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


Core Team

Bonnie Halpern-Felsher, PhD, FSAHM: Founder, Executive Director

Dr. Bonnie Halpern-Felsher is Professor of Pediatrics at Stanford University and is the Director of Research for the Division of Adolescent Medicine.  

Ira Sachnoff, MA: Co-founder, Director of Dissemination and Training

    Ira Sachnoff is currently a school Alcohol, Tobacco, and Peer Helping Program Consultant for school districts and counties throughout California.

Stephen Smuin: Co-founder, Director of Curriculum Development

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.

Tobacco Prevention Toolkit Project Director

Adrienne Lazaro, M.S.
Assistant Clinical Research Coordinator
Stanford University
Stanford, CA

Tobacco Prevention Toolkit Project Director

Richard Daniel Ceballos, B.A.
Department of Pediatrics
Division of Adolescent Medicine
Stanford University
Stanford, CA


Special thanks to Malena Ramos, Ed.M.

Tobacco Prevention Toolkit Project Director from 2009 until 2016


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
Friday Night Live Partnership
Visalia, 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
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

Thank You to Our Advisors and Interns


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.

CVS Health Foundation