Decreasing Tobacco Use in Youth

Steps to reduce tobacco use in youth have been presented at the local, national, and state level. The Centers for Disease Control and Prevention (CDC) (2012) mentions that mass-media campaigns, school-based programs, tobacco-free campuses, tobacco reduction advertising, and increased taxing and costs of tobacco products have all been combined to impact the initiative. Putting these policies into action at all levels is making a difference toward the tobacco epidemic. The U.S. Department of Health and Human Services (2012) describes over 45 years of evidence has shown that programs, increased pricing, policies, controlling access, reducing promotion, smoking bans, and implementing campaigns have reduced the toll tobacco takes on families and communities.

Primary prevention efforts are key to preventing the choice to smoke. The CDC (2012) mentions that over 80% of adult smokers begin before the age of 18 and every day 3800 adolescents smoke their first cigarette. Preventing these adolescents from ever starting tobacco use could further decrease this statistic.

Using health belief model, young people would need to be motivated to take action through education from many perspectives. Glanz, Rimer, and Viswanath (2008) describe constructs of the model; here, it is presented relating constructs to tobacco prevention in young adults:

• Perceived susceptibility of getting cancer

• Perceived threat of death

• Perceived benefit of never smoking

• Perceived barriers to making the healthy choice to not use tobacco

• Cues to action such as negative portrayal of smoking in the media

• Self-efficacy required to remain tobacco free

Young smokers can be challenged with barriers to promote cessation. The U.S. Department of Health and Human Services (2012) proposes community interventions such as increasing the unit price of tobacco products, mobilizing community support to reduce access, and reducing financial barriers for cessation therapies. Locally, the community collaborates with law enforcement to do sting operations aimed at assessing underage tobacco sales. Those that break the law are fined to further decrease the incidence of young people accessing tobacco.

Empowering adolescents to lead their peers in changing the social perception behind tobacco use is an effective method to impact prevention of the epidemic. This method of intervention has been used for other public health problems facing this target population. Wyman et al. (2010) trained suicide prevention to peer leaders from diverse social cliques so they could conduct school wide messaging to change the norms and behaviors of their peers through activities with adult mentoring. The study improved peer leaders’ adaptive norms regarding suicide, connectedness to adults, and school engagement (Wyman et al., 2010). The intervention also increased perceptions of adult support for suicidal youths and acceptability of seeking help for all students (Wyman et al., 2010). Peer pressure produced positive outcomes for this measure.

The Centers for Disease Control and Prevention (CDC) (2012) mentions that when smoking is portrayed as a social norm among cool, sophisticated, or rebellious teens, they often respond by copying their behaviors. Teens are susceptible to social influences and value their friendships, wanting to fit in with their group. A world is needed where smoking is the exception, not the norm. The CDC (2012) states “as a society, we can no longer allow our young people’s health to go up in smoke” (p. 16). Continued emphasis on peer programs must be supported to successfully embrace this vision.

Efforts should continue at the primary prevention level, attempting to change social norms of tobacco use. The CDC (2012) mentions that the perception that tobacco use is the norm is associated with youth tobacco use. Glanz et al. (2008) describe the subjective norm as a concept of the theory of reasoned action and theory of planned behavior. The author states that a person’s subjective norm will be negative if they believe that important referent individuals think they should not perform the behavior. Continued negative emphasis on tobacco use will assist with this measure.

Centers for Disease Control and Prevention. (2012). Youth and tobacco use. Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm

Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health behavior and health education: Theory, research, and practice. San Francisco, CA: Jossey-Bass.

U.S. Department of Health and Human Services. (2012). Tobacco use. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=41

Wyman, P., Hendricks, B., LoMurray, M., Schmeelk-Cone, K., Petrova, M., Yu, Q., Walsh, E., Xin, T., & Wang, W. (2010). An outcome evaluation of the sources of strength suicide prevention program delivered by adolescent peer leaders in high schools. American Journal of Public Health 100(9), 1653-1661.