Up In Smoke - The Pushers And Their Victims
Up In Smoke - The Pushers And Their Victims
Course Study Description
CCEUS21 - Up In Smoke - The Pushers and Their Victims: Developing A Program For Smoking Cessation and Prevention In The School. [10 contact hours] - [$50.00 - NO OTHER COURSE FEES APPLY]
The Center for Disease Control estimates that about 3000 teenagers in the United States reach adulthood as "hooked" and habitual cigarette smokers. Most of these teen smokers had their first cigarette at age 14 or 15. An estimated one in four of these individuals will eventually dies of a smoking-related illness. Of the 400,000 people who die each year from a smoking-related disease or illness, 80-90% began smoking as teenagers. As the overall number of smokers has declined as adults have quit or died premature deaths, the number of teens who start more than offset this decline. The Surgeon General's report of 1964 and subsequent findings have had little impact on these young people. In the future, the issue of underage smoking is likely to draw continual comment from scientists, politicians , educators, public health advocates, parents and the teens themselves. This course attempts to examine the issues surrounding these devastating conditions, its history, the health facts, perspectives of smokers, ex-smokers, and non-smokers, and a wide range of thought on the causes and effects of teen smoking. The 3000 young people that make the decision each day to start smoking with all of the attendant health and social considerations will affect not only their own lives, but the attendant effects of this health debacle will have health access issues for all of us. This course is designed to help a counselor begin planning for a smoking cessation program in the school by examining many of the major issues surrounding the serious problem. Facts, figures, and statistics are presented that show the terrible cost that smoking inflicts upon people, especially young people. Some programs that have been successful throughout the country are outlined and reviewed. The counselor role in the education of young people in this vital health area is reviewed.Course Directions
Click on the Course Directions page to read course procedures.
Course Outcomes
As a result of the work in this course the counselor/student will:
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understand the origins of teen smoking. |
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learn the real dangers of smoking. |
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learn about the pushers of tobaccos and their victims. |
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understand the measures of big tobacco takes in marketing to teens. |
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examine the role of peer pressure in starting to smoke. |
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understand the part that individual choice plays in starting to smoke. |
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recognize the role of tobacco promotions in fostering teen smoking. |
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understand the economic and human toll of smoking. |
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examine some ways to convince teens that starting to smoke is a mistake. |
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learn about nicotine and its harmful effects. |
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learn the myth of big tobacco's "prevention programs." |
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understand the problematic nature and outcome of the "War on Tobacco." |
Text [Required Reading To Be Prepared For The Exam]
Teen Smoking Mary E. Williams, ed. $17.45 on The Bookstore page .
Study Guide Questions
What are the origins of teen smoking?
List the real dangers of smoking tobacco.
Who are the pushers of tobacco and who are their victims?
How does "big tobacco" market to teens.
How does advertising contribute to teen smoking?
In what way does individual choice play a role in teen smoking?
How does peer pressure play a role in teen smoking?
What are tobacco promotions, and how do they seduce teens to smoke?
Describe the economic toll of smoking on an individual's life.
Describe the health toll of smoking on an individual's life/
What are some approaches to help teens to not make the decision to start smoking?
What is nicotine and why are its effects so deadly?
Why are big tobacco's "prevention programs" a myth?
What are the positive and negative aspects of the war on tobacco?
Vocabulary
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advertising |
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CDC |
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tobacco |
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nightshade |
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Rodrigo de Jerez |
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chaw |
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cigar |
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cigarette |
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Lucy Page Gaston |
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Smoking And Health |
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nicotine |
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Brown & Williamson |
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P. Lorillard |
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R.J. Reynolds |
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blunts |
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FDA |
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heart disease |
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lung cancer |
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emphysema |
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SAMMEC |
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SAF |
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demonization |
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personal responsibility |
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misinformation |
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smoke-free society |
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Henry Waxman |
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camel cash |
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Winston Cup |
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peer pressure |
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self-accountability |
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cigareet promotions |
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addiction |
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tar |
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"It's The Law" |
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C.O.U.R.S.E. |
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"We Card" |
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"Support The Law - It Works" |
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"Action Against Access" |
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War On Tobacco |
Supplementary Readings [Required Reading To Be Prepared For The Exam]
Children are becoming addicted to nicotine. The average teenage smoker starts at 14-1/2 years old and becomes a daily smoker before age 18. More than 80 percent of all adult smokers had tried smoking by their 18th birthday and more than half of them had already become regular smokers by that age. Studies show that if people do not begin to smoke as teenagers or children, it is unlikely they will ever do so.
