ARIZONA SCHOOL TOBACCO POLICY SURVEY REPORT 2000
Hye-ryeon Lee, Ph.D. & Kristie Taylor, M.A. The University of Arizona
ARIZONA SCHOOL TOBACCO POLICY SURVEY REPORT 2000
Hye-ryeon Lee, Ph.D. & Kristie Taylor, M.A.
Arizona Cancer Center The University of Arizona
Funded by the Arizona Department of Health Services Tobacco Education and Prevention Program
ACKNOWLEDGMENTS Funding for this project was provided by the Tobacco Education and Preventio n Program, a Division of Arizona Department of Health Services, through funding from the Tobacco Tax and Health Care Act. The questionnaire used in the survey was originally developed as part of the Full Court Press Evaluation Project funded by a grant from the Robert Wood Johnson Foundation. Drs. David Buller, Laurie Chassin, David MacKinnon, Jennie Kronenfeld, Michael Cummings and Tracy Orleans contributed to the development of the survey questionnaire. Donna Grande, Linda Augenstein, Eileen Stoneman, and Nina Jones also reviewed the survey questionnaire and provided helpful suggestions. Dr. Merrill Eisenberg made a major contribution to the revision of the questionnaire. Robert Leischow, Jean Ajamie and Nina Jones contributed to the project by reviewing and providing feedback on the earlier draft of the report. Additional contributors to the project include: David Haynie, Annette Hillman, Kirsten Elliot, Ronald Woodard, Jean Keppel, Jo yce Fredricks, Paloma Montero, Deanne Wood and Melissa Burton. Finally, we would like to acknowledge the contributions of school district officials, school officials and teachers whose participation in the survey made this report possible.
Table of Contents
Executive Summary..............................................................................................2
I. Background .....................................................................................................4
II. Methods...........................................................................................................6 A. School List Creation..................................................................................6 B. Data Collection Method ............................................................................6 C. Survey Questionnaire ................................................................................7
III. Findings...........................................................................................................8 A. Sample Description...................................................................................8 B. Establishment of Written Tobacco Policy ................................................9 C. Policy Content.........................................................................................10 D. Policy Communication Mechanism........................................................12 E. Policy Enforcement.................................................................................15 F. Discipline for Policy Violations ..............................................................16 G. Tobacco Prevention Programs ................................................................17 H. Tobacco Cessation Programs ..................................................................18
IV. Discussion and Conclusion...........................................................................20
Appendix A: School Policy Survey Questionnaire............................................22 Appendix B: Sample Sizes and Missing Values ................................................35
ARIZONA SCHOOL TOBACCO POLICY SURVEY REPORT - 2000 EXECUTIVE SUMMARY In 1999, the Arizona State Legislature passed a comprehensive school-tobacco law (Arizona Revised Statute 36-798.03). Specifically, ARS 36-798.03 prohibits tobacco products on school grounds, inside school buildings, in school parking lots or playing fields, in school buses or vehicles and at off-campus school-sponsored events. The law applies to any K-12 public, charter or private school. Violation of the law is a petty offense. To document the extent to which Arizona public schools are in compliance with this legislation, the Arizona Cancer Center conducted the Arizona School Policy Survey as a project of the Tobacco Education and Prevention Program (TEPP) of the Arizona Department of Health Services (ADHS). This survey was a follow- up to a similar survey completed in 1998. The major findings of this project are as follows:
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98.3% of the 1430 schools surveyed reported that they had written policies or rules regarding tobacco use. Of those, 1322 (92.4%) prohibited tobacco products for all students, staff and visitors. This represents 94% of schools with written tobacco policies. The 1998 survey was conducted prior to the passage of ARS 36-798.03. In that survey, a school was classified as tobacco- free if that school's policy (1) was written, (2) prohibited the use of tobacco by students and staff on school grounds, inside school buildings, in school parking lots or playing fields, in school buses or vehicles and at off-campus school-sponsored events, and (3) was in effect both during regular school hours and during non-school hours. By that definition, 1365 (96.5%) of the schools surveyed in 2000 were classified as tobacco- free. This is a significant (p < 0.01) increase from 1998, when only 61.3% of schools were tobacco-free. Among schools with written policies, notification of tobacco use policy to staff and students was most frequently made through student/staff handbooks or by verbal announcements. Visitors were most often notified of the policy by signs. A majority of schools used a single method to communicate their staff and student policies. However, 46.4% of schools used two or more methods to notify students, while 46.2% of schools used two or more methods to notify staff. Most schools had one person designated to enforce tobacco use policy for students (67.3%), staff (78.2%) and visitors (69.0%). The principal was most commonly chosen to enforce the policy, followed by the assistant principal.
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The most common responses when students violated the tobacco use policy were requiring parents to meet with school officials (85.3%), suspending students from school (45.4%), or requiring in-school detention (28.9%). This pattern is largely identical to what we found in 1998. The 2000 study showed that 1244 (87.1%) schools taught a tobacco use prevention lesson during the previous school year, similar to what we found in 1998. Tobacco use prevention was part of a required class in 273 (19.1%) schools. This is a significant decrease from 1998 when 532 (48.7%) schools reported that tobacco use prevention was part of a required course. Tobacco use cessation services were available at 41.8% of schools. Services were available to students and staff at 27.6% of schools, to students only at 7.1% of schools, and to staff only at 6.9% of schools.
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In conclusion, Arizona public schools have made significant progress toward establishing tobacco-free norms between 1998 and 2000. Data clearly demonstrate the positive impact of the comprehensive school-tobacco law passed by the Arizona Legislature in 1999. Even though the 2000 survey took place soon after the passage of ARS 36-798.03 and thus there were only limited education and outreach activities for schools, over 92% of Arizona public schools adopted policies that conform to the law. Data also show that communication about tobacco use policies has become more formalized. There was a marked increase in formal written communication of policies to students and staff. Schools are also making progress in offering appropriate programs to reinforce policies. There was an increase in the availability of tobacco use cessation programs However, cessation services were not commonly linked to enforcement of tobacco use policy. Given the addictive nature of tobacco, cessation assistance programs may be a more effective and longer-term solution than conventional disciplinary actions. However, students who are mandated to attend assistance programs should not be mixed with students who attend voluntarily. While there was no significant difference in the total number of schools that taught tobacco use prevention lessons compared with the previous survey, there was a marked decrease in number of schools that taught tobacco use prevention lessons as part of a required course. One plausible explanation is that, with the implementation of Arizona's Instrument to Measure Standards (AIMS), a state mandated standardized test requirement for high school graduation, there has been much pressure to focus on traditional academic subjects. However, more in-depth research is needed to uncover the reasons for this change. We recommend that efforts to link policy and programming should continue as a way to reinforce tobacco-free norms in Arizona schools. Also, more effort should be made to link schools with other programs and activities in communities at large. After all, school is only one of many settings where students learn about tobacco use norms. A tobacco- free norm would have the strongest impact on students if messages from the multiple settings where they learn, live and play were consistent and unified.
