The Unfiltered Truth: Tackling Youth Smoking
By Stephen H. Baumann
The statistics are stark. Thousands of young people are taking up smoking each day, tobacco companies continue to promote their products to the under-18 market, and the adverse health effects of teenage tobacco use are demonstrable. With so much science generating so much data, how is it possible that tobacco use continues to be the number-one U.S. adolescent public health problem?
In search of new solutions, in early 2000 the New Jersey Department of Health and Senior Services (DHSS) put out a call for partners for its Comprehensive Tobacco Control Program. Funding would be made available through the 1998 Master Settlement Agreement between the states and the tobacco companies. What DHSS needed was innovative educators who could reach students in grades 4-12 with a message about the realities of youth smoking.
Liberty Science Center jumped at the chance. Our extensive experience in running outreach programs and our yearly youth audience in excess of 450,000 (one third from the most underserved communities in New Jersey) made us a logical complement to established community partnerships, cessation programs, and media campaigns. A visit to the science center in May convinced the Commissioner of Health we were right for the job.
Over the summer, our program developers and science educators began to pinpoint concepts and goals that would become the foundation of our program. Through focus groups, presentations, and brainstorming, we scrutinized previously successful tobacco education programs identified in the 1999 Department of Health and Senior Services' paper "Youth and Community Background." Seeking a distinct niche that would build on our strengths and not replicate existing efforts, we came up with four program goals:
- to decrease the acceptability and initiation of tobacco use among youth aged 9-17.
- to increase scientific understanding about the harmful effects of tobacco use and the creation of tobacco products.
- to increase awareness of the negative effects of smoking in community and personal settings.
- to increase awareness of how strategic marketing by the tobacco industry masks the negative aspects of tobacco use and products.
During this process, one thing became clear: No single initiative or experience would suffice. We needed a set of integrated experiences, each able to stand on its own, that would present our youth audience with multiple opportunities, in a variety of media, to interact with our anti-tobacco messages.
In October 2000, we submitted a request for funding to DHSS for a three-part tobacco education program entitled The Unfiltered Truth. A grant for $783,000 for development and implementation was approved, to begin January 1, 2001. All components of The Unfiltered Truth are actively under way in the 2001-2002 school year.
A three-part approach
Our first component is Extreme Choices, a 15-minute, 3-D laser show written by playwright Michael Hollinger and coproduced by the science center and Lightspeed Design Group. This on-site program tells the story of an adolescent boy who plays a new, high-tech arcade game. Urged on by his peers, and by the promise of a "prize" when he finishes the challenge, the young gamer initially encounters numerous choices that determine events within the game. As the game progresses, however, and the smoking and tobacco themes are introduced, the choices dwindle.
Ultimately, the game takes command, in much the same way that a burgeoning nicotine addiction would. As the climax nears, the teenage boy (and the audience) experience firsthand how seemingly simple choices about when and how much to smoke can lead to extreme consequences.
Crafted to send home only one or two important ideas, the laser show uses the power of its visual and aural environment first as a hook to engage the audience in the game and then as a tool to drive home the climax and message.
Hot Air is a 45-minute play, also written by Michael Hollinger, currently being performed in middle school gyms, cafeterias, and auditoriums throughout New Jersey. Coproduced by the science center and Playwright's Theater of New Jersey, the production features six professional actors, portraying three middle school students and six adults, in a story that meshes smoking, athletics, advertising, and family relationships.
Jessica is a budding track star who can't seem to quit smoking. Her dad, an advertising account manager, has a new campaign aimed at promoting smoking among teens. As the conflicts emerge, the audience is both entertained and informed about the evils of smoking and the deceptions of tobacco marketing.
Unlike the laser show, this format allows for character development and more intricate storylines, as well as multiple messages about issues related to smoking. After each performance, the Hot Air cast takes questions from the audience: "Does smoking affect the way you run?" "Do people who have had throat cancer really try to smoke through the hole in their throat?" Questions like these indicate how the show is impacting the audience.
The third element of the program is a web site, The Science
Behind Tobacco (www.lsc.org/tobacco), which provides information,
images, links, and animations related to the cultivation of tobacco,
the manufacturing of cigarettes, and the health effects of tobacco
use. Intended for youth and adult users, the web site was developed
with input from student and teacher focus groups and includes
classroom guides for Extreme Choices and Hot Air,
plus background information on the relationship between the tobacco
plant, the cigarette maker, and nicotine addiction. The Science
Behind Tobacco debuted in November 2001.
Ongoing evaluation of The Unfiltered Truth is being conducted for Liberty Science Center by the Conservation Company of Philadelphia. Together, we have developed a variety of instruments, including surveys, interviews, and focus groups,to collect quantitative and qualitative data on the program's impact. Evaluation is occurring at the science center, in schools, and through an online survey on the web site. Results from the analysis will be available at the end of the 2001-2002 school year.
Meanwhile, many schools that booked Hot Air last spring have rebooked for this year, and a number have also visited the science center to see Extreme Choices. Some teachers have requested copies of the teacher's guide, and initial survey results indicate that others are downloading the support materials from the web site. With the online survey now operable, we anticipate clearer feedback on the ways that the web site supports student and teacher learning.
The presentation of a comprehensive program about tobacco use, through initiatives that engage guests on-line, offsite, and here at the science center, has been an institutional challenge. But for Liberty Science Center, telling the straight story about our number-one public health issue, in innovative and thought-provoking ways, is the essence of our mission.
Stephen H. Baumann is vice president of education and programs at Liberty Science Center, Jersey City, New Jersey.
TEENS AND SMOKING
Nationwide, well over a quarter of all high school students (grades 9-12) are current smokers, along with almost 15 percent of all eighth graders.--U.S. Centers for Disease Control and Prevention (CDC), November 2, 2001: The Monitoring the Future Study, University of Michigan, 2001
In 2000, the tobacco companies spent $59.6 million in advertising expenditures for the most popular youth brands in youth-oriented magazines. The Master Tobacco Settlement has not reduced youth exposure to advertisements for these brands.--Charles King and M. Siegel, "The Master Settlement Agreement and the tobacco industry and cigarette advertising in magazines," New England Journal of Medicine 345 (7): 504-511, 2001
High school seniors who are regular smokers and began smoking by grade nine are more than twice as likely as their nonsmoking peers to report poorer health; roughly two and a half times more likely to report cough with phlegm or blood, shortness of breath when not exercising, and wheezing or gasping; and three times more likely to have seen a doctor or other health professional for an emotional or psychological complaint.--D.R. Arday et al., "Cigarette smoking and self-reported health problems among U.S. high school seniors, 1982-1989," American Journal of Health Promotion 10 (2): 111-116, 1995