Each and every day, another 3,000 young people become regular smokers, and nearly 1,000 of them will eventually die as a result of their smoking. Currently, more than 3 million children and adolescents smoke cigarettes, and 1 million adolescent boys currently use smokeless tobacco. Smoking by young people is rising sharply. Between 1991 and 1994, the percentage of eighth graders who smoke increased 30 percent, and the percentage of tenth graders who smoke increased 22 percent.
Children tend to vastly underestimate the likelihood that they will become addicted to these products. Although only 5 percent of daily smokers surveyed in high school said they would definitely be smoking five years later, close to 75 percent were smoking 7 to 9 years later. A survey conducted in 1992 found that approximately two-thirds of adolescents who smoked said they wanted to quit and 70 percent said they would not start smoking if they could make that choice again.
Despite state laws prohibiting the sale of tobacco to minors, children can easily buy these products. One study estimated that teenagers annually consume 516 million packs of cigarettes and 26 million containers of chewing tobacco. A review of 13 studies of over-the counter sales found that on average, children and adolescents were able to successfully buy tobacco products 67 percent of the time.
Vending machines are a primary source of tobacco products for young smokers. A study by the vending machine industry found that 22 percent of 13-year-old smokers use vending machines compared with 2 percent of 17-year-old smokers. The 1994 Surgeon General's Report found that young people were able to buy cigarettes in vending machines an average of 88 percent of the time.
Free samples are obtained by children, including those in elementary school, despite industry code prohibiting distribution to anyone under 21. Free samples occur on street corners, at shopping malls, and sporting events. A New Jersey survey found that one-third of high school students who were smokers or ex-smokers reported receiving free samples before age 16.
A 1992 Gallup Survey found that half of adolescent smokers and one-quarter of adolescents who do not smoke owned at least one tobacco promotional item such as a tee shirt, cap, sporting good, or lighter. Used or worn by young people, they become "walking billboards," promoting these products in schools and other locations where tobacco advertising is usually prohibited.
Advertising and promotional activities can greatly influence a young person's decision to smoke or use smokeless tobacco products. Awareness of tobacco products and messages is very high among even the youngest children. Studies show that 30 percent of 3-year-olds and 91 percent of 6-year-olds could identify "Joe Camel" as a symbol for smoking.
"...from a public-health standpoint, keeping kids away from cigarettes is the single most effective way to fight the nation's leading preventable cause of death."
"Hooked on Tobacco:The Teen Epidemic," Consumer Reports, March 1995
According to the National Institute on Drug Abuse, in 1989 the proportion of high school seniors who were current smokers was 29 percent, with 18 percent of all seniors smoking daily. Neither the number of current smokers, nor the number of current daily smokers, is down significantly since 1984. Today more that 3 million youngsters under the age of 18 are regular smokers, and another 3 million experimenters are at high risk of addiction.
Studies document that most smokers acquire the habit as adolescents, with 80 to 90 percent of smokers starting before the age of 20, over 50 percent by age 18. Critics contend that, in this sense, children and youth are the cigarette industry's most important customers. Stop Teenage Addiction to Tobacco maintains that one of the key ways cigarette advertising increases smoking rates is by attracting children to become "replacement smokers for the more than 1,000 Americans who are killed every day by smoking-caused diseases."
The use of smokeless tobacco products by young people has risen in popularity. Tobacco-control advocates maintain that slogans such as "Take a pinch instead of a puff" and marketing campaigns that include free product samples and sports sponsorship contributed to an eight-fold increase in the use of moist snuff, a smokeless tobacco product, among 17- to 19-year-old males between 1970 and 1985.
Many of the marketing activities for smokeless tobacco products are tied in with sports, including professional rodeo, hunting, Indy car racing, including the Indianapolis 500, and monster truck, drag, and stock car racing. However, baseball is most often associated with smokeless tobacco.
