Workshop3 j mucsi

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  • Develop and enforce a school policy on tobacco use. Provide instruction about the short- and long-term negative physiologic and social consequences of tobacco use, social influences on tobacco use, peer norms regarding tobacco use, and refusal skills. Provide tobacco-use prevention education in kindergarten through 12th grade; this instruction should be especially intensive in junior high or middle school and should be reinforced in high school. Provide program-specific training for teachers. Involve parents or families in support of school-based programs to prevent tobacco use. Support cessation efforts among students and all school staff who use tobacco. Assess the tobacco-use prevention program at regular intervals.
  • Develop and enforce a school policy on tobacco use. Provide instruction about the short- and long-term negative physiologic and social consequences of tobacco use, social influences on tobacco use, peer norms regarding tobacco use, and refusal skills. Provide tobacco-use prevention education in kindergarten through 12th grade; this instruction should be especially intensive in junior high or middle school and should be reinforced in high school. Provide program-specific training for teachers. Involve parents or families in support of school-based programs to prevent tobacco use. Support cessation efforts among students and all school staff who use tobacco. Assess the tobacco-use prevention program at regular intervals.
  • Workshop3 j mucsi

    1. 1. School-based smoking prevention program in Gödöllő Action for Prevention Budapest, 30-31 May, 2011 Janos Mucsi MD Hungarian Alliance for Tobacco Control Anna Mucsi Török Ignác Gymnasium, Gödöllő
    2. 2. Students after 1st cigarette Global Youth Tobacco Survey, Hungary, 2003-2008 n=4484 (2003) n=3861 (2008) %
    3. 3. Waterpipe is an emerging outbreak Global Youth Tobacco Survey, Hungary, 2008 (n=3861)
    4. 4. Danger of smoking in the regular education <ul><li>Rate of students getting education at school about danger of smoking. </li></ul>Global Youth Tobacco Survey, Hungary, 2008. age: 13-15 yrs 48,6% 57,2%
    5. 5. Smoker brother/friend… real danger % Global Youth Tobacco Survey, Magyarország, 2008. age: 13-15 yrs
    6. 6. Students already tried tobacco in Gödöllö % (December, 2006, n=2948) age (years) Mucsi J., Mucsi A.: Tüdőgyógyászat, 2008.
    7. 7. One of two students leaves school as smoker in Gödöllő (n=32) (n=214) (n=243) (n=334) (n=337) (n=323) (n=321) (n=371) (n=273) (n=2346) age (years) Mucsi J., Mucsi A.: Tüdőgyógyászat, 2008.
    8. 8. Why don’t students want to smoke? <ul><li>Smoking is </li></ul><ul><ul><li>Stinking </li></ul></ul><ul><ul><li>Expensive </li></ul></ul><ul><ul><li>Unhealthy </li></ul></ul>
    9. 9. Smoking Prevention Program, Gödöllö <ul><li>(non-)Smoking Policy at school </li></ul><ul><li>Having information about smoking! </li></ul><ul><ul><li>Short/long time unhealthy effects of smoking </li></ul></ul><ul><ul><li>Social effects of smoking </li></ul></ul><ul><ul><li>Peer opinion, education </li></ul></ul><ul><ul><li>Be able to say „NO!” </li></ul></ul><ul><li>Smoking prevention education from kindergarden to 18 years of age </li></ul><ul><ul><li>Most intensive in age of 10 to 14 years </li></ul></ul><ul><ul><li>Reminder/strenghten in age of 14 to 18 years </li></ul></ul>Elements of smoking prevention program Based on CDC recommendation, 1994
    10. 10. Smoking Prevention Program, Gödöllö <ul><li>Smoking and program specific training for teachers </li></ul><ul><li>Inform/involve parents to support the program </li></ul><ul><li>Smoking cessation program for teachers and students </li></ul><ul><li>Regular activities during the school year </li></ul>Elements of smoking prevention program II. Based on CDC recommendation, 1994
