IN THE NEWS:

 

Not On Tobacco year summary

 

 N-O-T continues to help solve the tobacco problem among teenagers in West Virginia.  Teens who use tobacco are at risk for developing a lifelong addiction that can cause serious health problems and cut years off their lives.  Teenagers who want to stop using tobacco need help, and they don't always get it.  N-O-T is providing that support throughout West Virginia. This program could not be successful without our very compassionate volunteer Facilitators through out the state, our partners at the West Virginia Bureau for Public Health Division of Tobacco Prevention, the West Virginia Department of Education, all Eight Regional Educational Services Agencies and their support of the Regional Tobacco Prevention Specialist and of course the Arnold Agency.

 

The documentation of the N-O-T program success is due to the comprehensive evaluation sampling conducted through local facilitators, we obtain information that assists with measuring program success and implementation rates. To help ensure that the data will be valid and reliable, we train our facilitators in basic data collection for evaluation purposes the majority of our evaluations are self reported by teens. It is worth noting that in a report released in May 2007 researchers who compared self-reports of tobacco and other drug use with urine and hair samples found that most teen users accurately reported their own consumption. The Substance Abuse and Mental Health Services Administration (SAMHSA) report, "Comparing Drug Testing and Self Report of Drug Use Among Youths and Young Adults in the General Population," found that self-reports and urine tests for past-30-days smoking were in agreement 84.6 percent of the time. "This validity study concluded that biological drug tests can be used as objective markers of drug use to verify self reports among youth and young adults," the researchers noted. 

 

For Grant Year 2006/07, 42 Facilitators provided a total of 97 Classes that either ended in the grant year or started in the grant year. We had 343 students begin the N-O-T program 73 dropped out of the program before it was complete, 60 classes submitted a total of 273 student evaluations that were useful, 22 percent of the students quit  and 63% reduced their tobacco use. We had 23 all girl classes, 18 all boys and 18 mixed classes. There were 13 Quit & Fit classes that were implemented but did not report results to ALA. Thirteen classes were offered but were unable to implement due to time constraints (5) and recruitment (4). Twelve classes started but have not communicated their status by the end of the school year. Sometimes we will get evaluations turned in when school starts back up.

 

We were able to compare results based on type of school this year

 

 We were also able to compare types of classes 

 The average age of the students participating in our program was 15 and they started using tobacco when they were 11 years old; they have used an average of 4.25 years. 214 students had tried to quit using tobacco on their own, 38 percent tried to quit at least one time; 27 percent have tried to quit 3-4 times; 4 percent have tried to quit 5-6 times and 7 percent had tried to quit 7 or more times. Ninety Three percent of these students have friends that use tobacco, 82 percent of the students live with parents that use tobacco and only 58 percent have siblings that use. The average pack per day use for this group of students was about a third of a pack per day (.68 ppd). The average spit tobacco used was about a can per day (.98 cpd). When they began the program the students were moderately motivated to quit using tobacco. By the end of the program only 5 students did not plan to quit using tobacco.155 (82%) students felt the program was important to their quit attempts. 158 (92%) felt confident that they could stay quit. Eleven percent of the students had participated in N-O-T previously.

We were able to evaluate students that used both forms of tobacco; smoking and smokeless or “Poly Users” this year. We found that 10 percent (32) of the students participating in the program were Poly Users. Six Polys quit using cigarettes (13 reduced) and 9 Polys quit spit tobacco (6 reduced) and only two Polys quit both. 

Only 10% (33) of the participants were smokeless only users the average per day use was almost a can of smokeless per day. The average onset age was 11 years old. Only 3 smokeless users quit but 73% reduced their intake.

We were not able to include evaluations from nine students that had quit using tobacco prior to beginning N-O-T; however it’s noteworthy that of these nine students five of them felt the N-O-T program was very or extremely important.

