Tobacco use worksite wellness policies in Georgia schools : results from the 2014 Georgia School Health Profiles Survey (SHPS)

The Georgia Department of Public Health
Tobacco Use Worksite Wellness Policies in Georgia Schools:
Results from the 2014 Georgia School Health Profiles Survey (SHPS)
There is no safe level of secondhand smoke exposure. Even the most advanced ventilation system cannot eliminate secondhand smoke or its harmful effects 2006 Surgeon General Report1
This is a summary of results from the 2014 Georgia School Health Profiles Survey (SHPS) on the status of tobacco use prevention policies as worksite wellness policies for faculty/staff in Georgia public schools including charter and alternative middle and high schools. The Georgia SHPS is a system of surveys used to assess school health policies and practices within the state. The survey is conducted every two years in Georgia among middle and high school principals and lead health education teachers. The survey is used to monitor school health education and physical activity requirements; school health policies related to tobacco use prevention, nutrition, and HIV, STD, and teen pregnancy prevention; asthma management activities; and injury and violence prevention.2 Georgia has 510 middle schools, 391 high schools, and 29 junior/senior high schools, giving a total of 930 worksites for their faculty/staff.3 A total of 299 principals from sampled schools completed the SHPS questionnaire (77% response rate), which asked about tobacco use prevention policies adopted at their school. Results were weighted to be representative of all public middle and high schools in Georgia.
The Pro-Children Act of 1994 (reauthorized by the No Child Left Behind Act of 2001) prohibits smoking inside facilities where federally-funded educational, health, library, daycare or child development services are provided to children under age 18 years.4 The CDC Guidelines for School Health Programs to Prevent Tobacco Use and Addiction and the Healthy People 2020 Objective Tobacco Use-15 (TU-15) recommend increasing tobacco-free environments in schools to include all school facilities, property, vehicles, and school events.4 Since tobacco use is the most preventable contributor to mortality in the United States, it is important to restrict use or exposure to tobacco products. Environmental interventions aimed at reducing use of tobacco in public places and worksites lead to reduction of tobacco use. Prohibiting use of tobacco products at all times, whether or not school is in session, protects students and faculty/staff from the harmful effects of secondhand smoke.1,4 The extent to which Georgia schools have developed, implemented and enforced a policy that creates a totally tobacco-free environment for faculty/staff is summarized below.
Capacity to Develop Policies Related to School Health
About half of all public middle/high schools (52%; 470 schools) in Georgia had used the School Health Index or other self-assessment tool to assess the school's policies, activities and programs in tobacco use prevention
Only about 51% of middle schools and 45% of high schools had one or more groups (e.g. school health council, committee or team) at the school that offers guidance on the development of policies or coordinates activities on health topics
Only 31% of middle schools and 45% of high schools had students' families help in the development and implementation of policies and programs related to school health

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Oct 2015

Tobacco Use Worksite Wellness Policies in Georgia Schools
Types of Tobacco Prohibited in Schools Approximately 96% of middle schools and 99% of high schools have adopted a policy prohibiting tobacco use during schoolrelated activities Of the schools that have adopted a policy prohibiting tobacco use (Figure 1): o 97% of middle schools prohibit use of all tobacco products, including cigarettes, smokeless tobacco (chewing tobacco, snuff, dip), cigars, and pipes by faculty/staff o 95% of high schools prohibit use of all tobacco products, including cigarettes, smokeless tobacco, cigars, and pipes by faculty/staff
Times in Which Tobacco Use is Prohibited Of the schools that have adopted a policy prohibiting tobacco use (Figure 2): o 79% of middle schools prohibit tobacco use by faculty/staff during both school hours and non-school hours o 81% of high schools prohibit tobacco use by faculty/staff during both school hours and non-school hours
Locations in Which Tobacco Use is Prohibited Of the schools that have adopted a policy prohibiting tobacco use (Figure 3): o 98% of middle schools prohibit tobacco use by faculty/staff in all locations (school buildings, outside on school grounds, school buses or other vehicles, at off-campus events) o 97% of high schools prohibit tobacco use by faculty/staff in all locations