    11. 11. Our dream: Smokefree schools <ul><li>First goal: less students try and start to smoke! </li></ul><ul><li>Background: </li></ul><ul><ul><li>80-90% of active smokers start to smoke <18 years of age </li></ul></ul><ul><ul><li>Quitting </li></ul></ul><ul><ul><ul><li>difficult </li></ul></ul></ul><ul><ul><ul><li>expensive </li></ul></ul></ul><ul><ul><ul><li>unsuccessful </li></ul></ul></ul><ul><li>Prevention is more effective than smoking cessation treatment </li></ul>
    12. 12. Be positive and motivated <ul><li>Focusing on short time </li></ul><ul><li>benefits and handicaps </li></ul>Programs for teachers X X <ul><li>Why is smoking good for you? </li></ul><ul><li>Relationship building </li></ul><ul><li>Quiet down </li></ul><ul><li>Keeping concentration </li></ul><ul><li>Why is smoking bad for you? </li></ul><ul><li>Stinking </li></ul><ul><li>Expensive </li></ul><ul><li>Unhealthy </li></ul><ul><li>Why is non-smoking good for you? </li></ul><ul><li>Non-stinking </li></ul><ul><li>Keeping pocket money </li></ul><ul><li>healthy </li></ul><ul><li>Why is non-smoking bad for you? </li></ul><ul><li>Being alone (no friends) </li></ul><ul><li>Nervous </li></ul><ul><li>Not able to concentrate </li></ul>
    13. 13. Preparing prevention campaign <ul><li>November 2006. </li></ul><ul><ul><li>Finalize questionnaire </li></ul></ul><ul><ul><li>Prepare action plan </li></ul></ul><ul><ul><li>Program consultations </li></ul></ul><ul><ul><ul><li>Directors of schools </li></ul></ul></ul><ul><ul><ul><li>School doctor, school nurse, pulmonologist, psychiatrist, medical officers </li></ul></ul></ul><ul><ul><ul><li>Health and education committee of city, mayor </li></ul></ul></ul><ul><ul><ul><li>National experts </li></ul></ul></ul><ul><ul><li>Getting approvals </li></ul></ul><ul><ul><ul><li>Director of schools, chief medical officer </li></ul></ul></ul><ul><ul><li>sponsorship </li></ul></ul><ul><ul><ul><li>Mayor, deputy mayor, municipal foundations </li></ul></ul></ul>
    14. 14. Starting Smoking Prevention Program <ul><li>December 2006. </li></ul><ul><ul><li>Copying questionnaire (4500 pieces) </li></ul></ul><ul><ul><li>Performing survey </li></ul></ul><ul><ul><li>„ Smokefree classes competiton” </li></ul></ul><ul><ul><li>Teachers’ education, gaining fiends, supporters </li></ul></ul><ul><ul><li>Informational letter to parents </li></ul></ul><ul><ul><li>Launch of campaign </li></ul></ul><ul><ul><ul><li>Movie „Thank you for smoking!” </li></ul></ul></ul><ul><ul><ul><li>Articles in local media </li></ul></ul></ul>
    15. 15. Thank you for smoking! <ul><li>Like movie club </li></ul><ul><ul><li>5-6. classes (10-12 yrs) </li></ul></ul><ul><ul><li>7-10. classes (13-16 yrs) </li></ul></ul><ul><ul><li>10-12. classes (16-18 yrs) </li></ul></ul><ul><li>Introduction </li></ul><ul><ul><li>Focusing for what </li></ul></ul><ul><li>Closing discussion </li></ul><ul><ul><li>Teacher, physician, peer </li></ul></ul><ul><li>Take home message </li></ul>
    16. 16. Smoking Prevention Program, Gödöllő <ul><li>January-May, 2007. </li></ul><ul><ul><li>Regular lessons about smoking </li></ul></ul><ul><ul><li>Meet the parents (class/semester based) </li></ul></ul><ul><ul><li>Continouos consultation with teachers </li></ul></ul><ul><ul><li>Getting support of Students’ Council </li></ul></ul><ul><ul><ul><li>Peer coordinators (education, starting) </li></ul></ul></ul><ul><ul><li>Web support </li></ul></ul><ul><ul><ul><li>Background materials on web </li></ul></ul></ul><ul><ul><ul><li>www.megved.hu , www.tudobeteg.hu , www.tig.hu , www.godollo.hu </li></ul></ul></ul>
