Why should I care about Tobacco?

Tobacco use is the leading preventable cause of death and disease in the United States.

• Tobacco use causes about 440,000 deaths a year;
• Smoking harms nearly every organ in the human body;
• Tobacco causes many kinds of cancer, heart disease, stroke, chronic obstructive pulmonary disease (COPD or emphysema), problems with reproduction and pregnancies, low birthweight babies, sudden infant death syndrome, aortic aneurysms, vascular disease, cataracts, dental disease, peptic ulcers, and other health problems; and
• Over $75 billion are spent per year in direct tobacco-related medical costs.

Environmental tobacco smoke (ETS or “secondhand smoke”) is a public health risk.

• ETS is classified as a Group A (known human) carcinogen by U.S. Environmental Protection Agency (EPA); and
• Exposure to ETS has been shown to cause many of the same diseases smoking does.

Tobacco use by young people is a major concern.

• Tobacco use usually begins during adolescence;
• Nicotine is highly addictive;
• The younger a person is when they start using tobacco, the more likely s/he is to become a heavy user as an adult; and

• Tobacco may be a gateway to use of alcohol and other drugs.

Studies also suggest that tobacco use has a negative effect on academics.

• Some studies suggest that tobacco use may interfere with learning;
• Tobacco use is a common reason for in- and out-of-school suspensions, causing students to miss time in the classroom; and
• Students who use tobacco tend to have poorer attitudes toward school, be less motivated, and do worse in their classes.

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What are Rhode Island's state requirements for Tobacco in schools?

Tobacco Use Prohibited on School Grounds

Tobacco use is prohibited in all Rhode Island elementary and secondary schools by the “Smoking Restrictions in Schools Act” (RI General Laws Chapter 23-20.9). This includes:

• All persons - including students, staff, contract workers, and visitors;
• All areas of the school - including all buildings, indoor and outdoor athletic facilities, playgrounds, buses and other vehicles, and outside areas within 25 feet of any school building; and
• Any substance or item which contains tobacco, including smokeless tobacco.

The school district must adopt and publicize enforcement procedures and post no smoking signs at every entrance of every school.

Smoking is further prohibited in schools because they are considered workplaces under “Public Health and Workplace Safety Act” (RIGL Chapter 23-20.10) (See also Rules and Regulations for Smoke-free Workplaces). The law states that building entrances must be marked with No Smoking signs, which are available free of charge from the Department of Health.

Sale of Tobacco to Minors

It is illegal to sell or give tobacco products to minors in Rhode Island (RIGL § 11-9-13). Sections §11-9-13.1 through §11-9-13.9 of RIGL Chapter 11-9 provide additional stipulations.

Tobacco Use or Possession by Minors

According to RIGL § 11-9-14, “No person under eighteen (18) years of age shall smoke or chew or possess when such possession is clearly visible tobacco in any public street, place or resort, any tobacco in any form whatsoever."

Health Education

Tobacco is one of the main topics of health education, which is required for all students in grades 1-12 (see RIGL §16-22-4). Tobacco is a required health education content area, according to Sec. 5.1.1 of the Rules and Regulations for School Health Programs and the RI Health Education Comprehensive Health Instructional Outcomes.

Staff Tobacco Cessaction

A law passed in 2006 (RI '06 Public Laws - Chapter 06-262/06-293) requires RI health insurance providers to cover smoking cessation counseling, as well as nicotine-replacement therapy for each subscriber (see RIGL §27-18-66, §27-19-57, §27-20-53, and §27-41-70).

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What are some of the best practices for schools around Tobacco?

• Have a tobacco-free school environment policy that bans all forms of tobacco use by students, staff, contract workers, and visitors, in school buildings, on school grounds, in school vehicles, and at off-site school events, applicable 24 hours a day.

• Enforce the tobacco-free school policy consistently.

• Communicate the tobacco-free school policy to students, families, staff, and visitors through a variety of means, including, at a minimum, handbooks, newsletters, and signs.

• Make information about tobacco cessation available to students and staff in each building in the school district.

• Offer tobacco cessation programs to students on a voluntary basis.

• Offer tobacco cessation programs to staff on a voluntary basis, directly, through an employee assistance program, or through the district’s employee health insurance plan.

• Prohibit all forms of tobacco advertising, including all tobacco promotional items (e.g. clothing, bags, lighters, and other personal articles) on school grounds, in school vehicles, and at school-sponsored events.

