Educating Smoke-Free Teens

August 21, 2003

Heather Heilman
Phone: (504) 865-5714

The Acadiana Coalition of Teens Against Tobacco was launched in 2000 with the goal of convincing a class of high school students in six south Louisiana parishes that smoking is uncool--and of measuring the success of those efforts through comparison with schools where no intervention took place.

inside0801_smokingThe idea was to send health educators to the schools to work with a cohort as they moved through 10th, 11th and 12th grades. For the past three years, they've been travelling to 10 high schools in Vermillion, Lafayette, St. Landry, St. Martin, Lafourche and Iberia parishes.

The study is funded with a $1.5 million grant from the Louisiana Tobacco Settlement, awarded by the Louisiana State Board of Regents.

As researchers gear up for the last year of intervention, there have been successes, surprises and even forays into politics. This spring they forwarded more than 2,000 letters from students and eight petitions to state legislators in support of the repeal of Louisiana's tobacco preemption laws. Currently, local governments in Louisiana are prohibited from passing tobacco laws that are more restrictive than state regulations.

There's been a wave of new no-smoking ordinances across the country, such as New York City's new ban on smoking in bars and restaurants. But while there's strong support for similar bans in some towns in Louisiana, state preemption means such a ban couldn't be implemented even if everyone in town voted for it. When talking to students, educators found that teenagers really cared about the issue.

"Even teenagers who smoke tell us they don't want children to be exposed to secondhand smoke," said Dixye Brewer, a health educator for the project. So they decided to help kids get their voices heard by organizing the letter-writing campaign. Since the student's aren't quite old enough to vote, they circulated petitions among the adults in their communities.

"Can we compete with the tobacco lobby? Probably not, but at least these kids know that their voices were heard," said Carolyn Johnson, principal investigator and clinical associate professor of community health sciences.

On the local level, she's been talking with school boards to encourage them to designate school grounds as smoke-free areas, but it's a hard sell because of the teachers who smoke. When teachers are being recruited for higher paying jobs across the state line in Texas, school boards don't want to do anything to alienate them.

Johnson decided to base the study in Acadiana because kids there are somewhat more likely to smoke and start smoking earlier than the national average. Baseline measurements at the onset of the study showed that 25 percent of the 9th graders had smoked at least one cigarette in the last 30 days. The first year the health educators were able to get some classroom time with the then-10th graders, who are the focus of the study.

But since then, because of intense pressure to prepare for the LEAP test, they've had to confine their efforts to school hallways at lunchtime.

"We're trying to create awareness and to educate kids about the tobacco industry and the effects of smoking. That's a challenge when we don't have a curriculum and we can't get classroom time," Johnson said.

The hallway activities end up attracting and involving students from throughout the school, not just the class targeted for intervention. That allows a larger number of kids to be affected, but also dilutes the effectiveness of the intervention for the cohort. It also affects the coalition's budget because the educators must bring enough giveaway material for the whole school.

"There are so many kids to deal with," Johnson said. "You don't know who you're getting through to and who not. You never know if one thing you said or did made a difference in someone's life. But if you affected just 10 people in each school, the program is worth it."

After the cohort graduates it will be tracked for one year. Researchers hope to see a lower rate of tobacco use than among the cohort's peers at 10 control schools. If so, they'll be offering similar interventions to the 10 schools that served as controls.

Heather Heilman can be reached at

Tulane University, New Orleans, LA 70118 504-865-5000