Tobacco Use Worksite Wellness Policies in Georgia Schools
Approximately 60% of Georgia schools follow a model policy that mandates a tobacco-free environment, which prohibits tobacco use at all times by students, faculty/staff and visitors in school buildings, at school functions, in school vehicles and at off-site school events
About 90% of middle schools and 90% of high schools that have a model tobacco-free school policy post signs marking a tobacco-free school zone or a specified distance from school grounds where tobacco use is not allowed
Enforcement of Tobacco-Free School Policy About 92% of middle school principals and 93% of high school principals stated that their school or school district has an enforcement plan for its tobacco-free school policy Only 17% of middle schools and 18% of high schools have promotion of cessation services to faculty/staff as a component of the tobacco-free school policy enforcement plan (Figure 4) About 42% of middle schools and 61% of high schools have had a reduction in violations of the policy by faculty/staff since adoption and enforcement of the tobacco-free school policy (Table 1)
Only 6% of middle schools and 9% of high schools have had increased requests for cessation services since adoption and enforcement of the tobacco-free school policy

Tobacco Use Worksite Wellness Policies in Georgia Schools
The resources most needed for enforcement of tobacco-free school policies were educational materials, tobacco-free school signage and example public service announcements (PSAs) (Figure 5)
Lack of funding and signage were the most common barriers to adoption of an enforcement plan (Figure 6)
Tobacco Cessation Provided by Schools Only 17% of middle schools and 16% of high schools provide tobacco cessation services for faculty/staff (Figure 7) About 28% of middle schools and 23% of high schools have arrangements with organizations or health care professionals not on school property to provide tobacco cessation services for faculty/staff
Recommendations More assessments of tobacco use policies, activities and programs are needed for Georgia's middle and high schools Increase access to tobacco-free school policy signage, educational materials and example PSAs for schools adopting tobacco-free school policies Georgia middle and high schools need to support cessation efforts among faculty/staff, especially when the school has adopted a tobacco-free school policy5,6 Cessation programs for faculty/staff should include a combination of approaches such as selfhelp materials, group support, individual counseling, skills training, family interventions and interventions supplemented by pharmacologic treatments5,6

Tobacco Use Worksite Wellness Policies in Georgia Schools
Health promotion activities and employee assistance programs should include cessation programs for faculty/staff, which may help lower staff absenteeism and decrease health insurance premiums5,6
Increase faculty/staff awareness of cessation services available through the Georgia Tobacco Quit Line
QUITTING TAKES PRACTICE!
The Georgia Tobacco Quit Line is available for all Georgians 13 years of age and older who want to quit using tobacco. To receive free counseling, support and referral services call:
1-877-270-STOP (English) 1-877-2NO-FUME (Spanish) 1-877-777-6534 (Hearing Impaired)
www.livehealthygeorgia.org/quitLine/index.shtml
References: 1. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. 2. Centers for Disease Control and Prevention (CDC). (2014, Sept 23). Adolescent and School Health: School Health Profiles. Retrieved from http://www.cdc.gov/healthyyouth/profiles/index.htm. 3. Georgia Department of Education 4. CDC. (2013, Aug 20). Item Rationale: 2014 School Health Profiles, School Principal Questionnaire. Retrieved from http://www.cdc.gov/healthyyouth/profiles/2014/ItemRationaleP.pdf. 5. Centers for Disease Control and Prevention. Guidelines for school health programs to prevent tobacco use and addiction. MMWR 1994; 43(RR-2):1-18. 6. NIOSH [2015]. Current intelligence bulletin 67: promoting health and preventing disease and injury through workplace tobacco policies. By Castellan RM, Chosewood LC, Trout D, Wagner GR, Caruso CC, Mazurek J, McCrone SH, Weissman DN. Morgantown, WV: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2015-113, http://www.cdc.gov/niosh/docs/2015-113/.
*More information about the Georgia SHPS can be found at: http://dph.georgia.gov/shps.
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