Comments from the 32 facilitators that provided feedback via the facilitator process form indicated that word of mouth was the most effective form of recruiting students into the program, followed by teacher referrals and the use of incentives. Other recruiting methods listed were the Alternative to Suspension Program, Posters and flyers, making the program fun, and school announcements via PA and the school TV channel.

Time was the biggest barriers identified by the facilitators; closely followed by trust issues between the students and the facilitator and parents finding out that the kids smoke or parents providing tobacco to the children. Other barriers that were identified were that the teens did not want to look “un-cool”; school staff complaining that the kids were missing class time, space to have the meetings, students getting off topic, and lastly not enough funding to provide incentives.

When we reviewed the Alternative To Suspension evaluations we found that 65 classes were implemented but only 61 submitted evaluation packets. Seventeen High Schools, Six middle schools and one each Alternative, Vo-Tech and a Juvenile Detention Center participated. Two Hundred Sixty Three students participated and turned in 251 evaluations. When we averaged all the students we had an 18 percent quit rate and a 26 percent reduction rate. The average daily use for both groups of participants was just over half a pack or can a day (.60 ppd /.67cpd). We had 80 girls and 171 boys participate in ATS this year. Students that “smoked only” numbered 144 and 21% of the smokers only group were able to quit using cigarettes, 77 of the students were “smokeless only” (25% quit) and 17 were “poly users” (5 quit spit and 5 quit cigs none quit both).  The average participant was 16 years old and had been using tobacco for 4 years. Seventy One of the students had no intention to quit at the beginning of the class by the last session 31 percent of these students had changed their mind and marked an intent to quit using on the final evaluation. Eight percent of the students had participated in ATS in a previous year.

Studies¹ indicate that tobacco users take 7.67 more sick days than non-users; this easily translates to 821 more school days attended for our students.  The West Virginia Department of Health and Human resources estimates (2005 Progress Report, pg 9) that for every smoker that quit using, $11,042 are saved in total life time health care costs. As a direct result of the N-O-T and ATS programs 104 children have given up tobacco; that translates into a total lifetime health care cost savings of $1,148,368 or $13.51 for every dollar spent on implementing the program. Another way of assessing the success of this program is that the CDC² estimates smokers lose an average of 13.85 years of life by dying prematurely; if we take this number and multiply it by the number of kids that quit this last year we find that we helped save 1,440 years of life.  

As per WVU’s definition of “Active Facilitators” We have a total of 259 school staff (teachers, counselors, nurses, etc.) certified to provide the program. We have 17 County Board of Education Staff; 57 community members/volunteers; and 23 certified facilitators that work at other institutions i.e. Boys * Girls clubs, juvenile detention centers, alternative schools, private schools, residential clinics etc.. We also have 19 Tobacco Control Staff (DTP, RTPS, RTPCC etc) that have been through the training. In all we have 356 Active Certified Facilitators (not counting tobacco control staff)

Over a quarter (27 percent) of all High Schools in West Virginia are using one of our cessation programs, however only six percent of middle schools are taking advantage of our programs. By my estimates we have 330 Middle, High and Vocational schools in the state of those 136 (42%) have certified facilitators working in the school. We also have 8 private schools that have trained facilitators.

¹ http://www.iht.com/articles/2007/04/11/arts/snvital.php

² http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5114a2.htm

Historical Comparison

 

 2469 West Virginia students have stopped using tobacco as a direct result of ALA programs. That translates into a total health care costs savings of $27,262,698 in the last 7 years or 3.9 million per year.

While this is a positive report and demonstrates that we are making progress we need to keep in our forethoughts that although our High School smoking rates are down to 25.3 percent this still represents 23,500 students that need help. Each year in West Virginia 2,900 more children become daily smokers, of these young people who become regular smokers each day, nearly 1,000 of them will have their lives shortened from tobacco-related diseases

"100 years from now, it will not matter what kind of car we drove, what kind of house we lived in,

how much was in our bank account nor what our clothes looked like. But the world may be a little better because we were important in the life of a child."

                                                                                                                                                            anonymous

 

Improving Life, One Breath at a Time