Tobacco Use Is Still the Leading Cause of Preventable Death
Tobacco use continues to be the number one cause of preventable death in the United States and around the world. Tobacco killed one hundred million people worldwide in the 20th century and is on track to kill one billion people in the 21st century.1
The Role of SBHCs in Tobacco Use Prevention & Education
School-based health centers (SBHCs) and wellness centers can help prevent tobacco use in students through health education and are well-positioned to provide tobacco cessation services.
- One of the unique advantages of a SBHC is its ability to go beyond the provision of clinical medical services and engage in public health activities at the schoolwide level.
- SBHC staff provide health education in classrooms, conduct schoolwide screenings, hold youth and parent education groups, and work with school staff to identify high-risk students.
- This ability of SBHCs to fuse clinical care and public health makes them well-suited for many prevention activities, such as tobacco prevention and cessation.
Peer education programs have demonstrated effectiveness in preventing youth tobacco use.3
- Young people are more receptive to tobacco prevention messages delivered by their peers than those delivered by their teachers.4,5
- For the peer educators, providing tobacco prevention education to their friends provides an opportunity for positive youth development.5
- SBHCs who are already providing group education should consider peer programs as a way to enhance the effectiveness of their prevention education.
Tobacco Use Is Typically Started & Established During Adolescence
- Approximately 90% of adult smokers tried their first cigarette before age 18 and nearly 700 children become regular smokers each day. 6
- E-cigarettes, including vapes, e-pens, e-pipes, and e-hookah, are known collectively as electronic nicotine delivery systems (ENDS) and are the most commonly used tobacco product among high school and middle school students. While cigarette use is on the decline, middle and high school students’ use of e-cigarettes has increased exponentially, with 1 in 10 middle and high school students reported having used e-cigarettes, according to the National Youth Tobacco Survey.7
- 14.1% of high school students (1 in 7) and 3.3% (or 1 in 30) of middle school students reported current e-cigarette use.8
The most effective way to reach young people with prevention education is through their peers.
School-based health centers excel at engaging youth in peer-to-peer education campaigns to improve population health.
The California School-Based Health Alliance and The Los Angeles Trust for Children’s Health – which serves as the Los Angeles Unified School District’s backbone health entity – partnered to educate high school students on tobacco and vaping prevention.
Youth learned about nicotine addiction, e-cigarette ingredients, and the harmful health effects of smoking and vaping from the Stanford University Tobacco Prevention Toolkit and then created projects to share their knowledge schoolwide.
Student Advisory Boards (SAB) at eight LAUSD high schools conducted a joint in-person and social media campaign to mark World No Tobacco Day to educate students on:
- E-cigarette ingredients and health dangers;
- Myths that perpetuate smoking and vaping;
- Misinformation and tactics the tobacco industry uses to attract underage consumers.
Youth leaders reached additional youth through interactive social media polls that educated them on the concept of addiction and the chemicals inside JUUL pods.
In-person events held at schools urged students to commit to stop smoking and vaping or to pledge to never start. One SAB participant participated in a press conference to spotlight how tobacco companies target young people and the African-American community specifically with menthol cigarettes.
Youth engagement teaches students valuable leadership skills while also empowering all students how to turn knowledge about a health challenge into advocacy and preventive action.
“I learned that [big tobacco] spends $1 million a minute on advertising.”
“What shocked me was … that cigarettes are responsible for the death of a lot of people but [tobacco companies] don’t get criminally charged”
“I was surprised how much I ended up learning from other students when I shared the information I got during trainings with them.”
These projects are supported with grants from the California Department of Education Tobacco-Use Prevention Education Program.
The Stanford Tobacco Prevention Toolkit offers theory-based and evidence-informed resources created by educators, parents, and researchers aimed at preventing middle and high school students’ use of tobacco and nicotine.
Stanford University has additional resources, including the Vaping Prevention Toolkit, the Cannabis Prevention Toolkit, the Vaping Information, Solutions, and Interventions Toolkit (VISIT), and the Healthy Futures Curriculum, which is an alternative to suspensions education program for students caught using tobacco substances on campus.
The Centers for Disease Control and Prevention (CDC) has useful information about the negative health effects associated with tobacco including reports, fact sheets, and videos created by youth explaining the harmful effects of tobacco with suggestions on how to prevent young people from using tobacco.
The truth campaign has a website and media campaign geared toward youth and young adults.
Resources for Parents
There are many resources out there for young people to learn more about the effects of tobacco and nicotine, but it can be overwhelming to read so much information. In hope of easing the burden and engaging more young people, CSHA put together some of the most youth-friendly tobacco education resources. These are select resources we believe youth would find the most relevant:
Websites Recommended by Our Youth Board & School-Based Health Providers
Our Youth Board and school-based health providers from across the state reviewed existing substance use prevention websites and found these websites to be the most youth-friendly and impactful:
Tobacco Cessation Resources
Interested in quitting tobacco, nicotine, or vaping? Our Youth Board researched the web for the most engaging and youth-friendly resources and selected these to share with young people:
- For ages 13-17
- 6-8 week program
- Daily text messages that help you quit smoking
- Helps you quit cigarettes, vapes, and/or smokeless tobacco
- Work with a Quit Coach
- Youth resources as curated by one of CSHA’s Youth Board members
(1) Campaign for Tobacco Free Kids. (2015).
(2) Ziedonis, Douglas M., et al. “Barriers and solutions to addressing tobacco dependence in addiction treatment programs.” (2007).
(3) Black, David R., Nancy S. Tobler, and John P. Sciacca. “Peer helping/involvement: an efficacious way to meet the challenge of reducing alcohol, tobacco, and other drug use among youth.” Journal of School Health 68.3 (1998): 87-93.
(4) Klepp, Knut‐Inge, Andrew Halper, and Cheryl L. Perry. “The efficacy of peer leaders in drug abuse prevention.” Journal of School Health 56.9 (1986): 407-411.
(5) Valente, Thomas W., et al. “Effects of a social-network method for group assignment strategies on peer-led tobacco prevention programs in schools.” American journal of public health 93.11 (2003): 1837-1843.
(6) US Department of Health and Human Services. “Preventing tobacco use among youth and young adults: a report of the Surgeon General.” Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health 3 (2012).
(7) National Youth Tobacco Survey (NYTS), 2021, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion
(8) Cooper M, Park-Lee E, Ren C, Cornelius M, Jamal A, Cullen KA. Notes from the Field: E-cigarette Use Among Middle and High School Students — United States, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1283–1285. DOI: http://dx.doi.org/10.15585/mmwr.mm7140a3.