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I.
BACKGROUND
Schools have more influence on the lives of youth than any other social institution except the family. Every year, youth spend approximately 180 days in schools. While schools alone cannot be expected to address the health and related social problems of youth, they can serve as a focal point for efforts to reduce health risk behaviors and improve the health status of youth. Schools constitute a key environment to instill strong tobacco- free norms among youth. The Surgeon General's 1994 report points out that schools that have comprehensive policies have significantly lower smoking rates than do schools with less comprehensive policies. It is in this vein that the Federal Goals 2000 Educate America Act (PL 103-227) now requires any federally- funded school or facility that provides services to children, such as a library, a day care facility, or a health care facility, to prohibit smoking indoors. However, this law does not address smoking on other areas of school grounds, such as playfields. Until 1999, Arizona Public Health and Safety Code (A.R.S. 36-601.01) also restricted only indoor smoking. With concerted efforts from various tobacco control advocates and key state agencies including the Department of Health Services and the Department of Education, the Arizona State Legislature passed a comprehensive school-tobacco law in 1999 (Arizona Revised Statute 36798.03). As shown in Table 1, ARS 36-798.03 prohibits tobacco products on school grounds, inside school buildings, in school parking lots or playing fields, in school buses or vehicles and at off-campus school-sponsored events. The law applies to any K-12 public, cha rter or private school. Violation of the law is a petty offense. Table 1. Provisions of the Laws Governing Tobacco-Use in Schools, 1998 and 2000 Provisions The law applies to: Students Staff Visitors The law restricts: Indoor Use Outdoor Use School Buses/Vehicles Off-campus events Possession yes no no no no yes yes yes yes yes
yes
Covered In 1998 2000 yes yes yes
yes no
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To document the extent to which Arizona public schools are in compliance with federal and state legislation, the Arizona Cancer Center conducted the Arizona School Policy Survey as a project of the Tobacco Education and Prevention Program (TEPP) of the Arizona Department of Health Services (ADHS). The primary goal for the survey is to assist ADHS, TEPP-funded programs and other community agencies in their efforts to promote tobacco- free norms in school environments, by providing upto- date information on the current level of tobacco education and prevention policies and on enforcement in all public schools and districts in Arizona. Specifically, the data collected by the survey will (1) help TEPP- funded local projects as well as other community and government agencies to understand the true status of tobacco control policies at our schools and to develop plans to effectively promote tobacco-free norms in schools, (2) help TEPP- funded local projects to tailor their interventions for different schools according to the current policy environment, thus maximizing the outcome of their interventions, and (3) document the progress made by the TEPP-funded programs in increasing the number of schools that adopt and enforce tobacco- free policies.
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II.
METHODS
A. School List Creation The population for the survey consisted of all public schools in the state of Arizona including alternative schools (associated with public districts but serving special populations), charter schools (receiving public funding but not associated with the public school district) and other miscellaneous types of schools (such as special needs schools or tribal schools). Private schools, home schooling programs, preschools, schools associated with the criminal justice system, and schools for people with mental disabilities were excluded. The list of schools was created with information from multiple sources. A list of Arizona public schools and school districts with contact information was downloaded from the Arizona Department of Education (ADE) website (http://www.ade.state.az.us). ADE also provided separate lists of charter schools and of enrollment data for the 1998/1999 school year. We also solicited lists of schools from every county superintendent's office in the state, and in the case of conflicts between the county and ADE lists, we called individual districts to request lists. Furthermore, this list was compared to the list from the baseline survey, and any discrepancies were explored to determine if schools had been renamed, opened, or closed between the two waves of the survey. There were many differences in the data acquired from the various sources and several steps were taken to reconcile these differences. B. Data Collection Method The survey was conducted by telephone during a four- month period (January through April 2000) using trained interviewers. There were two stages: First, a call was placed to the school to explain the purpose of the survey, identify the appropriate respondent for the survey, and set up an appointment for a 15- minute interview with the designated respondent. Callers identified themselves as calling from the University of Arizona. At the time, some descriptive information about the type of school was gathered directly from the individual answering the telephone, usually the secretary. Second, interviewers made a second call to the designated respondent at the appointed time and conducted the telephone interview. Interviewers conducted the survey by telephone using a specially designed computer assisted telephone interview (CATI) system. Respondents were assured confidentiality. They were told that the names of individuals who answered the questions would not be revealed and that the information would be released only in aggregate form, with the exception of factual information that was routinely available to the public, such as a description of the school's current policy.
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C. Survey Questionnaire The survey questionnaire was developed from the school policy questionnaire used in the School Health Policies and Programs Study (SHPPS) 1 . The 1998 survey questionnaire was originally developed and pilot-tested in Tucson schools during 1996 as part of the Tucson Full Court Press Project evaluation2 . The questionnaire included topics such as current policies regarding tobacco use by students and staff in school buildings, school grounds and at outdoor events (e.g. football, soccer or baseball games), current level/frequency of enforcement of policies, communication mechanism for school policies, barriers to policy enforcement, perceived compliance with the policy, disciplinary actions for tobacco use, tobacco use prevention curriculum, availability of cessation service, perceived prevalence of smoking, perceived support for tobacco-free policy and tobacco prevention education offered. Minor modifications were made in 2000 to improve the readability and format of some questions. Further modifications were made on the basis of responses to the first wave of the survey and changes in the law. In 2000, questions about visitors were added to those already asked about students and staff, and follow-up questions were added to explore several issues more thoroughly, such as prevention, cessation, and monitoring. For more information about the questionnaire or our research methods, please see School Tobacco Policy Survey Report 1997/1998. The 2000 questionnaire is attached in Appendix A.
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A nationwide study funded by the Centers for Disease Control and Prevention to examine multiple components of the school health programs at the state, district, and school levels. 2 The Full Court Press Project is a comprehensive community intervention to reduce youth tobacco use in Tucson and is funded by a grant from the Robert Wood Johnson Foundation to the Coalition for Tobacco Free Arizona. Full Court Press Project Evaluation is separately funded by a grant from the Robert Wood Johnson Foundation to the Arizona Cancer Center, The University of Arizona. 7
III.
FINDINGS
Key findings from the survey are presented in the following sections. The results reported in these sections represent those variables that we deemed to be most important and relevant for understanding the nature of school tobacco use policies in Arizona. To test whether there were statistically significant differences among study subgroups and between the 1998 and 2000 surveys, a series of chi-square tests and t-tests were conducted for key variables. The results reported here are all statistically significant at the p<0.05 level or better unless otherwise noted in the text. It is strongly recommended that inferences not be made about differences that are not statistically significant. Percentages reported here are based on valid responses only and do not include missing values. Sample sizes and details about missing values are summarized in Appendix B. A. Sample Description Interviews were attempted with 1613 schools. Of these, 100 schools were excluded from the list because they were either closed, a duplicate entry, or did not conform to the criteria outlined in the Methods section above. Thus, a total of 1513 valid attempts were made. Of these, 83 schools (5.5%) refused to participate in the survey. Surveys were completed with 1430 schools. Of these, 1085 (75.9%) were regular schools, 72 (5.0%) were alternative schools, 246 (17.2%) were charter schools, and 27 (1.9%) were other types of schools, including special education schools, schools associated with correctional facilities, or tribal schools. Figure 1 shows the types of schools surveyed in 1998 and 2000. A notable difference from the first wave of the survey is the growth of charter schools. However, school type was found to have no statistically significant impact on the results of the survey.
