Learning: Health and Fitness
Getting Teens To Stop Smoking: A Different Kind of Challenge

Trying to quit smoking is tough enough, but convincing teens to stop can be bruising. We know it's worth the effort--giving up cigarettes can prevent long-term health problems and foil premature death--but kids rarely focus on those seemingly far-away concerns. To get a heads-up on the special needs of youth, Michele Hodak of the NEA Health Information Network talked to Dr. Corinne Husten, a medical officer in the Office on Smoking and Health at the National Centers for Disease Control and Prevention (CDC).

What are the latest statistics on teen tobacco use?
According to the 1999 National Youth Tobacco Survey conducted jointly by the American Legacy Foundation and the CDC Foundation, cigarette use among middle school students was 9.2 percent, and more than a quarter of high school students were smokers. Although cigarette use among teens has dropped over the years, each day more than 5,000 kids try their first cigarette and more than 2,000 kids under age 18 become new daily smokers.

How quickly do teens become addicted to nicotine?
Nicotine is found naturally in tobacco and is as addictive as heroin, cocaine, or alcohol. But how quickly a teen gets hooked depends largely on how much he or she smokes or uses a tobacco product. The younger people are when they start to smoke cigarettes, the more likely they are to become strongly addicted to nicotine. A recent study conducted by Joseph R. DiFranza, et al., suggests that addiction can happen more quickly than previously thought--perhaps within weeks or even days after occasional smoking begins.

What are some special issues teens face when they think about giving up smoking?
Teens see themselves as invincible. Therefore, they tend to ignore the potential long-term health consequences of tobacco use and the connection to their current tobacco use. Young people think they will be able to quit whenever they want. And they don't think of trying to get help to do it, or think of it as even useful.

To make matters worse, teens are faced with an incredible amount of peer pressure to use tobacco products, and often that occurs in schools and other community settings. They are also strongly influenced by tobacco industry advertisements and parental use. These influences make it a challenge for young people who do want to quit smoking.

What tobacco cessation programs are available for teens and have they been proven effective?
A variety of programs are available, but few have been evaluated. Of those that have, the research is not conclusive enough to show they are effective. However, studies are currently being conducted, and in another year or two, more data will be available.

So what should a school be looking for if they want to implement a teen program?
They should select a program based on sound theory. Cognitive behavioral therapies appear promising here. And they should ask key questions about whatever research has been done on that program: How many kids were enrolled? How many completed the program? Of all the students who started, how many quit smoking and for how long?

Do teen programs differ from adult programs in any way?
Individual or group sessions usually focus on issues that are important and relevant to young people. For example, discussion may focus less on the long-term effects of tobacco use and more on the immediate effects and consequences.

Youth-oriented programs also have specific attainable goals and use contracts that include rewards. They also provide social support and teach avoidance, stress management, and refusal skills. Students need opportunities to practice skills and strategies that will help them remain nonusers. Finally, medication--mainly nicotine replacement therapy--seems to work for adults, but not necessarily for teens.

Are there different approaches to tobacco cessation for male and female teens?
Some programs separate gender, and others combine them. It hasn't been determined yet if one way is better than the other.

Schools, teachers, and other education support professionals can play a crucial role in preventing teens from using tobacco and encouraging current tobacco users to quit. Specifically, they can:

• Establish and enforce school smoke-free policies.

• Provide access to tobacco prevention and cessation programs that help students stop using tobacco rather than punishing them for violating tobacco-use policies.

• Use school-based health clinics to offer students advice on quitting.

• Carefully evaluate any cessation programs based on a core set of evaluation measures.

• Provide comprehensive tobacco prevention education.

Need Some Advice?
Here are some helpful resources:

• Guidelines for School Health Programs to Prevent Tobacco Use and Addiction.
• A Resource Guide to Youth Tobacco Cessation Programs, American Cancer Society. Call 800/227-2345 to request a copy.
• Core Evaluation Measures for Teen Cessation Programs (Draft), CDC Office on Smoking and Health. For a copy call 770/488-5705.

Dumping the Stress by Getting Fit

Is your New Year's pledge to eat better and get fit already history? Don't beat yourself up. It's not always easy following the advice of health professionals, even when you know benefits await. So what to do? Get inspired. Here's one busy member who's doing all the right stuff--and feeling great.