The marketing strategies have been successful. Of the estimated 10 million American users of smokeless tobacco products, 3 million are under the age of 21. According to the 1990 Youth Risk Survey, 24 percent of all white male high school students currently use smokeless tobacco. The use of smokeless tobacco also rose 40 percent among college athletes from 1985 to 1989. In 1989 the National Collegiate Athletic Association reported that 57 percent of NCAA baseball players used smokeless tobacco products.
Efforts to eliminate smoking and use of smokeless tobacco by young people include smoking prevention programs in schools, increased public health education efforts, policies to reduce minor's access to tobacco products, availability of smoking cessation programs, and changes in tobacco advertising and pricing practices.
California's smoking control campaign has used mass media to reach teenagers to debunk the tobacco industry's ads linking smoking with social benefits. Tobacco ads are particularly strong in promoting the benefits of smoking in social settings and at parties, and in weight control. The mass media campaign includes a series of anti-smoking ads featuring an MTV-type character who interviews young smokers while wearing a gas mask. Other ads aimed at girls and young women depict what smoking can do to beauty. The idea behind the ads is to focus on the immediate consequences of smoking rather than long term health problems.
Youth and Drugs: Society's Mixed Messages. CSAP Prevention Monograph 6 (1990) BK172
Alcohol, Tobacco, and Other Drugs Resource Guide on Tobacco (1993) MS452
"Tobacco May Provide Gateway to Drug, Alcohol Abuse," NIDA Notes (1991)
Smokeless Tobacco. Tempe, AZ: Do It Now Foundation (1991)
"Smoking Behavior of Adolescents Exposed to Cigarette Advertising," Public Health Reports: Journal of the U.S. Public Health Service 108(2):217-224, 1993
The most common form of snuff is the moist type, consisting of particles or strips of tobacco (or packets resembling tea bags) that may be treated with flavors such as mint, menthol, and wintergreen, then packaged in small, flat , round cans. Typical brands and manufacturers include Skoal, Copenhagen and Levi Garrett.
Most snuff is placed between the lip or cheek and the gum; thus, it is more easily hidden in the mouth at times when the us of other tobacco products is not appropriate. The user sucks on the moist mass of tobacco - called a "quid" - in a practice referred to as "dipping." Most "dippers" hold the quid in the same location in the mouth, the site where 93 percent of the primary lesions are found that can lead to cancer.
Dry snuff, a finely powdered tobacco that is placed in the nostrils, is more common in Great Britain and is not as serious a problem in the United States. Chewing tobacco consists of tobacco leaf that is shredded or compressed into a "plug," is actually chewed by the user, and creates the swollen-cheek appearance often associated with smokeless tobacco use.
Since 1981, snuff production has increased from 30.7 million pounds to an estimated 46 million pounds in 1990, an increase of more than 50 percent. (During this same period, there was an 18 percent drop in cigarette consumption.) In the last year alone, there has been an increase in snuff production from 42 million pounds, or 8 percent.
Per capita consumption of snuff has increased by 8 percent since 1981 while per capita consumption of all tobacco products has fallen by nearly 28 percent.
According to the U.S. Department of Agriculture: "The hike in snuff use from 1988 to 1990 possibly results from the growing number of restrictions on smoking, stable employment in industries where workers typically use smokeless tobacco, effective industry promotion, and possibly, a waning impact of warning labels, tax hikes, and publicity against smokeless tobacco use."
In all but 11 states, the minimum age for legally purchasing snuff is 18 or 19 years of age.
Revenues from the sale of snuff rose to $602.1 million in 1989, up from $539.7 million in 1988 and $435.7 million in 1986.
| The chemically addicting substance in smokeless tobacco is
nicotine. The average "quid" of Smokeless tobacco contains the
nicotine of two cigarettes, and is more efficiently extracted by saliva.