Figure 1. Types of Schools Surveyed
1998 n=1355 2000 n=1430
100% 79.3 75% Percentage 1998 2000 17.2 6.2 5.0 2.7 1.9 75.9
50%
25%
11.8
0% Regular Charter Alternative Type of School Other
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B. Establishment of Written Tobacco Policy Of the 1430 schools that completed the survey, 1406 (98.3%) reported that they had written policies or rules regarding tobacco use that varied in comprehensiveness. This is a slight but significant increase over the 95.9% of schools that reported having written policies or rules in 1998. In 2000, of the 1406 schools that had a written tobacco use policy, 1369 (97.5%) had a policy that addressed tobacco use by students, staff and visitors. The school board is the predominant source for tobacco policies. As shown in Figure 2, of the 1406 schools with written policies, the school board was the body most likely to establish policies for students (94.2%), for staff (94.6%) and for visitors (95.0%).
Figure 2. Source of Written Tobacco-Use Policy (at schools with written policy)
100% 94.2 94.6 95.0 n=1406 For Students For Staff 75% Percentage For Visitors
50%
25% 3.1 2 . 7 2.6 0% School Board Principal Superintendent Other 1.8 1.8 1 . 7 0.9 0.9 0.7
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C. Policy Content Current Policy According to ARS 36-798.03, tobacco products are prohibited on school grounds, inside school buildings, in school parking lots or playing fields, in school buses or vehicles and at off-campus school-sponsored events. This law applies to all students, staff and visitors. Many of the written policies were not comprehensive enough to classify a school as tobacco-free. As shown in Figure 3, 1322 (92.4%) of the 1430 schools in the year 2000 were tobacco- free according to the definition used in ARS 36-798.03. This represents 94% of schools with written tobacco policies. Of the 108 schools that do not comply with the law's requirements, 6 (0.4%) are without any policy at all, 3 (0.2%) had a policy under consideration, and 99 (6.9%) had only partial restrictions.
Figure 3. 2000 Policy Status of Arizona Schools Under ARS 36-798.03
n=1430 100% 75% Percentage 50% 25% 0% Prohibit Tobacco for All Students, Staff & Visitors Partial Restrictions No Policy Under Consideration 92.4
6.9
0.4
0.2
Of the schools surveyed in 2000, only a small minority was not tobacco- free. Consequently, we cannot examine these schools in great detail as we did in the previous report. Among the 99 schools that had only partial restrictions on tobacco use:
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47 did not have rules about possession of tobacco products 43 did not have rules about chewing tobacco 33 did not have rules about smoking 49 did not have rules about visitors 33 did not have rules about staff 15 did not have rules about students
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Changes from 1998 The 1998 survey was conducted prior to the passage of ARS 36-798.03 and thus used a slightly different definition of tobacco- free policy. Thus, to estimate changes in tobacco use policies between 1998 and 2000, the 2000 data had to be recoded using the definition used in the 1998 survey. In the 1998 survey, a school was classified as tobacco- free if it met all of the following three conditions: 1. Had a written tobacco use policy. 2. The policy stated that students and staff are not permitted to use any type of tobacco (cigarettes, pipes, cigars, or smokeless tobacco) inside school buildings, on school grounds, in the parking lots or playing fields, in school vehicles or at off-campus school-sponsored events. (Note: if a school did not have one of these locations, it was not required to have a policy addressing it in order to be considered tobacco- free). 3. The policy was in effect both during regular school hours and during non-school hours. The main differences between this definition and the ARS 36-798.03 definition are that the 1998 definition does not include provisions for visitors or restrict tobacco possession. Of the 1430 schools completing the survey in 2000, 1365 (95.5%) were classified as tobacco-free under the 1998 definition. This represents 97.1% of the 1406 schools with written tobacco use policies. This is a significant (p < 0.01) increase from 1998, when only 61.3% of schools (64.0% of those with written policies) were tobacco free. Figure 4 summarizes the comparison of tobacco policy status between 1998 and 2000.
Figure 4. Tobacco-Use Policy Status Under the 1998 Definition
1998 n=1355 2000 n=1430 100% 95.5 1998 2000 61.3 50% 34.8
75% Percentage
25% 3.9 0% Tobacco-Free Partial Restriction No Policy 3.9 0.6
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D. Policy Communication Mechanism Respondents were asked if tobacco use policies were made known through student handbooks, staff handbooks, verbal announcements, signs, district handbooks, and/or handouts. Among schools with written policies, notification of tobacco use policy was most frequently made through student and staff handbooks or by verbal announcements. Twenty-three (1.8%) schools with written policies did not provide notification about those policies using any of these methods. As shown in Figure 5, students were most frequently notified of the policy through student handbooks (91.2%). This is a significant increase from 1998, when 81.7% of schools notified students through handbooks. As the written notification through the handbook increased, schools' use of verbal announcements significantly decreased from 50.8% in 1998 to 26.5% in 2000. Figure 5. Communication Mechanisms Used to Inform Students of Tobacco-Use Policies (at schools with written policies)
100% 75% Percentage 50.8 50% 25% 0% Student Handbook 26.5 17.2 17.4 6.8 Verbal Announcements Signs 4.3 7.5 Handouts 91.2 81.7 1998 n=1299 2000 n=1406 1998 2000
8.2
As shown in Figure 6, there was a significant increase in written communication to staff in 2000. 74.2% of schools used the student/staff handbook to inform staff of tobacco policies, compared to 1998, when only 68.8% of schools used student handbooks. Reflecting the student communication trend, the use of verbal announcements to inform staff of tobacco policies declined from 49.2% in 1998 to 23.1% in 2000. Use of the district handbook also went up to 26.7% in 2000 compared with 14.2% in 1998.
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District Handbooks
Figure 6. Communication Mechansims Used to Inform Staff of Tobacco Policies (at schools with written policies)
1998 n=1299 2000 n=1406 100% Percentage 75% 50% 25% 0% Student/Staff Handbook 68.8 74.2 49.2 23.1 26.7 14.3 11.4 Signs 14.2 District Handbooks 6.4 6.6 Handouts
2.6 Handouts
1998 2000
Communication of policy to visitors was explored only in the 2000 survey, since the law did not address visitors in 1998. Signs were the most frequently used means to inform visitors of the school's tobacco policies (Figure 7). 82.2% of schools used signs to inform visitors of the school's policy.
