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Center for Substance Abuse Prevention (US); Grover PL, editor. Reducing Tobacco Use Among Youth: Community-Based Approaches (Practitioners' Guide). Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1997. (Prevention Enhancement Protocols System (PEPS), No. 1.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of Reducing Tobacco Use Among Youth: Community-Based Approaches (Practitioners' Guide)

Reducing Tobacco Use Among Youth: Community-Based Approaches (Practitioners' Guide).

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General Recommendations: How Can Practitioners Have the Greatest Impact?

On the basis of its analysis of research studies and practice cases, the PEPS Expert Panel makes the following General Recommendations:

Use a Community-Based, Integrated, Multicomponent Approach

Community-based means that the program involves general community members and representatives of local organizations, agencies, schools, and the media. An integrated approach means that the individual components support and enhance each other. A multicomponent program is one in which a number of coordinated efforts target a single issue. Working in concert, the various components have a more powerful, visible, and lasting impact.
The following example illustrates the differences between a single-component intervention and a multicomponent approach to reducing youth access to tobacco.

  • Single-component intervention: Passing a law to prohibit tobacco sales to minors
  • Integrated multicomponent approach:

    - Enacting laws prohibiting tobacco sales to minors
    - Enforcing these laws through publicized purchase attempts involving underage purchasers and police sponsorship or cooperation
    - Educating merchants and community members about adolescent tobacco use and laws prohibiting tobacco sales to minors
    - Seeking broad-based community support of these prevention efforts
    - Educating judges to impose significant consequences on violators of the tobacco sales laws

Each of the approaches described in this guide works well as part of a community-based, integrated multicomponent program, the prevention model that has proven to be most effective.

Involve Community Members and Organizations From the Earliest Stages

Strive for sustained, comprehensive community support. This will make the program part of the community and provide the structure necessary for success over the long term. A community partnership should include the following individuals and organizations:

  • Elected officials and other community leaders
  • Representatives of all ethnic groups in the community
  • Local business persons and merchants
  • Students and student organizations
  • School system
  • Government agencies
  • Social agencies and associations
  • Mayor's office
  • Police department and judicial system

Educate Merchants, Law Enforcement Officials, and Judges

For community education components in youth access interventions, prevention efforts should include retail merchants, policy- and decisionmakers, the police, and the judicial system. Retail merchant education should include written materials for the retail store owner and clerks and the regional executives of retail store chains. Ideally, these materials should be delivered in person by teams including representatives from the police department, adolescents, and the community. Practitioners should aggressively pursue partnerships with the police and judges. Police in some areas are reluctant to enforce adolescent tobacco sales laws and may need coaxing. Similarly, judges are often reluctant to impose consequences on local merchants for violating the adolescent tobacco sales laws. With perseverance and by providing targeted information and education, however, the police and judges can become ardent supporters of prevention efforts.

Involve Adolescents in All Aspects of the Program

Adolescents have shown themselves to be particularly valuable in the design, planning, and implementation of community programs. Youth involvement is vital for two primary reasons:

  • Adolescents understand the values, attitudes, perspectives, and beliefs of their peers.
  • Youth involvement may serve as a deterrent to future tobacco use and helps create a strong and informed generation in which being smoke-free is the norm.

Gather Baseline Data To Determine the Extent of the Problem in Your Community

This information will help you define your target population and program goals, objectives, and activities. Some of the information might come from adolescents who are invited to participate in focus groups or similar small-group sessions. You will need to know:

  • The prevalence and patterns of tobacco use among youth, which can be obtained through the health department
  • Community knowledge, attitudes, and practices relating to youth and tobacco products
  • The degree of readiness for change in various sectors of the community (Who will work with you? Who will work against you?)
  • Existing efforts addressing tobacco issues, especially interventions to prevent tobacco use among youth
  • Where and how easily minors can purchase tobacco products in the community
  • The adequacy of school-based smoking prevention programs

Select Your Target Group and Define Your Goals and Objectives

The target group and goals should be determined on the basis of your community's needs, as revealed by the needs assessment. Be as specific as possible; also, make sure your goals are realistic. Include the following four elements:

  • Who?(the target group for change)
  • What?(the action or change you expect)
  • How much?(the extent of change you expect)
  • When?(the time frame for change)

Select Interventions That Will Actively Involve Your Target Population

Review the six prevention approaches described in this document. Which of these approaches are most appropriate for your population? Which intervention activities best support your goals and objectives? Before you select an approach, review each one carefully, paying special attention to the "Level of Evidence" (see Appendix A for criteria) regarding the effectiveness of the approach, the "Lessons Learned," and "Recommendations for Practice."

Provide an Array of Activities

After you have selected your approach, review the activities suggested for that intervention and choose those that will best help you meet your objectives. Call on the creativity of your planning group to develop additional activities that move you toward your goals.

Link Your New Initiatives With Existing Programs or Activities Whenever Possible

This approach has several benefits:

  • Prevention activities become part of existing networks.
  • The likelihood of local acceptance and support is increased.
  • Duplication of services is avoided.
  • A valuable partnership with key community members is developed.

Use Existing Materials

There exists a wealth of effective printed and audiovisual educational prevention materials regarding adolescent substance use, much of it in the public domain. When such materials are available and appropriate for the target audience, using them can save time and money. Similarly, modifying existing prevention materials to more effectively meet the needs of a target audience is much less expensive than developing them from scratch. Existing educational materials may be appropriate for one audience but may need to be revised to ensure cultural sensitivity and appropriateness. Some programs develop or modify a few elements of an existing multielement educational program. When such materials include specific identifiers of the community, setting, and sponsors, the sense of partnership and ownership can be enhanced.

Include Smokeless Tobacco Use Prevention in Your Interventions

One study reported that smokeless tobacco was used by 15 percent of nonsmokers and 32 percent of youth who smoked during the past month.

Consider the Need for Programs To Help Nicotine-Dependent Youth Quit

Conventional primary prevention (encouraging people not to start) or secondary prevention (encouraging people to quit) may not be powerful enough to break dependence on nicotine. Special programs for nicotine-dependent youth should be a part of all tobacco control programs.

Gather Data at All Stages

As noted above, you will need baseline data to mount a successful program. Once you have this information, develop procedures to routinely collect data as program implementation proceeds. A well-documented program is more likely to receive funding. Equally important, data collection generates information of great value to your colleagues and researchers in the field.

Prepare for Opposition

Learn what the tobacco industry is doing regionally, and develop counterarguments and strategies, especially with respect to youth's use of tobacco products.

Realize That Prevention Efforts Need To Be a Sustained Process

New smokers are continually joining the ranks of youth who use tobacco. Success in prevention depends on continually assessing and improving interventions. If your effort is to be sustained, your community efforts must be continually strengthened with new members. Community education should be ongoing.

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