School-based tobacco control reduces use among adolescents, says study

TechnoparkToday.com (July, 2013)>>Even as schools are working to reactivate Hon’ble Kerala High Court’s directions on tobacco control in the new academic year, a recent review paper in the prestigious Indian Journal of Paediatrics has concluded that school-based tobacco control programmes have a significant potential in reducing tobacco use prevalence among adolescents.

The paper, based on review of literature on school-based tobacco control programmes, has brought out that overall tobacco use among school-going adolescents decreased by 17% after intervention in a study that covered 14,063 students from 32 schools in Delhi and Chennai. The intervention included measures such as behavioural classroom curricula, school posters, parental involvement and peer-led activism.

In contrast, tobacco use among adolescents increased by 68% in the control group, which did not receive any intervention.

Authors of the review paper Ms Monika Arora, Mr Manu Raj Mathur and Ms Neha Singh have also proposed an IMPACT model for tobacco control among adolescents and children. IMPACT, acronym for ‘Intervention model for protecting adolescents and children against tobacco’ advocates a three-tier intervention strategy comprising policy level, community level and individual level approaches.

School health programmes lie at the core of community level approach together with youth advocacy and empowerment, and mass media campaigns. Increased taxation on tobacco products and prohibition of tobacco advertising, promotion and sponsorship are some of the policy level approaches. Promoting cessation and brief advice to quit form part of individual level approach.

The authors point out, “Adolescents and youth play a critical role in constructing a social norm change within the communities as they form a large and important segment of the community population. School-based intervention accompanied with youth advocacy would provide sustained benefits for tobacco control at community as well as individual level.”

Hon’ble Kerala High Court, in its judgement of 26 March 2012, has directed strict implementation of Prohibition on Sale of Cigarettes and Other Tobacco Products around Education Institutions Rules, 2004, of COTPA, 2003. The judgement directs the Kerala Government and the DGP to ensure that no tobacco products of whatever nature are sold within 100 yards of educational institutions.

Towards strict implementation of the COTPA rules on sale of tobacco products around educational institutions, all schools have been directed to form a six-member School Protection Committee chaired by the Head of the Institution. The Committee, with the Sub Inspector/Station House Officer of local police station as its member, is mandated to meet at least once in a month.

Director of Public Instructions Mr A Shajahan said, “Stern directions have been given to all schools to hold monthly meetings of School Protection Committees and to liaise with the police to ensure that there is no sale of tobacco products within 100 yards of the institution. This paper that shows encouraging results for school-based tobacco control interventions only reinforces our commitment.”

The IMPACT model put forth in the review paper gives a prominent role to paediatricians for advocating with governments for policy reforms and lead community and individual level approaches. Noted paediatrician Dr T Suresh Kumar said, “Static tobacco control warning boards in schools will strengthen repetitive messaging, which is critical for preventing tobacco use. In addition, strict enforcement of the 100-yard direction will go a long way in protecting youngsters from initiation. These warnings can leave behind everlasting impressions about the dangers of tobacco use among young minds.”

An educational institution classifies as a ‘public place’ under Section 4 of COTPA. As such, all schools have to set up “no smoking” boards of minimum size 60 cm x 30 cm at the entrance and at conspicuous places inside. Section 6 mandates the setting up of a board outside the school premises stating, “Sale of tobacco products in an area within a radius of 100 yards of educational institutions is strictly prohibited and that it is an offence punishable under Section 24 of COTPA, 2003.