MODELS FOR PRACTICE
FOCUS
AREA: TOBACCO USE
Program
Name: Too Smart
to Smoke Tobacco Prevention Campaign
Location: Newport, Vermont
Problem Addressed: Tobacco Use
Healthy
People 2010 Objective: 27
Web
Address:
http://www.nchsi.org
SNAPSHOT
THE
MODEL
Blueprint: The tobacco prevention program is spearheaded by North Country Hospital’s (NCH) community health
planner and is implemented by a part-time coordinator hired by the hospital.
The Tobacco Prevention coordinator is responsible for organizing and
implementing the tobacco prevention activities and events according to grant
guidelines. The grant-funded coordinator’s role is to enlist participation of
community groups, primarily youth, to engage in tobacco prevention activities
and events. The coordinator is supervised by the NCH community health planner
who initiates the grant process, completes all reports, and generally oversees
the direction of the grant.
NCH provides a significant amount of funding and
in-kind support in the form of space, supplies, supervision, and program
administration. Funding is also through the Vermont Department of Health first
from Centers for Disease Control (CDC) money that came to the state and since
2001, tobacco settlement money.
The goals of the program are to:
- reduce the percentage of youth in the HTS ONE area who smoked
cigarettes in the past month to 16 percent by 2010;
- reduce the percentage of adults in the ONE area who smoke to 12
percent by 2010; and
- reduce the percentage
of young children in the ONE area who are regularly exposed to tobacco
smoke in the home to 10 percent by 2010.
These
goals are congruent with Healthy Vermonters 2010. To accomplish these goals, a
variety of cessation and prevention strategies are used, aimed at changing
perceptions regarding tobacco use.
The
following list of events and programs are used in tandem to meet the
objectives:
·
recruitment of local youth and adults to
write and record tobacco prevention messages that are aired on local radio
stations;
·
a youth summit, youth and family day sponsorship;
·
poster contests in all elementary
schools;
·
anti-drug theatre productions at local
schools;
·
a “Clear the Air” program aimed at
reducing exposure to second-hand smoke in the area;
·
a Focus on Life photo workshop where
teens learn the basics of picture-taking while focusing on healthy lifestyles.
The photos are then exhibited for public viewing throughout the area; and
·
support of healthy youth behaviors, such
as community winter carnivals, school/community dinner dances, scholarships for
local summer camps, wilderness camps and teen leadership workshops, and school
projects that focus on healthy hearts, aerobic exercise, and not using tobacco.
Each
of these activities is a collaborative effort between the Tobacco Prevention
Program and various community members. The program attributes its success to a
strong sense of cooperation and collaboration held in this rural area.
Making a Difference: Orleans and Essex Counties
are rural, economically disadvantaged areas of Vermont. Smoking contributes to chronic
obstructive pulmonary disease (COPD) at higher incidence in these counties
compared to state rates. State COPD-related deaths were 44 per 100,000 adults
in 1998 compared to Essex and Orleans Counties with a rate of 57 per 100,000
adults. Smoking during pregnancy rates are also higher in the North Country Hospital
area (ranging from an all time high of 40 percent to a current 33 percent)
compared to the state average in 2001 of 21 percent. However, as of 2001, the
rate of smoking cessation among pregnant women before the fourth month is 28
percent in the NCH service area compared to the state average of 22 percent.
In 1999, the state’s estimated smoking rate among
eighth and twelfth graders was 22 percent and 42 percent, respectively. At the
same time, twelfth graders in two of the three school districts in Orleans and Essex Counties
reported higher smoking rates of 48 percent and 54 percent, respectively. One
of the school districts reported a prevalence of smoking (28 percent) among
eighth graders.
Data from 2001 revealed significant progress toward
smoking cessation in not only Vermont
as a whole but also in Essex and Orleans Counties. In 2001, the state rate of
smoking among twelfth graders was 30 percent (a 12 point drop from 1999). All
three of the school districts in Orleans
and Essex Counties were below or equal to the
state average. Among eighth graders, the Vermont
smoking rate dropped from 22 percent in 1999 to 13 percent in 2001. In Orleans and Essex Counties,
one school district showed a significant decrease in smoking among eighth
graders from 28 percent in 1999 to 18 percent in 2001. However, an increase was
seen in another school district (from 20 percent to 25 percent). The adult
smoking rates for Orleans
(23.6 percent) is slightly higher than the state rate (22.7 percent); however,
the Orleans
rate has decreased since 1999. In Essex
County, the adult smoking
rate has remained consistently lower than the state average at 20.9 percent.
These data indicate that rates of smoking for twelfth
graders in these two counties have significantly declined from 1999 to 2001;
rates among eighth graders reveal mixed results. Adult rates have declined as
well.
In designing the various programs and events,
program organizers also consider the Developmental Assets as one mechanism to
improve program effectiveness. The Developmental Assets were developed by the
Search Institute and are now used by the state of Vermont.
Beginnings: The Health and Traffic
Safety Coalition for Orleans
and Northern Essex was initiated by the North Country Hospital in 1991. The coalition was
originally formed to allow various members of the community to join together
with the mission of improving traffic safety, with a particular focus on
preventing and reducing the incidence of driving while under the influence of
alcohol and increasing seat belt use. Over the years, the coalition’s mission
has expanded to include broader community health issues including combating
tobacco and substance use. Today, the coalition’s membership exceeds 40, with
representation from a broad cross-section of the community ranging from
businesses, health agencies, youth groups, schools, and legislators.
North
Country Hospital
has been instrumental in the development of the smoking prevention program.
NCH, a leader and the facilitator of the HTS ONE coalition, acts as the fiscal
agent of the tobacco prevention funds.
NCH provided tobacco prevention/cessation
assistance through its Wellness
Center for almost 20
years. However, in 1996, with the receipt of increased grant funding, the
tobacco prevention program became more structured and firmly established. In
1998, tobacco prevention strategies for the community were officially
implemented. The rural counties of Orleans
and Essex were targeted due to a higher
prevalence of tobacco use compared to state rates. The program serves three
school districts comprised of 21 elementary schools (public and private), a
junior high school, and four high schools (public and private).
Challenges and Solutions: The primary challenges to the HTS ONE
coalition are continued funding. As the program has expanded, funding has
expanded from both the national level as well as the local level, including
grants from NCH and HTS ONE. The program utilizes a variety of communication
channels to disseminate information on the program including newspapers,
newsletters to students, press releases, radio, and informational booths at
numerous community events.
PROGRAM CONTACT INFORMATION
Joanne
Fedele, RN, MS, Community Health Planner
Too
Smart to Smoke Tobacco Prevention Campaign
North Country Hospital
189 Prouty Drive
Newport, VT
05855
Phone:
(802) 334-3208
Fax:
(802) 334-3281