Smoking Cessation a Success at Local High School

The Cancer Association of Greater New Orleans (CAGNO), a United Way community impact partner, is positively impacting the lives of local students by teaching them about the dangers of tobacco use.

In 2001, the Centers for Disease Control and Prevention (CDC) reported that 28.5 percent of high school students smoked cigarettes. If young people continue to take up smoking at such an early age, the CDC estimates that 6.4 million people who are currently under the age of 18, including 107,000 people in Louisiana alone, will die prematurely from a tobacco-related disease.

So, for the past six years, CAGNO has been collaborating with Jefferson Parish Safe and Drug Free Schools and a local high school to change those statistics. In 1998, the principal at East Jefferson Senior High School approached Kris Gonzales, Prevention Specialist for East Bank high schools, about the possibility of starting a smoking cessation program on his campus because he realized that there was a dire need for one. "Not only is it against the law, but they’re going to die," Gonzales remembers the principal telling her.

Gonzales put together a collaborative program, which was originally comprised of her organization (Safe and Drug Free Schools), the No Smoking Environment Coalition (NoSE), the American Cancer Society and CAGNO. The first three years of the program were the most "difficult." Students were placed through a Tobacco Education Group (TEG) and a Tobacco Awareness Program (TAP). But what the collaborating groups realized was that for the majority of the students in the program, smoking was a coping mechanism.

"It relieves some stress," a sophomore currently going through the program said.

"These kids had so many problems and smoking was a way for them to cope with these problems," Gonzales explained. "Getting them to quit was horrendous. We didn’t see very good results. We were frustrated as facilitators."

So after three years of interacting with these students, Gonzales and CAGNO’s health educator, Tammy Louk Swindle, realized that they had to restructure the program and become "much more creative," Gonzales said. "[The students] thought [smoking] was their lifesaver. We had to become more skilled in giving them other coping skills."

Today, East Jefferson’s Tobacco-Free Schools Pilot Program, a collaborative effort between CAGNO and Safe and Drug Free Schools, has evolved into a much more effective program. Each year, the faculty attend an in-service training on tobacco education during their staff development day. Parents are exposed to a similar tobacco education in-service during Open House and Parent Conference Day. Information about the smoking cessation program is also mailed out to the students’ houses.

With the zero-tolerance policy in place, students who are caught smoking or using tobacco products on campus face the following consequences:

• 1st offense - participate in a 10-week group, where students learn alternative coping skills such as stress management, communication, exercise and nutrition. Students also discuss how much money their habit costs them and how they can better use that money. Swindle remembers that one student who she helped quit several years ago told her that he saved the money that he previously spent on cigarettes to buy a television set for his bedroom.
• 2nd offense - 1 1/2 hour meeting with parent and student
• 3rd offense - student is placed under school arrest--they attend all of their classes that day, but their parents or guardians are notified of the offense and told that they must come to the school to fill out police paper work before the student can be released to their custody at the end of the school day.
• 4th offense - 1-day suspension

Most of the students entering the program are "rebellious, angry and mad initially," Gonzales said. "But by the 5th or 6th lesson, they started to understand that they started smoking for a reason and now they are addicted and how that addiction could alter their lives. They become more open to quitting. They really try."

Swindle estimates that each year, approximately 25 percent of the students going through the program actually succeed in quitting during the school year. "The problem is that during the summer, they relapse," she explained. But it is still a much higher quit percentage than average. In 2001, the CDC reported that only 5 percent of smokers succeeded in quitting smoking for three months or more.

In addition, according to the book Treating Tobacco Use and Dependence, smokers are more likely to be successful when they combine counseling, pharmacotherapy and support from their family, friends and co-workers. None of these students have access to pharmacotherapy. And the majority of the students’ "smoking behavior is modeled on a family member’s," Gonzales said. "They’re up against a lot," Swindle concurred.

"Anyone who has ever tried to quit knows how difficult it is," Swindle said. And according to the U.S. Department of Health and Human Services, on average, former smokers make eight to 11 quit attempts before succeeding. "This [program] is the students’ first real quit attempt," Swindle said. "In a sense, what we’re trying to do with this group is to get them started. I never expect them to quit in great droves." So when they do, it is all the more rewarding.

Several years ago, one student in the program went from being a D student to being an A/B student, Swindle said. This student was even named Jefferson Parish Drug-Free Student of the Year. "It positively affected her whole life," Swindle said about the student. "It’s very fulfilling. With smoking cessation, we actually get to watch the kids change."

A year ago, some of the successful students had the opportunity to be involved in two films produced by Discover Films: Kicking the Nic and What’s wrong with Nicotine. "The students wanted to do the films because they wanted to be able to help other students quit smoking," Swindle said.

Although some students do actually succeed in quitting, "typically what happens is that [students] cut back at school," Gonzales explained. During the 2002-2003 academic school year (the first year of the zero tolerance program), for instance, approximately 90 students entered the program on their first offense, 60 on their second offense and 15 on their third offense. During the 2003-2004 academic school year, an estimated 40 students were caught on their first offense, six on their second and none on their third. During the last two nine weeks, 21 students were caught on their first offense, 17 of whom were either new to the school or had just started smoking. Only two students were caught on their second offense and none on their third offense. One senior who is currently going through the program said, "I don’t smoke at all on campus anymore."

"We just hope that through the program we can give students the knowledge that they can have a better life and the tools necessary to handle it better the next time," Swindle reiterated. "I also want to give them a good role model to look up to."

For more information about CAGNO, call (504) 733-5539. For additional information on other United Way community impact partners, visit our website at www.unitedwaynola.org.