He's Greg Oborny, and he's convinced that staying fit and eating right have been critical to his success as an educator these last 15 years. "As a new teacher and graduate student in my 20s, I was very busy and my stress levels were really high," Greg says. "I realized that exercising regularly helped bring down that stress."

A former first grade teacher who is now an elementary school principal in Olathe, Kansas, Greg works hard at wellness. He plays in two competitive tennis leagues and visits the gym nightly for a combination of cardiovascular exercise and strength training workouts. He also takes weekly yoga, step aerobics, and kickboxing classes. A deep breathing routine helps him cope with the daily stresses of his job at Regency Place Elementary School.

"Interruptions are a big part of my day," Greg explains. "I often have back-to-back meetings, and when I don't work out regularly it affects the rest of my life and how I deal with people." It's all evidence, he says, that physical and emotional well-being go hand in hand.

"Establishing healthy habits can get you through the tough spots," he notes. "When I feel fit, everything else falls into place."

But Greg admits that eating healthy at an elementary school presents a challenge. "There are lots of birthdays and the kids put three or four cupcakes on my desk every day," he says. But he tries to compensate with healthier snacks. Meanwhile, he avoids "fad" diets and sticks to balanced meals that include fresh vegetables, wholesome grains, fish, and lean meats.

And he doesn't crawl in a hole when he isn't perfect. "Working out daily and always eating well is not realistic for most of us," Greg says, "but if you set realistic goals and start slowly, then you will see your investment pay off." He suggests writing down fitness goals and posting them. It's a great motivater, but "you do have to stick with it."

Partnering with someone can give you a boost, too, Greg says. At his school teachers work in pairs or with their families as they introduce healthy menus and nightly walks into their routines. His school district also offers a staff fitness program called, "Choose Wellness," that includes yoga, step aerobics classes, and cholesterol screenings. Staffers win prizes for participating in fitness activities, and many have been inspired to make life changes.

To find out more about how to add exercise and a healthier diet into your life, visit the President's Council on Physical Fitness and Sports website at www.fitness. gov/ and the American Dietetic Association at http://www.eatright.org.

--Kandra Strauss

Quick Tip

Low on energy? Totally stressed out? Yoga may be just what you need!

With roots in Eastern philosophy, yoga really is a wonder, offering therapeutic and preventive health benefits for the mind, body and spirit.

Its joys are endless: It increases joint mobility and muscle flexibility, eases back pain, increases circulation and helps create balance in the body. Once you're hooked, you won't be able to live without at least a weekly dose.

But be aware: There are many varieties of yoga. Find a licensed, reputable instructor and talk about your needs. Some classes focus on slow, relaxed movements; others incorporate tough, strengthening workouts.

I go once a week to keep my back healthy, reduce stress, and increase my flexibility. Try it out!

Sameta Rush is a fifth grade teacher at Strawberry Park Elementary School in Steamboat Springs, Colorado. E-mail her at: srush@sssd.k12.co.us.

From the NEA Health Information Network

New Drug Prevention Classroom Activities Available
TeachersGuide, a drug education resource developed by the National Youth Anti-Drug Media Campaign, is now available. TeachersGuide activities offer ways to integrate drug prevention into the curriculum for students aged 11-14. Included: Internet links, teacher and student fact sheets, worksheets, and transparencies. To download and access other resources, go to www.teachersguide.org.

Resource Guide for Adult and Adolescent Immunization
The National Coalition for Adult Immunization has released the Resource Guide for Adult and Adolescent Immunization, 5th edition. The catalog addresses the issue of immunization with emphasis on the top vaccine-preventable diseases in adults and adolescents. To order, go to: www.nfid.org/neai/publications/guide. The cost is $20 per guide.

Tour Breatherville, USA for a Hometown Approach to Asthma and Allergies
Allergy & Asthma Network Mothers of Asthmatics has created a web-based fictional town that teaches families about asthma and allergies in an interactive and fun way. By clicking on various buildings--pet shop, school, city hall, or market--visitors can obtain asthma and allergy information relevant to that setting. See: www.aanma.org/breatherville.htm to visit Breatherville.

Meningitis Information Available
Meningitis is an infection in the fluids that surround the spinal cord and brain. It is usually caused by either a virus or bacterial infection. Knowing the difference is important. For more information from the National Centers for Disease Control and Prevention, log on to: www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm.