The Tobacco Prevention Toolkit

Project History

Adolescent cigarette use has declined over the past decade; however, adolescents continue to use tobacco and nicotine, through electronic cigarettes or vapes, smokeless tobacco, cigars and cigarillos, and cigarettes.  While there are many school-based tobacco education efforts, there are gaps in what students are learning about tobacco. Few tobacco prevention programs are developed by first directly asking the stakeholders of these programs (educators, students, and parents) what is missing from school-based tobacco prevention programs, and then incorporating these missing aspects into new prevention messages and delivery strategies. We set out to develop a new Toolkit that contains missing aspects of current tobacco education curriculum.  Through a series of focus groups with educators, students, parents, and school administrators, we learned that there are four missing components.  First, we learned that adolescents lack information about nicotine and nicotine addiction, and that educators feel ill-equipped to teach addiction, including the corresponding brain biology. Second, we learned that information about electronic cigarettes/vape pens is missing from most tobacco prevention curriculum, despite the increasing use of these products among middle and high school students.  Third, we learned from educators that they would benefit from having more information on how best to implement a Positive Youth Development (PYD) framework into their teachings.  While PYD is mandated by the California Department of Education’s Tobacco Use Prevention Education program (TUPE) and encouraged by others as a best practice for changing behavior, many educators lack information about PYD.  Finally, stakeholders expressed the need for better communication about school tobacco policies, and parents wanted information about tobacco prevention that they could discuss at home.  We thus set out to develop curriculum, in the form of modules, that addressed each of these four gaps. 

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     The Tobacco Prevention Toolkit is based on Dr. Bonnie Halpern-Felsher’s (Professor and Principal Investigator of this project) research on adolescent tobacco use, risk perceptions, and decision-making, which shows that adolescents’ perceptions of risks, benefits, and social norms predict tobacco use.  Our curriculum is also theory-driven, based on health models including the Information, Motivation, and Behavioral Skills Model (IBM) and the Theory of Planned Behavior, as well as frameworks for improving adolescent health (e.g., the Positive Youth Development Framework).  These models argue that knowledge, motivation, attitudes, and behavioral skills are critical determinants of risk behavior and prevention.  Further, attitudes, perceived social norms, and peer and social influences (including marketing and media) are important predictors of behavior.  We also conducted formative research to inform our curriculum, including holding a series of focus groups with students, health educators, tobacco prevention researchers, leaders within the California Department of Education’s Tobacco Control Branch, and basic scientists focusing on tobacco in general, e-cigarettes more specifically, and addiction, to identify the most important content areas that need to be included, delivery strategies that are engaging for youth, and to obtain the latest evidence known about tobacco to ensure that the information presented in our curriculum is accurate. These working groups helped us refine our topics and concepts for the Toolkit, including definitions of addiction and nicotine addiction, brain biology, pleasure pathways, tobacco ingredients, tobacco industry manipulation, current information on e-cigarettes/vape pens, definitions of PYD, activities and information to be included in each module, to name a few. We also analyzed existing multi media via YouTube videos and websites to gain an understanding of what is already accessible and available. The activities developed have taken into account various resources available to educators that are simple in concept but rich in information.

The ultimate goals of the Toolkit are: 

  1. For students to understand basic information about tobacco products, including e-cigarettes/vape pens, and the harm they cause
  2. For students to gain awareness of strategies manufacturers of tobacco, including e-cigarettes/vape pens, employ to increase use among adolescents through deceptive and creative marketing strategies
  3. For students to gain skills to refuse experimentation and use of tobacco
  4. For school teachers and administrators to be able to develop and set new school policies

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Core Team

Bonnie Halpern-Felsher, PhD

Dr. Bonnie Halpern-Felsher is Professor of Pediatrics at Stanford University. She is a developmental psychologist whose research has focused on cognitive, psychosocial and environmental factors involved in adolescents’ and young adults’ health-related decision-making, perceptions of risk and vulnerability, health communication, and risk behavior.

Ira Sachnoff, MA

Ira Sachnoff is currently a School Alcohol, Tobacco, and Peer Helping Program Consultant for school districts and counties throughout California. He has his own consulting company, Peer Resource Training and Consulting, where in the last 25 years has trained over 5,000 youth peer educators and over 1,000 adults in the art of setting up comprehensive prevention and education programs for youth.

