High schools need to bolster tobacco control efforts

December 19, 1999

Suspending or expelling high school smokers may do more harm than good, yet many schools are quicker to mete out such punishments than to employ smoking prevention and cessation programs, according to a survey of South Carolina high schools.

Nearly 68 percent of South Carolina high school students face suspension or expulsion for their second smoking offense, according to the results of a survey conducted by researchers from the University of South Carolina School of Public Health, in Columbia.

The researchers found tobacco education curricula were rarely employed. Only six percent of principals reported using tobacco cessation educational programming for students caught smoking.

"Using methods like suspension or expulsion alone to penalize smokers is not just ineffectual; such methods may achieve the exact opposite of their intended result," said lead study author Maurice W. Martin, MEd.

"Students who smoke are likely to miss a disproportionate number of educational days compared to their non-smoking peers," said Martin. "Truancy has been shown to be associated with poor academic achievement and is known to be a major factor contributing to students dropping out."

"Low academic achievement has been associated with smoking; that is, both men and women with less than a high-school education are more likely to smoke than those with more advanced education. It is possible that by suspending and expelling students who smoke, educators may be perpetuating the tobacco-use cycle that they desire to disrupt," said Martin. The results of the research appear in the current issue of Nicotine & Tobacco Research.

South Carolina high school smoking rates have increased over the last several years. More than 80 percent of smokers start when they are younger than 18 years old, according to the researchers.

Approximately 39 percent of 9th through 12th graders smoke regularly - 13 percent more than in 1991 - according to the results of the 1997 South Carolina Youth Risk Behavior Survey cited by the researchers.

This increase occurred despite a general tightening of school tobacco control policy. Nearly all of the surveyed high schools prohibit cigarette use (97 percent), and 95 percent prohibit cigarette possession.

To successfully reduce smoking levels without increasing truancy among high schoolers, Martin and colleagues advise that school anti-smoking programs and policies address both primary prevention and smoking cessation.

Two tobacco education programs are listed in the Centers for Disease Control and Prevention1s (CDC) list of "Programs that Work," but few South Carolina high schools implement them. The study results indicate a need to find strategies to encourage schools to use the CDC-recommended programs.

"In summary, schools may be able to curb smoking among their students, decrease truancy, and possibly improving their drop-out rates by using effective smoking cessation programs in conjunction with the policies and prevention efforts already instituted," said Martin.

The research was partially funded through the American Stop Smoking Intervention Study.
Nicotine & Tobacco Research is the official peer-reviewed quarterly journal of the Society for Research on Nicotine and Tobacco. For information about the journal, contact Gary E. Swan, PhD, at (650) 859-5322.

Posted by the Center for the Advancement of Health < http://www.cfah.org >. For information about the Center, call Petrina Chong, < pchong@cfah.org > (202) 387-2829.

Center for Advancing Health

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