• Refuse endorsement, sponsorship, funding, or goods from any tobacco company or tobacco industry-affiliated foundation for any school-related operations, programs or events.

• Provide skills-focused tobacco-use prevention education, as part of a comprehensive, sequential, culturally-appropriate K-12 health education curriculum, that is aligned with Rhode Island standards and that:
• Is introduced in elementary school, intensified in middle/junior high school, and reinforced in high school;
• Uses evidence-based curricula and/or is based on theories and methods that have been shown to be effective;
• Teaches about the short- and long-term physiological, legal, social, economic, and cosmetic consequences of tobacco use;
• Decreases the acceptability of tobacco use;
• Addresses the reasons why people might or might not use tobacco;
• Counteracts student overestimates of how many of their peers use tobacco;
• Instructs how to find valid information and services related to tobacco;
• Teaches how to recognize and respond appropriately to social influences on tobacco use, including media, family, peers, and culture;
• Develops skills related to not using tobacco (e.g., communication, assertiveness, goal-setting, problem-solving, and decision-making skills);
• Covers other important issues, such as addiction, secondhand smoke, smokeless tobacco, substances in tobacco products, effects on athletic performance, and effects on fetal development;
• Explains how students can support others who abstain from or want to quit using tobacco;
• Includes school and community action to support a tobacco-free environment;
• Engages family members as partner’s in students’ education and promote discussions at home;
• Integrates tobacco-use prevention concepts into the instruction of the other subject areas, to the greatest extent possible;
• Is coordinated with the Great American Smokeout, Kick Butts Day, or other events;
• Is closely coordinated with the other components of the school health program;
• Is coordinated, to the extent possible, tobacco use prevention education in the community.

• Allocate funds and release time to support annual professional development for teachers of health on tobacco education, curricula, programs, cessation, and policies.

• Actively recruit and involve students, parents, families, and community members in the development and implementation of school health policies and programs, including those related to physical activity.

• Provide families with information about tobacco, community tobacco cessation resources, and parent/child communication, and promote tobacco-free homes and vehicles.

• Coordinate programs and policies with media and community tobacco prevention efforts. 

• Ensure that the school nurse and counseling/psychological/social service providers identify and refer students with problems related to tobacco use.
  

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What data are available about Tobacco in Rhode Island?

Quick Facts

• Dramatic improvements have been made in rates of tobacco use among Rhode Island high school students, according to the 2005 Rhode Island Youth Risk Behavior Survey (YRBS):
  • Almost one sixth (16%) of RI high school students were current smokers in 2005 (i.e., smoked cigarettes on one or more of the past 30 days). This was a major decrease from 1997, when the rate was 35%.
  • Just 2% of female students reported using chewing tobacco or snuff on within the previous 30 days, compared to 7% of males.
  • In 2005, 13% of students reported having their first cigarette before age 13, compared to 24% in 1997.
  • Only 8% of Rhode Island high school students in 2005 had smoked cigarettes on school property during the previous 30 days, down significantly from 20% in 1997.
• Nonetheless, according to Tobacco Free Kids:
  • Children in Rhode Island buy or smoke about 2.1 million packs of cigarettes each year.
  • Approximately 23,000 children under the age of 18 in RI will ultimately die from smoking.
  • About 53,000 RI children are exposed to secondhand smoke at home.
• There were 374 suspensions of students in RI public school students for tobacco-related offenses during the 2005-2006 school year.
• According to the School Health Profiles survey, 98% of middle schools and high schools had a tobacco use prevention policy, although only 64% had a policy that met the CDC's definition of an ideal policy (prohibiting use by students, staff, and visitors in school buildings and property, on buses, and at school-sponsored events).

More Data

• The RI Youth Risk Behavior Survey has more statewide data about tobacco among high school students, as well as differences between grades and between males and females. The "Tobacco Use" topical report has key data on current tobacco use and trends. The “Tobacco Use” brief for schools and "2005 Update: Tobacco Use" have information and suggestions on how schools can use YRBS and other data to prevent tobacco use among students and staff.
• The School Accountability for Learning and Teaching (SALT) Student Survey has school-level and statewide data from the SALT student survey on tobacco use among students in grades 4-12. (Click on School Report Cards, search for a school, and click on the “Health” chart link. For more detailed data, click on SALT Survey Reports, search for a school, select a year, select “Student Reports,” and then click on one of the “Health Risk” charts.)
• School Health Profiles - Tobacco provides basic statewide data about policies and practices related to tobacco prevention and education in middle and high schools. More detailed information is available from the principal survey and from the teacher survey.
• The CDC's School Health Policies and Programs Study website provides fact-sheets with national data on tobacco-use prevention, as well as summaries of state-level policies related to school health issues, including those addressing tobacco prevention and education.
• Tobacco Free Kids has a summary of "The Toll of Tobacco on Rhode Island".