Stephen Smuin

Stephen K. Smuin is the former Founding Head of the Odyssey Middle School and Nueva Middle School, is completing his 42nd year as an educator.  Steve began his formal teaching/coaching career in Libby, Montana.   After returning to graduate school at the University of Montana he assumed coaching and teaching at Loyola-Sacred Heart High School.


Special thanks to Malena Ramos, EDM

Ms. Ramos served as the Tobacco Prevention Toolkit Project Director from 2009 until 2016 and was intrumental in the development of the Toolkit. Ms. Ramos has focused on adolescent and young adult risk behaviors, including the attitudinal and contextual factors involved in those risks. Her work includes the application of study findings to the development of intervention and prevention programs. She has extensive experience in curriculum design and implementation through her graduate work at Harvard University Graduate School of Education.

Consultants

Cherrie Boyer, PhD
Professor of Pediatrics
Department of Pediatrics
University of California, San Francisco
San Francisco, CA

Emily Justice, MA
Manager, Tobacco Use Prevention Education (TUPE)
Contra Costa County Office of Education
Pleasant Hill, CA

Jim Kooler, DrPH
Administrator
Friday Night Live Partnership
Visalia, CA

Adrienne Lazaro, BS
Stanford Health 4 All Alumna
Staff Research Associate
Stanford University
Palo Alto, CA

Matt Rosen, MSW, MUP
Former Vice President of Programs
Youth Leadership Institute
San Francisco, CA

Kimberlee Homer Vagadori, MPH
Project Director
California Youth Advocacy Network
Sacramento, CA

Valerie Velez
Health Education Program Specialist
SCTI Project Director/TUPE Program
Educational Services Branch
Hemet Unified School District
Hemet, CA

Carson Benowitz-Fredericks, MPH
University of California, San Francisco
San Francisco, CA

Jasper Fung
Computer Ninja Extraordinaire
Reed College, Class of 2020
Portland, OR

Advisors

Patricia Barahona
Senior Director of Programs
Youth Leadership Institute
San Francisco, CA

Neal Benowitz, MD
Professor of Medicine
Bioengineering and Therapeutic Sciences
University of California, San Francisco
San Francisco, CA

Dawn Billman
Palo Alto High School PTA
Past VP Student Health and Welfare
Co-VP Parent Education
Palo Alto, CA

Lynda Boyer-Chu
Wellness Center Nurse
Tobacco Prevention Coordinator
George Washington High School
Student, Family and Community
Support Department
San Francisco, CA

Ralph Cantor
Drug Prevention Educational Consultant
San Francisco Bay Area

Ray Cordoba, MA, PPS
Dean/Head Counselor
Lowell High School
San Francisco, CA

Ryan Crowdis
Project Manager
TUPE, School & Community Services
Orange County Department of Education
Costa Mesa, CA

Heather Daly, PhD
EduCare Foundation
Los Angeles, CA

Robert Dousa
Program Specialist – Health Education
Alcohol, Tobacco & Other Drug (ATOD)
Prevention Programs
Oakland, CA

Leigh-Anne Ecklund
Co-Department Head: Science
Instructor in Biology and Chemistry
Aragon High School
San Mateo, CA

Elizabeth Escalante
TUPE Coordinator
Stanislaus County Office of Education
Prevention Programs
Modesto, CA

Jennifer Eseltine
Health Teacher
Antioch High School
PAR Consulting Teacher
Antioch, CA

Amy Fitzgerald
Assistant Principal
Hilmar Middle School
Hilmar, CA

Ken Fitzgerald
Regional Health and Safety
Planning Coordinator
Modesto, CA

Scott Gerbert
Coordinator, Student Services
San Ramon Valley Unified School District
San Ramon, CA

Patty Hoyt
Alcohol Policy Coordinator
Discovery Counseling Center
San Ramon, CA

Raquel Jimenez
Community Engagement Coordinator
Family, Schools, Community Partnerships
Oakland Unified School District
Oakland, CA

