July 26, 2000
Cigarette smoking makes your breath smell bad, your teeth yellow and your hair stink. In spite of these hygienic facts, teen-agers persist in smoking. Believing themselves invincible to the more serious health risks associated with cigarettes-lung cancer, emphysema, heart disease- young people continue to light up.
Youths in Louisiana are especially vulnerable to the hazards of smoking, says Carolyn Johnson, clinical associate professor in community health sciences at the School of Public Health and Tropical Medicine. Overall, Louisiana has a higher incidence of smoking than the national rate.
And with so many adults smoking, there is little to prevent young people from mimicking their elders. But Johnson will be trying to stop the trend of increasing adolescent smoking in several Louisiana parishes in Acadiana through a five-year study funded with a $1.5 million grant to Tulane from the Louisiana Tobacco Settlement and awarded by the Louisiana State Board of Regents.
Louisiana is scheduled to receive $4.6 billion during the next 25 years from the tobacco settlement, although Johnson doubts that all the money will be paid or that it will be used primarily for smoking prevention or cessation programs.
However, this fall, the Acadiana Coalition of Teens Against Tobacco, funded with initial tobacco-settlement money, will be launched in 20 public high schools. As of late July, Johnson had signed up participating schools in St. Martin and Vermilion parishes, and she was actively recruiting other schools in Lafayette, Lafourche, St. Landry, Iberia and Terrebonne parishes.
Johnson, principal investigator of the study, says the goal is to encourage students in 10 "intervention" schools, which will be randomly selected from the whole group of schools, to become "proactive against smoking."
The remaining 10 schools in the study will serve as a source for measurement and comparison data only. Through a program of peer advocacy in the intervention schools, Johnson hopes students create an environment where smoking is not the social norm. Johnson and the equivalent of two and one-half full-time health educators will go straight to campus clubs and drama classes to get the message out to students that smoking is neither "cool" nor socially acceptable.
Working with the schools' existing activity infrastructures-and apart from the academic curriculum-the coalition will promote in-school media campaigns against smoking. Students will participate in writing scripts for a "psychodrama" competition among the intervention schools, with trophies awarded for the plays with the most effective anti-smoking themes.
These efforts are all aimed at discouraging young people from taking up the habit and encouraging them to quit if they're already hooked. Johnson says the coalition also will send a newsletter home once every semester to parents, trying to gain their support.
"And, that's going to be hard," she says, "because so many of the parents are smoking. But we're going to try to convince them that it would be great if their kids didn't smoke, even though they smoke."
From her previous analysis of data from the Bogalusa Heart Study and the related Child and Adolescent Trial for Cardiovascular Health-for which she is co-principal investigator-Johnson has found out that in rural Louisiana, many Caucasian young people start experimenting with cigarette smoking in middle school.
This same research indicates that African-American teen-agers usually start smoking later, in high school. For both groups, though, Johnson says, "We know that the probability increases 13-fold if a kid's best friend smokes."
With friends smoking, siblings smoking, parents smoking and cigarettes easily available in the household, there is "an incredible likelihood that the child is going to smoke," says Johnson. Quite often, she says, the parent may start the child smoking, offering a cigarette because they see little harm in advocating something in which they partake.
"You know, there are a lot of people who simply deny the health consequences of smoking," she says. The collection of more data about the smoking, or non-smoking, patterns of teens is crucial to the Acadiana study, and the grant will also fund one tracking-and-measurement coordinator.
The study will track a cohort of ninth graders in the first year of the program for five years to assess smoking habits. Even those students who drop out of school will be surveyed. Johnson says that most people assume that a high percentage of high school dropouts smoke, but there is no real evidence to support or disprove that theory yet.
More than anything, Johnson says, the five-year program will test whether its anti-smoking activities in the schools have an impact on decreasing teen-age smoking. "We'll see if it works," she says. "And, if it works, we'll be going up to Baton Rouge and saying, okay, now we've got to get this program in other schools throughout the state."
Tulane University, New Orleans, LA 70118 504-865-5000 firstname.lastname@example.org