This is why Smokeless tobacco is even more addicting than smoking. Seventy
percent of Smokeless tobacco users unsuccessfully try to quit, and in a
large rehabilitation program, more than half rated nicotine withdrawal more
difficult than alcohol withdrawal. The symptoms include a craving for
tobacco, shakiness and nervousness. |
| Oral cancer has been shown to occur as much as 50 times
more frequently among long-term snuff users. |
| Nicotine raises blood pressure, constricts vessels and
raises the heart rate. Neither Smokeless tobacco nor cigarettes should be
used by those with high blood pressure, coronary or peripheral vascular
disease. |
There are about 30,000 new oral cancer cases in the U.S. each
year, and one-third are fatal. Smokeless tobacco users have a 50-fold increased
risk of oral cancer, and are trading the lung cancer risk of cigarettes for oral
cancer. Over 50 percent develop oral mucosal abnormalities within 3.3 years of
habitual Smokeless Tobacco use.
A major reason why fewer youth have become hooked on cigarettes in the last 20 years is that they have been exposed to heavy anti-smoking campaigns in the media, in school and the community, and at home. In addition, tobacco advertising and sales have been limited by legal restrictions, and over the next few years Federal regulations will put even more limits on marketing to youth.
Recently, though, tobacco companies have found new ways to promote their products to youth. They support their sporting events and concerts, and even give them discounts on hip clothing. Many of the companies' promotions especially target African Americans and Latinos. These youth, like some other urban and ethnic groups, have not responded as well as whites to anti-smoking campaigns because they often are not culturally relevant.
It seems that youth are beginning to participate in the current cigar fad, which has been spread through positive media stories showing celebrities of all ethnicities smoking. Also, smoking promotions appear frequently on the Internet. If youth smoking begins to increase again, it will be in spite of the fact that every year the habit kills more people than drugs, alcohol, AIDS, fires, homicide, suicide, and automobile accidents combined.
It is necessary to keep giving teenagers a serious anti-smoking education, provided in ways that reflect their cultures and experiences.
| Smoking is not personally or socially desirable. Debunk
the myths that tobacco is necessary for stress reduction, an attractive
appearance, and a good social life. Point out that the places where smoking
is allowed are decreasing--evidence that fewer people smoke and that many
people, including teenagers, don't want to be near cigarette smoke.
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| Speak directly to girls, possibly in separate
programs. Give them information showing the falseness of their
beliefs that smoking will help them lose weight, make friends, and look
sophisticated.
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| Smoking takes away a smoker's free choice.Adolescents
want to be in control of all areas of their lives. So show them how tobacco
addiction takes away free will, particularly the ability to stop smoking,
despite a smoker's desire to quit.
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| Smoking is not an adult habit or an effective act of
rebellion. Present the fact that only 27 percent of adults smoke to
show that smoking doesn't go hand-in-hand with maturity. Tell teenagers who
want to resist controls on their lives that their target shouldn't be
non-smoking adults. Instead, they should rebel against anyone who wants to
hook them on a habit that is very hard to break.
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| Smoking destroys good health. Show them the
probable physical effects of smoking in full detail. Warnings about future
health consequences may not be as effective as other messages, though,
because youth usually do not believe they will ever have serious physical
problems. Teenagers also have difficulty envisioning themselves (i.e., still
smoking) later in life.
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| Show the dangers of second-hand smoke. This
is as another way of telling smokers what health problems they are likely to
face, and it encourages non-smoking teens to make smokers feel unwelcome.
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| Most teenagers do not smoke. Point out that
fewer than 20 percent of teenagers smoke regularly. In fact, in California,
only 5 percent do. Therefore, youth who begin to smoke because their peers
do are really caving to perceived pressures from a minority.
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| It is okay to refuse to smoke. Teenagers will at times feel a pressure to smoke, no matter how slight, and to engage in other behavior they may not want to. Therefore, it is very important to help youth develop "refusal skills" to give them the courage to remain true to their own desires and beliefs. |
Anti-smoking programs that are created by, or at least involve, youth are most effective. They feel a greater commitment to the program's success, increase their self-esteem, and exert a positive influence on their peers. These are a few examples of programs that have captured the attention of urban youth:
| Rites of passage programs, for males and females
separately, which provide information on staying healthy physically and
emotionally.
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| A rap video using multicultural models in situations that
teach refusal skills.
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| A "take back the community" project, where
billboards with cigarette ads are whitewashed.
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| Short plays, written in street language and performed where youth gather, which provide information about smoking and other dangers to adolescents. |
Other successful anti-smoking projects include peer counseling, assemblies featuring speakers representing the same cultures as the young audience, booths at malls and fairs, and a contest for the best anti-smoking rock or rap song.
Some important limits on selling and marketing cigarettes to youth will be instituted nationally over the next few years. In the meantime, some of the same anti-smoking policies--and even some stronger ones--can be established locally. Parents, schools, and communities can work together to develop coordinated efforts to prevent youth smoking. Actions can include the following:
| Designate schools as smoke-free places, and prevent the
nearby sale and use of cigarettes.
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| Put an anti-tobacco message into many courses, not just
health education: economics, life management skills, home economics,
biology, etc.
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| Create, publicize, and uniformly enforce clear rules
regarding student substance use.
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| Provide intensive staff training in anti-smoking education. |
| Develop an anti-tobacco advertising campaign for print,
radio, and television media, and request free placement and air time. Use
models and situations that appeal to youth and reflect their cultures.
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| Incorporate anti-tobacco education into youth programs of
all types.
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| Incorporate anti-smoking strategies to use with their
children into all types of programs for parents.
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| Provide anti-smoking education along with other services in
adolescent clinics.
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| Provide addiction recovery services to adolescent and adult
smokers.
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| Prevent the sale of cigarettes to youth and display of
tobacco promotions.
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| Create a climate unfavorable to substance use and send the
message that use is not widespread.
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| Develop leaders and promote community bonding, cultural pride, and bicultural competence by youth. |
| Establish homes as smoke-free places. Refrain from smoking,
if possible, or at least provide a strong anti-smoking education.
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| Remind older children that they are role models for younger
family members, and that many youth begin to smoke because their older
siblings do. So, giving up cigarettes will not only improve their own lives,
but the lives of their younger relatives.
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| Provide children with good overall supervision and support.
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| Take a parenting skills course to learn how to provide an anti-smoking and refusal skills education at home. |
Anti-tobacco education that provides youth with information and support, and that continues over all the years of their growth, will help keep them from acquiring the smoking habit. At the same time, young people should be helped to deal with other problems that cause stress and depression: family neglect or abuse, school failure, unemployment, pregnancy and parenthood, and community crime and violence. These difficulties contribute to youth smoking as well as seriously lower the quality of the lives of young people in general.
Information in this guide was drawn from a digest published by the ERIC Clearinghouse on Urban Education: Smoking Prevention Strategies for Urban and Minority Youth.
The use of alcohol and tobacco has taken a great toll on
youth and society and is a predictor of future alcohol abuse and addiction, as
well as the use of other drugs. Therefore, Drug Watch International supports all
efforts to prevent use of these drugs by youth and supports efforts to restrict
advertising of them to the general public.
Background:
Alcohol and nicotine are legal drugs for adults in many countries. Even though
these dangerous and addictive drugs are "socially acceptable" for
adults, they are, to one degree or another, controlled substances for youth
throughout the world. Many cultures try to limit their young from using alcohol
or tobacco. Efforts to prevent the use of alcohol and tobacco by youth should
not be confused with efforts to prohibit adult use of either of these drugs.
However, it is time adults looked at their own alcohol and tobacco use, if they
want to influence young people.
In North America and other countries, alcohol is the number one drug used by
teens. It's use is also the number one contributing factor in youthful deaths.
In the U.S., the use of alcohol is associated with at least one-half of all car
crashes, suicides, drownings, crimes of violence, unplanned sex, poor school
performance, and other trauma among youth.
Alcohol and tobacco kill more people annually than all other drugs combined.
Alcohol alone is associated with at least one-fourth of all hospital visits in
the United States. Nicotine is one of the most addictive and harmful of all
drugs.
There is a false perception that if a drug is legal it must cause less problems.
In many countries and cultures, the use of alcohol and/or tobacco is so deeply
woven into the cultural fabric of those countries that neither is acknowledged
as a drug or even as a problem.