Figure 7. Communication Mechanisms Used to Inform Visitors of Tobacco Policies (at schools with written policies)
n=1406 100% Percentage 75% 50% 25% 0% Student Handbook 21.1 2.3 Verbal Announcements Signs 0.2 District Handbooks 82.2
Verbal Announcements
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As shown in Figure 8, while most schools used a single method to communicate their policies to students and staff, a significant number of schools used multiple methods. In 2000, 53.3% of schools with written policies used only one method to notify students of the policy, while 46.4% of schools used two or more methods. Only 4 schools (0.3%) did not notify students of the policy. 52.8% of schools used one method to notify staff of their policy, while 46.2% used two or more methods to inform staff. In contrast, 79.1% of schools relied on one method to communicate the policy to visitors, while only 14.2% used more than one method to inform visitors.
Figure 8. Number of Methods Used to Communicate Tobacco-Use Policy to Students, Staff and Visitors in 2000 (at schools with written policies)
100% 79.1 75% Percentage 53.3 52.8 50% 37.6 37.5 25% 13.1 0% 0.3 1.0 6.8 one two 6.5 6.9 1.1 1.5 0.8 0.6 five n=1406 Students Staff Visitors
1.1 0 four
0
zero
three
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E. Policy Enforcement The survey included questions asking if schools had an individual responsible for enforcing tobacco use policies (Figure 9). Most schools had one person designated to enforce tobacco use policy for students (70.7%), staff (83.1%) and visitors (73.8%).
Figure 9. Number of Individuals Designated to Enforce TobaccoUse Policy for Students, Staff and Visitors (at schools with written policies)
100% 83.1 75% Percentage 70.7 73.8
Students Staff Visitors
50%
25%
18.1 15.4 17.9
0%
00
zero
0 one two
6.0
1.3
7.5
4.9
0.2 0.8
0.4
00
three
four
five
As shown in Figure 10, in the majority of schools the principal was in charge of enforcement for students (73.8%), staff (81.9%) and visitors (73.8%), followed by the assistant principal, other staff and School Resource Officer (SRO) or Police. This pattern is equivalent to that of 1998.
Figure 10. Person Designated With Responsibility for Tobacco-Use Policy Enforcement for Students, Staff and Visitors (at schools with written policies)
100% 75% Percentage 50% 25% 0% Assistant Principal Principal 32.1 22.0 17.9 10.0 1.9 3.0 Teacher 17.7 21.1 7.5 Staff 81.9 73.8 73.8 Students Staff Visitors
0.2 0.1 0.1 Students
1.2 0.6 1.1 Guidance Counselor
4.1 1 . 65.3 Police/SRO
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F. Discipline for Policy Violations The survey included questions about a list of specific actions that might be taken when students are found in violation of the tobacco use policy. The most frequently used actions were requiring parents/guardians to meet with school officials, suspending students from school, and requiring students to attend in-school detention, suspension or weekend school. Table 1 presents the distribution of common disciplinary actions taken for the first, second and repeated violations of the policy for the most frequently used actions. Referral to an assistance program was used by only 9.4% of schools for a first offense, 7.3% of schools for a second offense, and 4.3% of schools for a third offense. Table 2. Common Disciplinary Actions Taken for Policy Violation for First, Second and Repeat Student Offenders
n=1430
Disciplinary Action Parents meet with school officials Student suspended Student assigned in-school detention Student referred to assistance program Student meets with counselor Student disallowed from participation in extracurricular activities Student placed in alternative program Student expelled Student assigned community service Other
1st 2nd Repeat Offense Offense Offense 85.3% 45.4% 28.9% 9.4% 8.1% 1.6% 1.3% 1.1% 1.1% 31.1% 87.8% 66.7% 19.1% 7.3% 5.6% 2.1% 0.8% 3.1% 1.7% 19.1% 81.8% 70.3% 5.4% 4.3% 4.9% 1.2% 1.8% 10.8% 0.8% 21.1%
This pattern is largely equivalent to what we found in 1998, suggesting that there has not been much change in how tobacco related discipline is implemented in schools.
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G. Tobacco Prevention Programs Of the 1430 schools that completed the survey, 1244 (87.1%) reported that tobacco use prevention lessons had been taught during the previous school year. Ninety-three of the 185 schools that did not teach a tobacco use prevention lesson during the previous school year plan to do so during this school year. There was no significant relationship between tobacco policy status and the provision of tobacco use prevention lessons. There were no significant changes from 1998 in the number of schools that offered tobacco use prevention lessons in the previous or current school year. Tobacco use prevention was part of a required course in 273 (19.1%) schools. This is a significant decrease from 1998 when 532 (48.7%) schools reported that tobacco use prevention was part of a required course. Among schools that reported providing tobacco prevention lessons during the previous school year, 251 (41.1%) reported that the teachers responsible for the lesson had received special training. This is a significant decrease from 1998, when 48.7% of schools reported that teachers had received special training. The survey asked specifically if tobacco prevention lessons were taught by a homeroom teacher, health teacher, social studies teacher, science teacher, PE teacher, school nurse, police, a local tobacco project, or a prevention/substance abuse coordinator. As shown in Figure 11, homeroom teachers were the most frequently identified teachers of tobacco prevention lessons (24.8%), followed by police (20.6%), local tobacco projects (13.2%) and health teachers (12.5%).
Figure 11. Responsibility for Teaching Tobacco-Use Prevention Lessons (at schools where lessons are taught)
n=1244 100% Percentage 75% 50% 25% 0% Homeroom Teacher Health Teacher 24.8 20.6 0.3 Social Studies Teacher 5.7 Science Teacher 4.9 PE Teacher 4.9 School Nurse Police (DARE, SRO)
12.5
13.2 Local Tobacco Project
8.0 Prevention/Substance Abuse Coordinator
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H. Tobacco Cessation Programs Of the 1430 schools that completed the survey in 2000, 567 (41.8%) reported that tobacco use cessation services of some kind were available. This is a slight increase over 1998, when 36.8% of schools reported that tobacco use cessation services were available. As summarized in Figure 12, cessation services were available to both students and staff at 27.6% (374) of schools, to students only at 7.1% (96) of schools, and to staff only at 6.9% (93) of schools. By comparison, in 1998, cessation services were available to both students and staff at 15.6% of schools, to students only at 8.1% of schools, and to staff only at 13.2% of schools.
Figure 12. Groups to Which Tobacco-Use Cessation Services Are Offered
1998 n=1355 2000 n=1430 100% 75% Percentage 50% 25% 0% Students & Staff Students Only Staff Only No Services 27.6 15.6 8.1 7.1 13.2 6.9 1998 2000
63.2
58.2
The 2000 survey included detailed questions about the available cessation services. At the 567 schools that provided tobacco use cessation services, services were available oncampus to students at 261 (46.4%) schools and to staff at 187 (33.5%) schools. Offcampus services were available to students at 278 (51.4%) schools and to staff at 335 (64.2%) schools (Figure 13).