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Where do I go for information or help with quitting smoking?

TrytoStop.org
This site from the Rhode Island Department of Health and the Massachusetts Department of Public Health has a Quit Wizard, Expert Advice, a Community Section, Resources and Tools to help smokers quit.
Try-To-Stop Resource Center M-Th 9-7, F 9-5

• English 1-800-TRY-TO-STOP (800-879-8678)
• Spanish at 1-800-8-DEJALO (800-833-5256)
• TTY at 1-800-TDD-1477 (800-833-1477)

Quit Tips Line 24 hours a day

• 1-800-9-GETATIP (1-800-943-8284)

Smokefree.gov
This site from National Cancer Institute, the Centers for Disease Control and Prevention, the American Cancer Society is intended to help people quit smoking. Different people need different resources as they try to quit. The information and professional assistance available on this Web site can help to support both a person’s immediate and long-term needs as they become, and remain, a nonsmoker.

QuitNet.com
QuitNet is dedicated to providing comprehensive resources and support for people trying to give up smoking.

Children Helping And Motivating Parents to Stop Smoking (CHAMPSS)
This is a site for children and teens who want to help a parent or guardian quit smoking.

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I'm a parent...  Where do I go for parent information and resources about Tobacco?

General Tobacco Resources

ParentLinkRI.org
This site has tips for parents on talking to their teens and preteens, including “Let’s Talk About… Helping your child say ‘No’ to Tobacco.”

Smoke-free Homes
The Environmental Protection Agency has information and resources for families in English and in Spanish about secondhand smoke, particularly in cars and homes, including:

• A brochure
• The Smoke-Free Home Pledge

Not in Mama's Kitchen
The African American Tobacco Education Network sponsors Not in Mama’s Kitchen, a campaign to encourage mothers and other women not to smoke in their home or car.

Got a Minute? Give It To Your Kid.
This brochure, public service announcement, and 10 Tips are designed to help parents keep their kids from using tobacco.

The 2004 Surgeon General’s Report: Health Consequences of Smoking: What it Means to You
The Surgeon General’s Report is nearly 1,000 pages long and is written for a scientific audience. However, the Surgeon General asked that this booklet be created. This booklet explains what the report says and what it means to people.

This is also available in Spanish (Las Consecuencias del Fumar en su Salud).

There is also an animated version of this booklet.

Secondhand Smoke: What It Means To You
This booklet explains The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General and how individuals can take action to improve their health.

KidsHealth
This site has health information on a variety of topics, including Kids and Smoking information for parents.  Also see Smoking (for teens) Smokeless Tobacco (for teens) and Smoking Stinks (for kids).

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I'm a teacher... What resources are available on Tobacco?

Curriculum, Instruction & Assessment

Health Literacy for All Students: The Rhode Island Health Education Framework
The Framework outlines the seven RI Health Education Standards, which describe what students should know and be able to do, as a result of K-12 health education instruction.

Comprehensive Health Instructional Outcomes
This document is designed to complement the RI Health Education Framework and it provides a resource to help develop, evaluate, and revise K-12 health education curricula. It provides performance descriptions for each of standards, broken out by health content area, for different grade spans. Tobacco is covered under the “Substance Use & Abuse Prevention” and the "Disease Prevention & Control" health content areas.

American Lung Association of Rhode Island (ALA-RI)
ALA-RI maintains a tobacco resource library for health educators and others. They offer youth tobacco prevention programs, including Teens Against Tobacco Use (TATU). They offer alternative to suspension programs and youth tobacco cessation programs, including Not On Tobacco (NOT). They also host the RI Tobacco Control Network.

American Cancer Society (ACS) - Southern New England Region
ACS has youth tobacco prevention resources and programs, including Fresh Start and Power of Choice.  ACS also hosts the Great American Smokeout.

