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PROGRAMS AND POLICIES REGARDING SMOKING IN NEW JERSEY SCHOOLS Survey by: New Jersey Commission on Smoking or Health, Education Comnittee 0

Education Committee Members: Shirley Green, M.Ed. New Jersey Interagency Council on Smoking or Health, Chairperson Regina Carlson New Jersey Group Against Smoking Pollution (GASP) Elizabeth Wilson, Ed.D. New Jersey State Nurses" Association Carol Scott New Jersey School Boards Association Carolyn Turner State Department of Education Margaret Sheppard, M.Ed. New Jersey Society of Professional Health Educators Laura Beauvais-Godwin, M.A. New Jersey Society of Professional Health Educators Thanks to: New Jersey School Boards Association for data analysis Margaret Sheppard for report writing October 14, 1988

INTRODUCTION Tobacco education is an important part of the health education of younq people. There are many resources to assist teachers and health professionals to teach the health risks that arise from smoking and to prevent initiation into smoking. It is important to know the extent to which educators use the resources and what further needs they have in order to update resources and provide needed training and development. METHODOIAGY A survey questionnaire was mailed to a random selection of 402 school nurses (from a total of 2,178 schools). The nurses were asked a series of questions about the smoking prevention programs in their schools. This survey sought to determine if there is a need for smoking cessation programs for school-age children, to determine the quality of support for smoke-free schools, and to assess the need for additional curricula assistance. -over- October 14, 1988

RESULTS one hundred and sixty-eight schools (42%) responded to the survey. Of these 61% were elementary schools, and only 1% (n=1) was a vocational school (Table 1) . The majority of the schools (64%) were suburban in nature (Table 2) and 72% had between 200 and 1000 students (Table 3). Overwhelmingly, tobacco education is taught in the health program (Table 4), however, the vocational respondent reported tobacco education was part of the substance abuse curriculum (Table 5). Grades 4-6 are the most popular grades for teaching about smoking (26%) but the other grades are almost as popular (Table 6). Most of the schools agreed that the time allotted to tobacco education is sufficient (Table 7), but 26% of the respondents from middle schools disagreed. The majority of schools agreed that the tobacco education programs help to discourage students from starting to smoke (Table 8). Some respondents did not agree the materials used do a good job demonstrating risk of smoking (Table 9). The major source of material is the American Cancer Society. The American Heart Association materials were used second most often and the American Lung Association ranked third. The majority of schools believed, that there is a need for smoking cessation programs and these programs should be held during school hours (Tables 10 and 11). Ten percent of the school nurses reported their schools have smoking cessation October 14, 1988

programs. Many respondents were undecided about the issue of separate cessations programs for pregnant smokers (Table 12). The respondents from the miqdle schools and the junior high schools were ambivalent as to whether peers should lead tobacco education programs. Fifty-eight percent of the elementary school respondents said that peers should lead programs while only 494 of the high school respondents agreed (Table 13). Ten percent of the schools reported they had a smoking cessation program. A majority of schools do not permit students to smoke anywhere on school grounds. of the high schools, only 56% have eliminated student smoking (Table 14). The majority of schools allow staff to smoke in the schools. Only 7% of the elementary schools and 6% of the middle schools said that smoking was not allowed by staff (Table 15). -over- October 14, 1988

DISCUSSION The returns appear to reflect the make-up of New Jersey, and therefore the results can be generalized to the total population. The majority of students in Jew Jersey schools receive some formal education about smoking, especially in Grades 4-6 where smoking behavior is initiated. Respondents are unsure of the effectiveness of the materials available for teaching smoking prevention. This points up the need for further staff development in use of smoking education material. A further focus can be ways of integrating smoking education into the overall curriculum for example as part of science (dealing with the pharmacologic effects and physiologic risk) and social studies (dealing with economics, advertising, peer group and decision-making skills). School nurses are unsure about the utility of using peer educators in smoking programs. This new area could benefit from further investigation. There is a strongly voiced need for smoking cessation programs for students, being held during school hours. WE RECOMMEND THAT SPECIAL CESSATION PROGRAMS DESIGNED FOR THE YOUNG ADDICTED SMOKER BE DEVEL(?PED AND IMPLEMENTED• IN THE SCHOOLS. There is a contradiction in school systems. Although formal ante-smoking messages are delivered in health education, many schools enable students' smoking behavior by providing smoking areas for students. Furthermore, a disconcerting number of October 14, 1988

schools allow modeling of smoking behavior by teachers and other influential adults in offices and staff lounges. There is"a need for more staff development regarding smoking education., development of policies for smoke-free schools and smoking cessation programs for both staff and students. 0 October 14, 1988

b e Grade Level of School Schoo ls in New Jerse y Returns N ~ N ~ Elementary 1558 72 78 61 Middle School I 234 11 16 12 Junior High School 25 1 3 2 High School 298 14 31 24 Vocational 20 1 1 1 Regional 43 2 Total 2178 129 ab e Community of School N urban suburban rural 32 105 26 2a 20 64 16 Total 163 -over-

TAble 3 Size of Student Population of School T # students N ; ~ 1 - 200 23 14 201 - 500 69 41 501 - 1000 52 31 1001 - 2000 22 13 2001 and over 2 1 Total 168 Tab e 4 Part of Curriculum in Which Tobacco is Taught. N ~ substance abuse 20- 16 science 6 5 physical education 1 1 social studies 3 2 health 96 N 76 Q ~ individual counseling 1 W Total 127 ~ ~ ~

Table 5 Place in Curriculum of Tobacco Education - by Grade Level 4 Substance. Abuse Science i Physical ', Education !Social 'Studies Health Individual Counseling v " elementary 21 4 - 4 71 - middle school 7 7 - - 86 - junior high - - - - 100 - high school 12 - - - 84 4 vocational 100 - - - - - Zable 6 ' Grade Levels for Smoking Programs I N Grade Level K - 1 50 13 2 - 3 62 16 4 - 6 101 26 7- 8 1 73 1 19 9- 10 58 15 N 1z 11 - 12 44 N 11 ~ Total 388 ~ (more than one response could be circled) ~ ~ -over-