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Figure 13. Location of Tobacco-Use Cessation Services (at schools that offer services)
n=567
70% 60% 50% Percentage 40% 30% 20% 10% 0% On-campus, students On-campus, staff Off-campus, students 46.4 33.5 51.4
64.2
Off-campus, staff
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IV.
DISCUSSION AND CONCLUSION
The results of this study show several positive changes in Arizona public schools between 1998 and 2000. Data clearly demonstrate the positive impact of the comprehensive schooltobacco law passed by the Arizona Legislature in 1999. The proportion of schools that have a comprehensive tobacco use ban for students and staff increased to 96.5% in 2000 from 61.3% in 1998. Even though the 2000 survey took place soon after the passage of ARS 36-798.03 and thus there were only a limited amount of education and outreach activities for schools, over 92% of Arizona public schools adopted policies that conform to the law. Specifically, at the time of the survey, 92.4% of public schools surveyed prohibited tobacco use and possession on school grounds, inside school buildings, in school parking lots or playing fields, in school buses or vehicles and at off-campus schoolsponsored events by anyone including students, staff and visitors. Data also show that communication about tobacco use policies has become more formalized. There was a marked increase in formal written communication of policies to students and staff. The number of schools that had formal communication of policies relating to staff more than doubled between 1998 and 2000 (from 34.1% to 74.2%). On the other hand, informal communication through verbal announcements decreased significantly. There was an increase in the availability of tobacco use cessation programs. The proportion of schools that had cessation services available for both students and staff increased to 27.6% in 2000 from 15.6% in 1998. However, cessation services were not commonly linked to enforcement of tobacco use policy. Data from 1998 showed that the most common disciplinary actions taken for first policy violation was requiring parents/guardians to meet with school officials and suspending students from school. For repeat violations, however, suspension was the most common disciplinary action. On the other hand, referral to an assistance program was used in a very small number of schools. Data from the 2000 survey show that there has been a slight but significant increase in the number of schools that refer first and second time violators to assistance programs. However, the magnitude of change is small and the prevailing disciplinary actions are still punitive, such as suspension and detention. Given the addictive nature of tobacco, cessation assistance programs may be a more effective and longer-term solution than conventional disciplinary actions. Linking tobacco education and cessation assistance to policy enforcement must be done carefully. There is evidence that students who are mandated to attend cessation classes should be separated from those who are voluntary participants 3 ,4 . While tobacco prevention and control experts favor taking an educational, rather than a disciplinary approach to youth tobacco use, this viewpoint is not shared as widely among public school administrators. We strongly recommend concerted efforts for (1) educating about the importance of linking cessation with policy enforcement and (2)
3 4
Eisenberg, M. 2000 School-Based Cessation Evaluation Report, Full Court Press, Tucson, Arizona. Moyer, N. 2001. Personal communication.
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providing assistance to establish appropriate infrastructures needed for such a linkage at schools. Finally, there was an unexpected finding from the 2000 study. While there was no significant difference in the total number of schools that taught tobacco use prevention lessons compared with the previous survey, there was a marked decrease in the number of schools that taught tobacco use prevention lessons as part of a required course. The percentage of schools that include tobacco use prevention in a required course declined from 48.7% in 1998 to 19.1% in 2000. After discussing this finding with various school personnel as well as Department of Education officials, we are still uncertain why such a decrease took place. One plausible explanation endorsed by many school personnel is that, with the implementation of Arizona's Instrument to Measure Standards (AIMS) test requirement for high school graduation in 1999, there has been much pressure to focus on traditional academic subjects. This pressure has caused most of the public schools to reexamine and reorganize their curricula to help their students perform better in the AIMS test. As a result, subjects that are not essential in the AIMS test may be removed from the required curriculum. More in-depth research is needed to uncover the reasons for this change. The results of this project should be interpreted carefully. This report is based on selfreport data. Consequently, results reported here may contain inaccuracies as reported by respondents. Furthermore, the respondents themselves were most often school superintendents, principals or assistant principals; it is possible that people in these positions see smoking issues differently than other school officials, such as teachers, coaches or prevention specialists. Overall, the results of this study demonstrate that Arizona public schools are making progress toward establishing tobacco- free norms. With the passage of the state law, schools made sweeping progress in adopting and implementing comprehensive tobaccofree policies. Schools are also making progress in offering appropriate programs to reinforce policies. Efforts to link policy and programming should continue as a way to reinforce tobacco-free norms in Arizona schools. Also, more effort should be made to link schools with other programs and activities in communities at large. After all, school is only one of many settings where students learn about tobacco use norms. A tobacco- free norm would have the strongest impact on student tobacco-use if messages from the multiple settings where they learn, live and play were consistent and unified.
21
Appendix A School Policy Survey Questionnaire
22
Arizona Tobacco Information Network Follow-up School Policy Survey 2000
The University of Arizona is conducting a follow-up survey of school officials concerning school policies towards the use of tobacco by students, staff and visitors. This project is conducted as part of the Arizona Tobacco Information Network and funded by the Arizona Department of Health Services. Your participation in the survey is voluntary and you may decline to answer any question at any time. However, your participation is very important for the success of the study. Information gathered through this survey will be used to better address the issue of youth tobacco use in Arizona. Are there any questions before I begin? 1. Does your school have a written policy or rules regarding tobacco? 0 o No (Continue with Q2)
1
o
Yes (Skip to Q4)
2. Does your school have a verbal policy or rules regarding tobacco? 0 o No (Continue with Q3) 1 o Yes (Skip to Q4) 3. Is a school tobacco policy under consideration? 0 o No (Skip to Q48, P9) 1 o Yes (Skip to Q9, P2) 4. a. Does the policy specify rules for tobacco smoking by the following groups: Students? 0 o No 1 o Yes Staff? 0 o No 1 o Yes Visitors? 0 o No 1 o Yes b. Does the policy specify rules for tobacco chewing by the following groups: Students? 0 o No 1 o Yes Staff? 0 o No 1 o Yes Visitors? 0 o No 1 o Yes c. Does the policy specify rules for tobacco possession by the following groups: Students? 0 o No 1 o Yes Staff? 0 o No 1 o Yes Visitors? 0 o No 1 o Yes In what year was the policy FIRST established for the following groups:
Year Policy does not address this group
5.
6. (If the policy addresses the corresponding group) Who established the policy?
School District/Board Principal Superintendent Other (Specify)
a. for students? b. for staff? c. for visitors?
o 2o 2o
2
o 1o 1o
1
o 2o 2o
2
o 3o 3o
3
o 4o 4o
4
1
7.
