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PREVENTION

What is the "Great American Smoke Out"?

"The Great American Smoke Out" is an annual event sponsored by The American Cancer Society. On November 18, 1976, the California Division of the American Cancer Society successfully prompted nearly one million smokers to quit smoking for a day. That event marked the first "Great American Smoke Out," which has now become a yearly nationwide event.

"The Great American Smoke Out" has helped to bring about dramatic changes in Americans' attitudes about smoking. Changing attitudes have paved the way for changes in organizations and institutions so that fewer Americans are exposed to secondhand smoke than ever before, and it has led the way to the development of community programs that focus on prevention and smoking cessation.

What anti-tobacco education is being done in the schools? How effective are programs such as DARE?

DARE (Drug Abuse Resistance Education) is an international program for school age children and teens to prevent the use of tobacco and illegal drugs, membership in gangs, and violence. It is a collaborative effort by law enforcement, educators, parents, and community leaders. DARE was founded in 1983 by the Los Angeles Police Department. It promoted the presence of police in the classroom as the most appropriate teachers for school children to learn that drugs and violence kill.

The goals of the program are to foster resiliency in young people, to improve their capacity to make healthy decisions, and to enhance independent growth and self-reliance. Students learn to substitute healthy activities and to avoid participating in risky behaviors, such as drug abuse, violence, and other destructive behaviors.

Police officers undergo 80 hours of special training in child development, classroom management, teaching techniques, and communication skills. The prevention program is comprehensive and age appropriate.

The curriculum for elementary students includes:

Tobacco smoking and advertising

Drug abuse

Inhalants

Alcohol consumption

Health and healthy lifestyles

Peer pressure in a social network

The high school curriculum is a reinforcement of the information provided at the primary level and adds how to:

Act in one's own best interest when facing high-risk, low-gain choices.

Resist peer pressure and other influences in making personal choices.

Funding comes from multiple sources: The Department of Education, The Department of Justice and The U.S. Drug Enforcement Administration, The U.S. Office of Justice and Delinquency Prevention, corporations, private foundations, individual contributions, state legislatures, local school districts, religious organizations, and local businesses, as well as youth organizations. Funding also may come from a State's Master Settlement payments.

Results Regarding the Effectiveness of These Programs Conflict

School-Based Programs are Effective: More than 20 studies conducted from around the country have documented that 93% of the children and young people who are DARE graduates have never tried drugs, 75% have never tried tobacco products, and 90% of the graduates stated that they learned to resist the temptation to try drugs and learned to deal effectively with peer pressure. In another study, the results showed that the use of illicit drugs among teens declined from 11.6% in 2002 to 8.8% in 2006. The reduced percentage of teens using marijuana was particularly pronounced.

School-Based Programs are Ineffective: DARE has become so controversial that many school districts have discontinued the program or substituted other programs for DARE. The Hutchinson Smoking Prevention Project conducted a long- term evaluation study of smoking prevention programs in Washington State school districts. It was one of the most rigorous studies conducted on smoking prevention in the schools. The study spanned 10 years across grades 3 to 12. The study concluded that the DARE school smoking prevention programs do not work, especially when the curriculum does not take into consideration family and community cultural norms.

The following are a few of the other criticisms:

DARE is ineffective and may have the opposite effect, promoting drug use.

DARE is ineffective in reducing violence.

DARE suppresses unfavorable research, rejects scientific evidence, and questions critics' integrity.

DARE misinforms, teaching that all drugs are equally dangerous.

DARE, by using policemen, the symbol of authority, may negatively influence a student to be against the police.

DARE undermines the family. Part of the program has a lesson entitled, "The Three R's: Recognize, Resist, Report," which encourages children to report if they find drugs in their homes.

DARE is a waste of time and money and should be replaced by a more effective program.

Although the outcomes of studies conflict, there is evidence that school-based programs are effective for some children and teens. The Surgeon General's 1994 Report found that after years of research on a wide variety of school-based programs, most of them demonstrated success in reducing tobacco use.

Two Morbidity and Mortality Weekly Reports (MMWR) showed that comprehensive school-based programs, combined with community and media-based activities were effective in preventing or postponing the onset of smoking in 20% to 40% of U.S. adolescents. The second report quoted recommendations from the National Cancer Institute advisory panel, which stated that prevention programs should include the following: the social and short-term physiological consequences of tobacco use; training students in refusal skills; involvement of parents, teachers, and peers in smoking-prevention activities; and reflection of the needs of each community, so that the program is culturally sensitive.

Recommendations from the Institute of Medicine (IOM) are that school-based programs should be comprehensive, be integrated into school health programs, be sequential across grade levels, use many different strategies, activities, and services, and be designed to promote physical, emotional, and social health, as well as providing prevention. The IOM recommended that the anti-smoking program should be designed by an interdisciplinary team of teachers and that the team should be accountable to the community. The overall conclusion from the conflicting studies is that there is no one "best program" that fits all communities. Programs should be designed locally in collaboration with all of the community's stakeholders.

 
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