Rationale:
In July 1995, the U.S. Food and Drug Administration (FDA) concluded for the
first time that nicotine is a drug and that it should be regulated as a
controlled substance. Regulations were proposed restricting access to tobacco
products and restricting attempts to make these products appealing to children
and adolescents. Indeed, if alcohol and tobacco were new products seeking FDA
clearance today, each would likely be rejected as hazardous and addictive.
A recent study by Columbia University's Center on Addiction and Subst,ance
Abuse, states that the earlier children use the gateway drugs tobacco or alcohol
or marijuana, the more likely they are to move on to other drugs. Youth who
drank alcohol were 50 times more likely to use cocaine, and those who smoked
tobacco cigarettes were 19 times as likely to use cocaine. Nearly 90% of cocaine
users had smoked tobacco or drank alcohol or used marijuana first. The study,
based on 30,000 American households, established a clear progression that began
with use of the gateway drugs of alcohol, tobacco or marijuana and led to use of
other drugs.
Dr. John Slade reported at the 1989 National Conference on Nicotine Dependence
in San Diego, California, that tobacco smoking teaches drug acquisition skills
to the youth. He said, "For the most part, they're illegal for kids to buy.
In addition, kids who smoke get firsthand experience in using a substance to
adjust emotional states." Slade reports that tobacco use teaches
drug-taking skills and that tobacco use promotes an attitude that fosters other
drug taking behaviors.
Compounding the problem is the relative ease with which youth can access alcohol
and tobacco. Both drugs are widely available, inexpensive and heavily marketed,
making them especially attractive to youth, who are the most price-sensitive
consumer age group.
The right of adults to consume either of these drugs is a notion heavily
promoted by the alcohol and tobacco industries. This argument is meaningless for
many young people who have reached the legal age for use with no real choice
left, because they are already addicted. They have been seduced into use of both
drugs by slick marketing targeted at youth long before they have had their first
drink or used tobacco for the first time.
Youth are bombarded daily with alluring advertising and marketing techniques.
Because new alcohol or tobacco users are rarely adults, images which imply
sexual prowess, athletic ability, popularity, freedom and escape from problems
are especially appealing to young people. Children grow up thinking that they
cannot have a good time without alcohol or tobacco. They don't realize that many
adults choose not to drink.
Alcohol can kill or cause serious problems any time a young person uses it. Yet,
some youth are convinced that drinking alcohol or using tobacco does not cause
immediate problems in their lives, and most are certain that they could quit at
any time. The average teen smoker had his/her first whole cigarette by 13 and
became a daily smoker by age 14.5.
Drug Watch International recognizes and supports the various efforts of many
concerned drug preventionists who are attempting to prevent the use of alcohol
and tobacco by youth. Many Drug Watch members are local and national leaders in
this aspect of prevention. We must never retreat in our efforts to prevent drug
use by youth.
Drug Watch International supports the many promising practices and strategies
aimed at preventing youthful alcohol and tobacco use, including: changing social
acceptance of use by youth, increasing law enforcement efforts for those who
provide or procure these drugs for youth, increasing excise taxes, Eating more
meaningful and effective consequences for those who provide alcohol or tobacco
to adolescents, increasing prevention programs, restricting advertising and
marketing, and supporting legislation and public policy that limits the lobbying
practices of the alcohol and tobacco industries.
Examination
The examination for this course is attached to this page. PRINT OUT THE EXAM. All examinations consist of both True-False and/or Multiple-Choice items with five answers. You must score 80% on the exam to gain the contact hours. When you have printed the exam, read each question carefully, choose the BEST answer and circle the letter of the answer you choose. Return the exam by mail to Dr. Budd A. Moore, Exam Scoring At CounselingCEUsOnline along with the signed Honor Pledge and a check or money order for $36.00 payable to Dr. Budd A. Moore. The exam and the honor pledge can also be faxed to our office at 1(717)597-2302; however, it will not be scored until the scoring fee is paid in full. When the fee and all of the materials are received, the exam will be scored within 48 hours. Results will be e-mailed to you as soon as they are available. A letter of congratulations, a certificate from CounselingCEUsOnline, and an official transcript will be mailed to you. Examinations will not be returned to the student. Records of your scores will be maintained by CounselingCEUsOnline and will be available for you for a $5.00 transcript fee.
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