Has the ORIGINAL policy for students, staff, or visitors ever been updated or amended? 0 o No (Skip to Q8) 1 o Yes (Continue with Q7a) 2 o Don't Know 7a. Were changes made to strengthen the policy? By "strengthen," I mean made more restrictive, increased punishments or added types of individuals covered by the policy. Was this done for the following groups: Students Staff Visitors
o 0o 0o
0
No No No
o 1o 1o
1
Yes In what year? ________ Yes In what year? ________ Yes In what year? ________
o 2o 2o
2
Not Addressed Not Addressed Not Addressed
7b. Were changes made to weaken the policy? By "weaken," I mean made less restrictive, decreased punishments or exempted persons from being covered by the policy. Was this done for the following groups: Students Staff Visitors 8.
o 0o 0o
0
No No No
o 1o 1o
1
Yes In what year? ________ Yes In what year? ________ Yes In what year? ________
o 2o 2o
2
Not Addressed Not Addressed Not Addressed
Is an amendment currently under consideration? 0 o No (Skip to Q9) 1 o Yes (Continue with Q8a) 8a. Are you considering strengthening the policy? By "strengthen," I mean made more restrictive, increased punishments or added types of individuals covered by the policy. Is this being considered for the following groups: Students Staff Visitors
o 0o 0o
0
No No No
o 1o 1o
1
Yes Yes Yes
8b. Are you considering weakening the policy? By "weaken," I mean made less restrictive, decreased punishments or exempted persons from being covered by the policy. Is this being considered for the following groups: Students Staff Visitors 9.
o 0o 0o
0
No No No
o 1o 1o
1
Yes Yes Yes
Have you used or intend to use the manual Full Spectrum: A Guide for Tobacco-Free Schools in Arizona to develop or revise your policy or policy under consideration? 0 o No 1 o Yes 2 o Not familiar with Full Spectrum
�
Is there a written or verbal policy in effect per Q1 & Q2? No (Skip to Q48, P9) Yes (Continue with Q10)
Now I am going to ask you some questions about the content of your tobacco policies.
2
10.
Please indicate if students, staff and visitors are permitted to smoke in any of the following places during regular school hours? By "smoking," I mean all forms including cigarettes, pipes, and cigars.
Students
No Yes
Staff
N/A No Yes
Visitors
N/A No Yes
a. Inside school buildings b. School grounds, not including parking lots c. Parking lots d. Playing fields e. School sponsored offcampus events f. School vehicles
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
N/A
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
11.
Please indicate if students, staff and visitors are permitted to smoke in any of the following places during nonschool hours? By "smoking," I mean all forms of smoking tobacco, including cigarettes, pipes, and cigars.
Students
No Yes
Staff
N/A No Yes
Visitors
N/A No Yes
a. Inside school buildings b. School grounds, not including parking lots c. Parking lots d. Playing fields e. School sponsored offcampus events f. School vehicles
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
N/A
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
12.
Are students, staff and visitors permitted to use smokeless tobacco in any of the following places during school hours? By "smokeless tobacco," I mean snuff or chewing tobacco.
Students
No Yes
Staff
N/A No Yes
Visitors
N/A No Yes
a. Inside school buildings b. School grounds, not including parking lots c. Parking lots d. Playing fields e. School sponsored offcampus events f. School vehicles
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
N/A
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
13.
Are students, staff and visitors permitted to use smokeless tobacco in any of the following places during nonschool hours? By "smokeless tobacco," I mean snuff or chewing tobacco.
Students
No Yes
Staff
N/A No Yes
Visitors
N/A No Yes
a. Inside school buildings b. School grounds, not including parking lots c. Parking lots d. Playing fields e. School sponsored offcampus events f. School vehicles
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o
1
Not Addressed
N/A
o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o
3
3
�
Is any box on the prior page marked "Yes" or "Not Addressed"? Yes (Continue with Q14)
No (Skip to Q19)
14.
15. 16. 17. 18.
How interested are you in adopting a policy that completely bans tobacco use (smoking and smokeless tobacco use) by students, staff and visitors on school grounds as well as in school buildings and at school sponsored off-campus events? 1 o Very interested 2 o Somewhat interested 3 o Not interested at all In your opinion, what percentage of school staff would support such a policy? % In your opinion, what percentage of students would support such a policy? In your opinion, what percentage of parents would support such a policy? % %
What is the most important reason why your school does not have such a tobacco-free policy?
19.
Does your school allow tobacco promotion or sponsorship in any of the following ways?
a. Tobacco advertising allowed on school property b. Tobacco advertising allowed in school publications c. Students allowed to bring or wear tobacco promotional items (e.g. tote bags, t-shirts, caps) on school property d. Faculty and staff allowed to bring or wear tobacco promotional items on school property e. Sponsorship of school activities, facilities, or programs by tobacco companies. 20.
o 0o
0 0
No No No No No
o 1o
1 1
Yes Yes Yes Yes Yes
o 2o
2 2
Don't know Don't know Don't know Don't know Don't know
o o o
o o o
o o o
0
1
2
0
1
2
How are students made aware of the policy? 1 o Student handbook 2 o Signs 3 o Handout 4 o Verbal announcement 5 o District handbook (e.g., Guidelines for Student Rights and Responsibilities) 6 o No notification 7 o Other (Specify) 8 o Check here if policy does not address students (see Q5) How are staff made aware of the policy? 1 o Student/Staff handbook 2 o Signs 3 o Handout 5 o District handbook 6 o No notification 7 o Other (Specify) 8 o Check here if policy does not address staff (see Q5) How are visitors made aware of the policy? 1 o Student handbook 2 o Signs 3 o Handout 5 o District handbook 6 o No notification 7 o Other (Specify) 8 o Check here if policy does not address visitors (see Q5)
21.
4
o
Verbal announcement
22.
4
o
Verbal announcement
4
23.
In your opinion, what proportion of students who smoke comply with the policy? 1 o None 2 o A few 3 o Some 4 o Most 5 o All of them 6 o Don't know In your opinion, what proportion of staff who smoke comply with the policy? 1 o None 2 o A few 3 o Some 4 o Most 5 o All of them In your opinion, what proportion of visitors who smoke comply with the policy? 1 o None 2 o A few 3 o Some 4 o Most 5 o All of them
24. 25.
6
o o
Don't know Don't know
6
26.
Is there someone on your staff in charge of monitoring student compliance with the policy? 0 o No (Skip to Q28) 1 o Yes (Continue with Q27) 2 o Policy does not address students (See Q5) (Skip to Q28) 27. Who is it? 1 o Principal 4 o Students 7 o SRO
Every day
o 5o 8o
2
Assistant Principal Guidance Counselor Other (Specify)
o 6o
3
Teacher All Staff
28.
How often are each of the following places monitored for compliance with the policy during school hours?
Continuous 10 or mo re 5 or more 1 or more Less then 1 per month per month per month per month Never Selfmonitored
a. b. c. d. e. f. g. h. i. j. 29.
Student restroom Teacher restroom Teacher lunch room School grounds near school buildings Parking lot Play field Gym locker room area Locker area Off-campus events Other (Specify)
o 0o 0o
0
o 1o 1o
1
o 2o 2o
2
o 3o 3o
3
o 4o 4o
4
o 5o 5o
5
o 6o 6o
6
o 7o 7o
7
o 0o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o 1o
1
o 2o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o 3o
3
o 4o 4o 4o 4o 4o 4o
4
o 5o 5o 5o 5o 5o 5o
5
o 6o 6o 6o 6o 6o 6o
6
o 7o 7o 7o 7o 7o 7o
7
How often are each of the following places monitored for compliance with the policy during non-school hours?
Continuous Every day 10 or more 5 or more 1 or more Less then 1 per month per month per month per month Never Selfmonitored
a. Inside school buildings b. On school property outside c. Off-campus events
o 0o
0 0
o 1o
1 1
o 2o
2 2
o 3o
3 3
o 4o
4 4
o 5o
5 5
o 6o
6 6
o 7o
7 7
o
o
o
o
o
o
o
o
5
These next questions are about the enforcement of your tobacco policies.
30. Is there someone on your staff in charge of enforcing the policy for students? 0 o No (Skip to Q32) 1 o Yes (Continue with Q31) 2 o Policy does not address students (See Q5) (Skip to Q32) 31. Who is it? 1 o Principal 4 o Students 7 o Police/SRO
o 5o 8o
2
Assistant Principal Guidance Counselor Other (Specify)
o 6o
3
Teacher All Staff
32.
Is there someone on your staff in charge of enforcing the policy for staff? 0 o No (Skip to Q34) 1 o Yes (Continue with Q33) 2 o Policy does not address staff (See Q5) (Skip to Q34) 33. Who is it? 1 o Principal 4 o Students 7 o Police/SRO
o 5o 8o
2
Assistant Principal Guidance Counselor Other (Specify)
o 6o
3
Teacher All Staff
34.
Is there someone on your staff in charge of enforcing the policy for visitors ? 0 o No (Skip to Q36) 1 o Yes (Continue with Q35) 2 o Policy does not address staff (See Q5) (Skip to Q36) 35. Who is it? 1 o Principal 4 o Students 7 o Police/SRO
o 5o 8o
2
Assistant Principal Guidance Counselor Other (Specify)
o 6o
3
Teacher All Staff
36.
Do you have difficulty enforcing the student policy? 0 o No problems with enforcement (Skip to Q38) 2 o Many problems with enforcement(Continue with Q37) 1 o Policy does not address students (See Q5) 3 o Some problems with enforcement(Continue with Q37) (Skip to Q38, next page) 4 o Few problems with enforcement(Continue with Q37) 37. What are examples of problems you face in enforcing the policy?
6
38.
What actions are taken when you catch a student in possession of tobacco for the first time?
39. What actions are taken when you catch a student in possession of tobacco for the second time? 40. What actions are taken for repeat offenders caught in possession of tobacco three times or more ?
o o o o o o o o o o o o o
o o o o o o o o o o o o o
o o o o o o o o o o o o o
a. b. c. d. e. f. g. h. i. j. k. l. m. n. o.
Parents/Guardian required to meet with school officials Student required to meet with school counselor Student referred to an assistance program Student assigned in-school detention or suspension Student suspended from extracurricular activities Student suspended from school Student expelled from school Alternative school programs Community Service Written warning Verbal warning No action Other (Specify) Other (Specify) Other (Specify)
41.
What actions are taken when you catch a student using tobacco for the first time? 42. What actions are taken when you catch a student using tobacco for the second time? 43. What actions are taken for repeat offenders who are caught using tobacco three times or more ? a. b. c. d. e. f. g. h. i. j. k. l. m. n. o. Parents/Guardian required to meet with school officials Student required to meet with school counselor Student referred to an assistance program Student assigned in-school detention or suspension Student suspended from extracurricular activities Student suspended from school Student expelled from school Alternative school programs Community Servic e Written warning Verbal warning No action Other (Specify) Other (Specify) Other (Specify)
o o o o o o o o o o o o o
o o o o o o o o o o o o o
o o o o o o o o o o o o o
7
44.
Do you have difficulty enforcing the staff policy? 0 o No problems with enforcement (Skip to Q46) 2 o Many problems with enforcement(Continue with Q45) 1 o Policy does not address staff (See Q5) 3 o Some problems with enforcement(Continue with Q45) (Skip to Q46) 4 o Few problems with enforcement(Continue with Q45) 45. What are examples of problems you face in enforcing the policy?
46.
Do you have difficulty enforcing the visitor policy? 0 o No problems with enforcement (Skip to Q48) 2 o Many problems with enforcement(Continue with Q47) 1 o Policy does not address visitors (See Q5) 3 o Some problems with enforcement(Continue with Q47) (Skip to Q48) 4 o Few problems with enforcement(Continue with Q47) 47. What are examples of problems you face in enforcing the policy?
Continue on to the next page...
8
Now, I would like to ask some questions about tobacco use prevention lessons taught in you school.
48. Was there a tobacco use prevention lesson taught last school year? 0 o No (Skip to Q55) 1 o Yes (Continue with Q49) For what grades was it taught? (please list all) Who taught the lesson? (check all that apply) 1 o Health teacher 2 o Social Studies teacher 3 o Science teacher 4 o Physical Ed teacher 5 o School Nurse 6 o Homeroom teacher 7 o Police (DARE,SRO) 8 o Local Tobacco Project 9 o Prevention/Substance Abuse Coordinator 10 o Other (specify) If taught by teachers, did they receive any special training on tobacco prevention? 0 o No 1 o Yes 2 o N/A Please name the tobacco use prevention curricula, programs, or textbooks used. Is this part of a required course for graduation? 0 o No 1 o Yes 2 o N/A Approximate number of hours for the program? hours Is your school planning on teaching tobacco use prevention this school year? 0 o No (Skip to Q63 on next page) 1 o Yes (Continue with Q56) If a tobacco use prevention lesson was taught last year, will the information you just provided be any different for this school year? 0 o No (Skip to Q63 on next page) 1 o Yes (Continue with Q57 on next column) 57. 58. For what grades will it be taught? (please list all) Who will teach the lesson? (check all) 1 o Health teacher 2 o Social Studies teacher 3 o Science teacher 4 o Physical Ed teacher 5 o School Nurse 6 o Homeroom teacher 7 o Police (DARE,SRO) 8 o Local Tobacco Project 9 o Prevention/Substance Abuse Coordinator 10 o Other (specify) If by teachers, will they receive any special training on tobacco prevention? 0 o No 1 o Yes 2 o N/A Please name the tobacco use prevention curricula, programs, or textbooks that will be used. Will this be part of a required course for graduation? 0 o No 1 o Yes 2 o N/A Approximate hours for the program? hours
49. 50.
51.
59.
52.
60.
53.
61.
54. 55.
62.
Continue with Q63 on next page...
56.
9
63.
Is there an on-campus tobacco use cessation service available to your students? 0 o No, (Skip to Q65) 1 o Yes, (Continue with Q64) 64. a. What are the reasons why students seek this cessation service? 1 o Voluntary 2 o School-ordered 3 o Other (Specify) b. Who delivers the cessation service? c. Do individuals who use the service have to pay for it? 0 o No 1 o Yes
65.
Is there an on-campus tobacco use cessation service available to your staff? 0 o No, (Skip to Q67) 1 o Yes, (Continue with Q66) 66. a. What are the reasons why students seek this cessation service? 1 o Voluntary 2 o School-ordered 3 o Other (Specify) b. Who delivers the cessation service? c. Do individuals who use the service have to pay for it? 0 o No 1 o Yes
67.
Is there an off-campus tobacco use cessation service available to your students ? 0 o No, (Skip to Q69) 1 o Yes, (Continue with Q68) 68. a. What are the reasons why students seek this cessation service? 1 o Voluntary 2 o School-ordered 3 o Other (Specify) b. Who delivers the cessation service? c. Do individuals who use the service have to pay for it? 0 o No 1 o Yes
69.
Is there an off-campus tobacco use cessation service available to your staff? 0 o No, (Skip to Q71) 1 o Yes, (Continue with Q70) 70. a. What are the reasons why students seek this cessation service? 1 o Voluntary 2 o School-ordered 3 o Other (Specify) b. Who delivers the cessation service? c. Do individuals who use the service have to pay for it? 1 o Yes 0 o No
10
71.
Are there any other services or programs related to tobacco use? 0 o No (Skip to Q73) 1 o Yes (Continue with Q72) 72. What are they?
73.
In your school, is there an active group or club run by students with tobacco use reduction as one if its main goals? 0 o No (Skip to Q75) 1 o Yes (Continue with 74) 2 o Don't know (Skip to Q75) 74. What is the name of the group or club?
75.
The following is a list of possible services for you to consider. Please tell me if they are not needed, would be somewhat helpful, would be very helpful, are needed urgently, or are already provided.(Prompt if needed)
Not needed Would be somewhat helpful Would be very helpful Needed Urgently Already provided
a. b. c. d. e. f. g. h. i.
Cessation services or programs for youth Programs that involve both parents and children Programs targeting parents Counseling for tobacco users Programs that address chew/smokeless tobacco Diversion programs for enforcement On-going awareness and information programs Special presentations and events Programs targeting girls
o 0o 0o 0o 0o 0o 0o 0o 0o
0
o 1o 1o 1o 1o 1o 1o 1o 1o
1
o 2o 2o 2o 2o 2o 2o 2o 2o
2
o 3o 3o 3o 3o 3o 3o 3o 3o
3
o 4o 4o 4o 4o 4o 4o 4o 4o
4
j. Is there anything else that you need? (specify)
76.
Are there any comments you want to add?
77.
Finally, the local tobacco project, funded with state tobacco tax money, may want to follow-up on some of the public information you have provided. Would you mind if we gave them your name? 0 o No 1 o Yes
11
78.
Thank you very much. Your input will be used to better combat the problem of youth tobacco use. We would like a copy of the tobacco policies you use in your school. Will you be able to fax or mail them to us?
0
o
No
o 2o
1
Yes, will fax Yes, will mail
Please fax your policy to: (520) 318-7104 Please send the policies to: School Tobacco Policy Project Cancer Prevention and Control Research Project Arizona Cancer Center 2302 E. Speedway #204 Tucson, Arizona 85719 Attn: Kirsten Elliott
Interviewer Notes:
-- Interview Completed -12
Appendix B 2000 School Policy Survey Sample Sizes and Missing Values
35
Variable Description
Types of schools surveyed (all schools) Schools that had written rules about tobacco use (all schools) School tobacco-use policy for students, staff & visitors (all schools) Source of written tobacco-use policy for students (at schools with written policy) Source of written tobacco-use policy for staff (at schools with written policy) Source of written tobacco-use policy for visitors (at schools with written policy) 2000 Policy Status of Arizona Schools Under ARS 36-798.03 (at all schools) Tobacco-free under ARS 36-798.03 (at schools with written policy) Rules about chewing tobacco are omitted from the policy (at non-tobacco-free schools only) Rules about smoking tobacco are omitted from the policy (at non-tobacco-free schools only) Rules about possession of tobacco are omitted from the policy (at non-tobacco-free schools only) Rules for students are omitted from the policy (at non-tobacco-free schools only) Rules for staff are omitted from the policy (at non-tobacco-free schools only) Rules for visitors are omitted from the policy (at non-tobacco-free schools only) Tobacco-use policy status--1998 definition (at all schools)
Page Number
8 9 9 9 9 9 10 10 10 10 10 10 10 10 11
Sample Size
1430 1430 1430 1406 1406 1406 1430 1406 99 99 99 99 99 99 1430
Number of Missing Cases
0 0 0 7 17 34 0 0 12 6 10 8 8 11 0
36
Variable Description
How are students, staff & visitors made aware of the policy? All methods. (at schools with written policy) Number of methods used to inform students, staff and visitors of policy. (at schools with written policy) Number of individuals designated to enforce tobacco-use policy for students (at schools with written policy) Number of individuals designated to enforce tobacco-use policy for staff. (at schools with written policy) Number of individuals designated to enforce tobacco-use polic y for visitors. (at schools with written policy) Person designated with responsibility for enforcing tobacco-use policy for students. (at schools with written policy) Person designated with responsibility for enforcing tobacco-use policy for staff. (at schools with written policy) Person designated with responsibility for enforcing tobacco-use policy for visitors. (at schools with written policy) Disciplinary actions taken after 1s t offense (at schools with written policy) Disciplinary actions taken after 2n d offense (at schools with written policy) Disciplinary actions taken after 3rd offense (at schools with written policy Was there a tobacco-use prevention lesson taught during the last school year? Was the tobacco-use prevention lesson taught during the last school year part of a required class? Did the teacher responsible for the lesson receive special training? Who taught the tobacco-use prevention lesson? (at schools where lessons were taught)
Page Number
12-13 14 15 15 15 15 15 15 16 16 16 17 17 17 17
Sample Size
1406 1406 1406 1406 1406 1406 1406 1406 1406 1406 1406 1430 1430 1430 1244
Number of Missing Cases
0 0 68 83 91 68 83 91 24 54 129 0 0 0 153
37
Variable Description
Is there a cessation service available? What groups are offered cessation services? Tobacco-use cessation availability: on-campus, students (at schools that offer services) Tobacco-use cessation availability: on-campus, staff (at schools that offer services) Tobacco-use cessation availability: off-campus, students (at schools that offer services) Tobacco-use cessation availability: off-campus, staff (at schools that offer services)
Page Number
18 18 18-19 18-19 18-19 18-19
Sample Size
1430 1430 567 567 567 567
Number of Missing Cases
0 73 4 9 26 45
38