Francina Kelly, MA, PPS
TUPE Specialist
Hemet Unified School District
Hemet, CA

John Lagomarsino
School Health Education Consultant
California Department of Education
Sacramento, CA

Sylvie Langbehn
Student Support Counselor
Alameda County Office of Education
Hayward, CA

Lori Lambertson
Staff Educator
Exploratorium Teacher Institute
San Francisco, CA

Don Leach
Retired SF Unified Psychology Teacher
Peer Resource Director
George Washington High School
San Rafael, CA

Kim Levine, MHA
School Health Program Coordinator
San Francisco Unified School District
San Francisco, CA

Pamela Ling, MD, MPH
Professor
Department of Medicine
University of California, San Francisco
San Francisco, CA

Nora Manzanilla
Program Director
Office of Los Angels City Attorney
Los Angeles, CA

Erik Martinez
LGBTQ Programs Coordinator
School Health Programs
San Francisco Unified School District
San Francisco, CA

Cathy McDonald, MD, MPH
ATOD Provider Network
Thunder Road
Oakland, CA

Charmaine Monte
TUPE Coordinator
Stanislaus County Office of Education
Modesto, CA

Tiffani Neal
Science Teacher
TUPE Site Coordinator
Samuel L. Gompers Continuation High
Richmond, CA

Carey Peck
Principal Analyst
TUPE Program Manager
Los Angeles Unified School District
Beyond the Bell Branch
Los Angeles, CA

Christopher Pepper
Lead Health Education Teacher
Balboa High School
San Francisco, CA

Pam Pierson
Dozier Libbey Med High School
Health Teacher
TUPE Trainer
Antioch, CA

Alissa Ralston
Project Director, Tobacco Free Youth
TUPE Site Coordinator
Bay Area Community Resources
Marin County Office of Education
San Rafael, CA

Divya Ramamurthi, MA
SRITA
Stanford University
Palo Alto, CA

Danielle Ramo-Larios, PhD
Assistant Professor
University of California, San Francisco
San Francisco, CA

Neal Rojas, MD, MPH
Assistant Clinical Professor of Pediatrics
Interim Chief, Division of Pediatric Behavioral Medicine
University of California, San Francisco
San Francisco, CA

Mark Rubinstein, MD
Professor of Pediatrics
University of California, San Francisco

Jackie Ryan
Health Teacher
Helms Middle School
San Pablo, CA

Janine Saunders, MPH
School Health & Safety Manager
TUPE Project Director
Alameda County Office of Education
Hayward, CA

Derek Smith, MSW, MPH
Health Educator
Tobacco Free Project
Community Health Equity Promotion Branch
San Francisco Department of Public Health
San Francisco, CA

Gideon St. Helen, PhD
Assistant Professor
Division of Clinical Pharmacology
University of California, San Francisco
San Francisco, CA

Alex Stalcup, MD
Medical Director
New Leaf Treatment Center
Lafayette, CA

Maria Silvia Velasquez
Coleman Advocates, Parent
San Francisco, CA

Lori Vollandt, EdD
Coordinator Health Ed
Los Angeles Unified School District
Los Angeles, CA

Rhodora Ursua, MPH
Director of Programs
Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL)
Oakland, CA

Jim Walker
Executive Director
Stop Tobacco Abuse of Minors Pronto
Los Angeles, CA

Kathy Ward, RN, MPH, SNC
Everett Middle School
San Francisco Unified School District
San Francisco, CA

Bruce Wilcoff
School Counselor
Former Member of the Ventura County Behavioral Health and Alcohol and Drug Advisory Board
Los Angeles, CA

Greg Wolfe
School Health Consultant
California Department of Education
Coordinated School Health and Safety Office
Sacramento, CA

And other contributors.

Funders

Tobacco-Related Disease Research Program 

The Tobacco-Related Disease Research Program (TRDRP) funds research that enhances understanding of tobacco use, prevention and cessation, the social, economic and policy-related aspects of tobacco use, and tobacco-related diseases in California.

California Department of Education

California will provide a world-class education for all students, from early childhood to adulthood. The Department of Education serves our state by innovating and collaborating with educators, schools, parents, and community partners. Together, as a team, we prepare students to live, work, and thrive in a multicultural, multilingual, and highly connected world.