CDC Youth Tobacco Educational Materials
CDC provides a variety of resources for teachers, including:

• Tobacco Information and Prevention Source (TIPS)
• Resources for Teachers
• You(th) & Tobacco Educational Materials
• Educational Materials

SAMHSA National Registry of Evidence-based Programs and Practices (NREPP)
The Substance Abuse and Mental Health Services Administration maintains a list of evidence-based prevention programs and curricula on tobacco, as well as other drugs and topics. Model programs include:

• Project Towards No Tobacco (TNT)
• All Stars
• Project SUCCESS

Kick Butts Day (KBD)
KBD is the Campaign for Tobacco Free Kids' annual celebration of youth advocacy, leadership and activism. KBD is a day to stand out, speak up and seize control in the fight against tobacco.  The next Kick Butts Day is Wednesday, April 2, 2008.

TarWars
TarWars is a tobacco-free education program for kids from the American Academy of Family Physicians. Contact Catherine Norton at the Rhode Island Medical Society at 401-528-3286 or cnorton@rimed.org.

Professional Development

Basic Skills for Working with Smokers
UMass Boston offers a self-paced online course designed as an introduction to the basic concepts needed by professionals who are working with tobacco users. CEUs are available for RNs, CHES, and others.

RITOH - Rhode Island Teachers of Health “Yahoo Group” (listserv)

This listserv is an open forum for RI K-12 teachers who teach health (HE, HE/PE, School Nurse Teachers, elementary classroom teachers, etc.) to:

• Share information, news, trainings, legislative updates, and other resources;

• Ask and respond to each other’s questions;
• Confer about curricula, lessons, and teaching strategies;
• Discuss issues and challenges in schools, and more.

To subscribe, email RITOH-subscribe@yahoogroups.com

 

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I'm a school administrator... What tools for schools are available on Tobacco?

Other Tools

Health Education Curriculum Analysis Tool (HECAT)
The HECAT can help school districts, schools, and others conduct a clear, complete, and consistent analysis of health education curricula based on the National Health Education Standards and CDC’s Characteristics of Effective Health Education Curricula. The HECAT includes a Tobacco Module.

Fit Healthy and Ready to Learn

This document was developed by the National Association of State Boards of Education (NASBE) with CDC support. This practical guide helps schools and local school districts establish strong policies on tobacco and other health issues in the context of a coordinated school health program.

RIEAP Student Assistance Services
The Rhode Island Student Assistance Program places Student Assistance Counselors in schools to address the unique needs of the middle, junior and senior high school populations. There are six program components: screening and assessment, prevention education, individual and group sessions, referral and case management, and environmental strategies.

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Where can I learn more?

Rhode Island Tobacco Resources

Rhode Island Tobacco Control Program
The Department of Health offers information, resources, data, tips, links and more.

American Cancer Society (ACS) - Southern New England Region
ACS has youth tobacco prevention resources and programs, including Fresh Start and Power of Choice.  ACS also hosts the Great American Smokeout.

American Heart Association – Providence Branch
The Heart Association has information and resources to fight heart disease and stroke.

American Lung Association of Rhode Island (ALA-RI)
ALA-RI maintains a tobacco resource library for health educators and others. They offer youth tobacco prevention programs, including Teens Against Tobacco Use (TATU). They offer alternative to suspension programs and youth tobacco cessation programs, including Not On Tobacco (NOT). They also host the RI Tobacco Control Network.

 

National Tobacco Resources

Centers for Disease Control & Prevention (CDC)
CDC’s Division of Adolescent and School Health has a page devoted to the topic of Tobacco  and schools. CDC’s Tobacco Information and Prevention Source (TIPS) has a wealth of information, publications, data, and resources for different audiences. Also see Health Topic Tobacco

Surgeon General

• The Health Consequences of Smoking: A Report of the Surgeon General
• The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General

Campaign for Tobacco Free Kids
This site provides policy information, data and reports nationwide and from each state on efforts to prevent tobacco use among children.

Join Together Online
This site provides current research and news on alcohol, tobacco, and other drugs.

The Truth campaign
This youth-oriented, mulitmedia public awareness campaign has been credited with decreasing tobacco use among youth.

World Health Organization
This site presents international tobacco information.

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Whom do I contact for more information?

Jan Mermin
Health Education Specialist
Rhode Island Department of Education
401-222-8954
Jan.Mermin@ride.ri.gov

Rosemary Reilly-Chammat, Ed.D.
Program Manager, Initiative for Healthy Youth
Rhode Island Department of Health
401-222-5922
Rosemary.Reilly-Chammat@health.ri.gov

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