School-Based Tobacco Prevention and Cessation Programs
The goal of school-based tobacco prevention and cessation programs is to keep young people tobacco
free so that they remain tobacco free for the rest of their lives. In 2000, the Surgeon
General's Report stated that school-based interventions can reduce or postpone the onset of
smoking among youth by 20 to 40%. In addition, the 2012 Surgeon
General's Report reviewed the literature on school-based programs and determined that many can be
effective in preventing and decreasing tobacco use in the short-term, and that certain programs
demonstrated long-term prevention effects as well. The report emphasized that effective programs are
integrated into community-wide prevention efforts.
School-based prevention programs: School-based prevention programs are often in the
form of age-specific classroom curricula, but are also implemented as special school programs, media
literacy training, and peer education programs. These programs can inform participants about the
dangers of secondhand smoke, build participants' capacity to identify and resist the influence of
peers and tobacco marketers, and teach refusal skills.
School-based cessation programs: School-based cessation programs focus on supporting
students in their efforts to quit using tobacco products. These programs can teach students refusal
skills and avoidance techniques, provide social support from peers and counselors, and link
participants to resources in the community.
Examples of School-Based Tobacco Prevention and Cessation Programs
Several federal agencies have compiled information about evidence-based tobacco prevention and cessation
programs in rural schools. Rural program planners should review the evaluation criteria and program content to
determine if these programs can address the needs of their students.
The National Institute of Justice's CrimeSolutions.gov
database lists several school-based programs in rural settings that have evidence of preventing or decreasing
LifeSkills® Training is a
classroom-based drug prevention program that focuses on building self-management, social, and
refusal skills to upper elementary and middle school-aged children.
Linking the Interests of
Families and Teachers (LIFT) is a preventive intervention that seeks to prevent antisocial
and aggressive behaviors and promote positive development among elementary school children.
The Midwestern Prevention
Project (MPP) involves implementing community-wide strategies that reinforce anti-drug
messaging among middle schoolers.
The National Cancer Institute's Evidence-Based
Cancer Control Programs database lists two school-based programs that have promising outcomes for
decreasing tobacco use:
Considerations for Implementation
In 1994, the Centers for Disease Control and Prevention (CDC) released Guidelines for
School Health Programs to Prevent Tobacco Use and Addiction. These guidelines suggested that
schools implement seven recommendations to effectively prevent tobacco use among youth:
Create school policies around tobacco use. There are several resources dedicated to
promoting tobacco-free school policies, including North Carolina's Assessment
Tool for Becoming a 100% Tobacco Free School District and Maine's guide to Implementing School
Policies. For more information about tobacco free-policies,
see Module 2.
Educate students on the negative physiological and social effects of tobacco use.
Rural school administrators should carefully review the content of their tobacco prevention and/or
cessation programs to ensure that they meet the needs of their student population.
Integrate tobacco prevention education for all students, with a focus on junior high and
middle school grades. Program planners should tailor the content of their school-based
prevention or cessation program to ensure it is appropriate for the target age group.
Offer special training to educators and other program facilitators. Many
school-based tobacco prevention and cessation programs provide self-led training materials to
teachers and other facilitators. School administrators in rural communities may also seek to
implement programs that enable teachers to receive training online or via video conferencing.
Engage parents in tobacco prevention efforts. Some rural communities may choose
to involve advisory councils or groups in their tobacco prevention and cessation efforts. Advisory
councils can include school district personnel, students' family members, and other stakeholders.
School administrators may need to seek permission from parents and guardians before providing a
tobacco prevention or cessation intervention to students.
Rural communities may also choose to involve students in the advisory group to ensure that programs
will be well accepted and meet their needs. One school
system in a county with a largely rural population that served high school students
expanded an existing tobacco use prevention program to include information about cessation. The
school system established a workgroup that included student representatives who solicited feedback
from their peers about important components for a cessation curriculum.
Offer tobacco cessation support to students and staff. School administrators may
consider building partnerships with local providers in order to strengthen the efficacy of
school-based cessation programs. Students may need referrals to a provider in order to receive
tobacco cessation medication or more intensive tobacco cessation counseling.
Consistently evaluate tobacco prevention programs. See Module
5 for evaluation considerations for a rural tobacco prevention and cessation program.
School based health centers (SBHC) provide another setting to reach students and promote tobacco prevention and
cessation. The Rural Health and Schools Topic Guide
outlines how SBHCs can be utilized to make positive health behavior changes in students. Further information on
how to integrate health services within rural SBHCs can also be found in the
State and local health departments can be valuable resources to rural school districts seeking to
implement a tobacco prevention program. For example, the Utah Department of Health Tobacco Prevention
and Control Program has prepared School Resource
Guide: Utah Comprehensive Tobacco-Free School Policy Toolkit to help school districts implement the
recommendations listed above. The South Dakota Department of Health developed a K-12
Tobacco Prevention Toolkit that discusses best practices for tobacco use prevention in school and
provides several implementation examples from rural schools. The Colorado Department of Public Health and
Environment offers Second Chance, a free online program for
youth who have violated their school's tobacco policy that serves
as an alternative to suspension.
Program Clearinghouse Examples
Resources to Learn More
Wisconsin School Tobacco Prevention
This collection of resources is hosted by the Wisconsin Department of Public Instruction. It contains
resources for school districts and others working with youth in tobacco prevention. Resources include
training for adults, education for youth, policy resources on other tobacco products (OTP), tobacco
assessment tools, and school resources.
Organization(s): Wisconsin Department of Public Instruction