    17. 17. Smokefree class competition <ul><li>Nominated: </li></ul><ul><ul><li>5 schools, 37 classes </li></ul></ul><ul><ul><li>942 students </li></ul></ul><ul><li>Successful (smokefree) final: </li></ul><ul><ul><li>4 schools </li></ul></ul><ul><ul><li>22 classes </li></ul></ul><ul><ul><li>567 students remained smokefree </li></ul></ul>
    18. 18. Individual competition for a Smokefree Life Focusing on students age of 10-12 yrs)
    19. 19. Drawing competition 7 schools, 62 drawings
    20. 21. Role of Program Coordinator <ul><li>Control the program </li></ul><ul><li>Consultation with stakeholders </li></ul><ul><li>Organizing education </li></ul><ul><ul><li>teachers </li></ul></ul><ul><ul><li>parents </li></ul></ul><ul><ul><li>students </li></ul></ul><ul><li>Media </li></ul><ul><ul><li>website </li></ul></ul><ul><ul><li>Media related relationship building </li></ul></ul><ul><li>Evaluation and development of program </li></ul>
    21. 22. Student Research <ul><li>Involving students into research regarding tobacco control </li></ul><ul><ul><li>How does influence smoking the opinion of students about smoking? </li></ul></ul><ul><ul><li>Does influence smoking vital signs of teenagers? </li></ul></ul><ul><li>Award winning presentations on National Scientific Conference of Hungarian Student Research Association. </li></ul>
    22. 23. Smoking changes opinion of smoker students regarding smoking Question: What do you think, what is smoking like? (classes 11-12.) n=137 n=45 n=22 * * * * * * * *
    23. 24. Change of pulse rate after physical excercise Pulse rate (beat/minute)
    24. 25. Change of diastolic blood pressure after physical excercise Blood pressure (mmHg)
    25. 26. Expensive drug <ul><li>1 box of cigarette = 2 Euros </li></ul><ul><li>1 year = 365 days </li></ul><ul><li>1 year = 730 Euros </li></ul><ul><li>5 years = 4000 Euros (5%) </li></ul><ul><li>10 years 10.000 Euros </li></ul><ul><li>15 év alatt 18.000 Euros </li></ul>
    26. 27. Have you ever tried waterpipe?
    27. 28. Waterpipe <ul><li>coal </li></ul><ul><li>tobacco </li></ul><ul><li>additives </li></ul><ul><li>liquid </li></ul><ul><li>people </li></ul><ul><li>45 minutes = 100 inhalations </li></ul><ul><li>1 inhalation = 3 sec </li></ul>
    28. 29. Waterpipe and carbonmonoxid (CO) <ul><li>Smoke of waterpipe: 0,34% - 1,40% CO </li></ul><ul><li>Smoke of cigarette: 0,41% CO </li></ul><ul><li>Smaller waterpipes produce more CO </li></ul>CO-hemoglobin(%) 1832 volunteers ( Saudi-Arabian men ) after 10-40 smoking
    29. 30. Other risks of waterpiping <ul><li>Waterpiping at least once </li></ul><ul><ul><li>increases trying cigarettes 8x </li></ul></ul><ul><li>Danger of additives </li></ul><ul><ul><li>Alcohol , drugs </li></ul></ul><ul><li>Particle materials </li></ul>
    30. 31. Continuous train the trainer program <ul><li>Pool of educational material </li></ul><ul><li>School nurses and teachers will organize the educational programs at schools </li></ul><ul><li>1 full job health education officer in local surgeon general’s office </li></ul>
    31. 32. Problems and hopes <ul><li>Problems </li></ul><ul><li>Fund raising </li></ul><ul><li>Schools are not interested in regular/continuous tobacco prevention program </li></ul><ul><li>Hopes </li></ul><ul><li>Smokefree low effective from Jan/2012 </li></ul><ul><li>Increasing tobacco prices </li></ul><ul><li>Smoking cessation will be reimbursed </li></ul><ul><li>More educated teachers and school nurses </li></ul>
    32. 33. Smokers try illicit drugs Have you ever tried any drug (e.g. Extasy, cannabis, cocain, heroin)? 15-19 yrs of age (n=1328) 1,5% 7,3% 28,8% 54,0% 54% Non-smoker Not in last 30 days Not every day Every day (dependent) Ever drug user 3 48 79 107 Not tried any drug 194 611 195 91

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