryland, Nebraska and New Jersey.
Across the United States, approximately 90 percent of adult smokers began smoking before age 18. Most children try smoking for the first time in sixth or seventh grade, or between the ages of 11 and 12, yet many begin smoking even younger.
In Virginia each year, more than 16,500 youth - or more than 45 each day - become new smokers. Given the political pressures, budgetary dilemmas and relentless marketing by the tobacco industry, our struggle is never-ending.
Declines in smoking rates do not mean that our job is done - far from it. In Roanoke, around Virginia and across the Unites States, we must continue to be vigilant in preventing teens from using tobacco products and encouraging cessation programs for teens and adults who already smoke regularly.
