Youth Nicotine Prevention and Cessation

In partnership with Horizon Health, SAFER conducts youth screenings to assess risk, connect students and families to appropriate supports, and refer to treatment when needed. Screenings open a dialogue about other impacts on a person's life. Early intervention can prevent the development of more severe substance use disorders.

 Not On Tobacco (NOT) is a student-focused program from the American Lung Association for students in active use. This can be delivered to students or as a "train the trainer" model with your district staff.

Unlike other cessation programs which simply modify adult curriculum, N-O-T was designed with teenagers in mind and addresses issues that are specifically important to them. The program takes a holistic approach with each session using different interactive learning strategies based on Social Cognitive Theory of behavior change that can then be applied and practiced in everyday life and encourages a voluntary change for youth ages 13 to 19.

N-O-T is taught by a trained and certified adult in ten, 50-minute sessions.  It is most effective in a small group format (6-10 participants) that emphasizes teamwork. The easy-to-use method helps teens quit by addressing total health in order to develop and maintain positive behaviors. Participants will talk about the importance of physical activity, nutrition, enhancing their sense of self-control, and improving life skills such as stress management, decision making, coping, and interpersonal skills. Additionally, they will learn to identify their reasons for smoking or vaping, healthy alternatives to tobacco use and finding people who will support them in their efforts to quit. Listed below are the topics for each session. Please note this is a voluntary program based on Motivational Interviewing (MI), students must be open to participating for the program to be fully effective.

Session 1: Reasons for Quitting
Session 2: Why I Smoke/Vape
Session 3: Nicotine Addiction and Triggers
Session 4: Effects of Smoking/Vaping
Session 5: Physical, Psychological and Social Benefits of Quitting
Session 6: Quitting Nicotine Use
Session 7: Overcoming Obstacles to Quitting
Session 8: How to Deal with Stress
Session 9: Myths of Big Tobacco
Session 10: Staying Committed to Quitting

N-O-T is an evidence-based program with an impressive success rate, with approximately 90 percent of teens who participate in the program cutting back or quitting tobacco all together. Post program, Not On Tobacco® program youth also have been shown to have better grades, higher motivation, fewer absences, better relationships with teachers and fewer school tobacco use policy violations.

In-Depth is a student-focused program from the American Lung Association that is utilized as an alternative to suspension for nicotine use with a focus on education and prevention rather than punitive measures.

Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health (INDEPTH) is a convenient alternative to suspension or citation that helps schools and communities address the teen vaping problem in a more supportive way. Instead of solely focusing on punitive measures, INDEPTH is an interactive program that teaches students about nicotine dependence, establishing healthy alternatives, and how to quit the unhealthy addiction that could lead to serious health related issues. 

INDEPTH is an alternative to suspension program that teaches young people about the risk factors to nicotine addiction and ways to quit vaping. Taught by a certified trainer, in four, 50-minute sessions. Each session addresses a different tobacco-related issue and can be facilitated either one-on-one or in a group setting. The goal of every program is to educate students about nicotine dependence and cravings and ultimately guide them through the process of identifying their own reasons for chewing, smoking, or vaping tobacco products. Listed below is an outline of each session topic.

Session 1: Getting the Facts: Breaks down the program for participants

• Session 2: Nicotine Dependence: Explains the harmful effects of nicotine and tobacco products
• Session 3 : Alternatives: Helps teens understand their urges and identify healthy alternatives to replace tobacco use
• Session 4: Past, Present, Future: Talks about next steps and how to avoid future tobacco-related problems

Although INDEPTH is not a cessation program in its entirety, 60 percent of student participants reported that they were willing to quit using tobacco products after completing the program. After program completion, resources are shared to help students become and remain tobacco and nicotine-free, including access to policy support and youth cessation programming such as Not On Tobacco (NOT). 

Stanford Medicine Safety First curriculum delivered to youth in classroom and/or community settings, focused on nicotine prevention and analysis of risk factors.

Stanford's REACH lab is well known for primary prevention education curriculum and resources. The You and Me, Together Vape-Free curriculum, part of the Stanford Tobacco Prevention Toolkit, is a 5-lesson evidence-based curriculum, approximately 50 minutes each. Every lesson provides activities, online quiz games, and worksheets in addition to presentations, resources, and other materials aimed at addressing key factors associated with youth e-cigarette use, including changing adolescents’ attitudes towards and misperceptions about e-cigarettes; increasing their refusal skills to pulls of flavors, marketing, and social media; reducing stress and depression which have been linked to e-cigarette initiation and use; improving coping; and decreasing intentions and actual use of all e-cigarette products.

These 5 in-class sessions are reinforced outside of the classroom with follow-up discussion guides that provide open-ended questions and activities for youth to discuss various e-cigarette-related topics with a trusted adult and/or peer in order to open dialogue between youth and adults. The curriculum is meant to reach all youth, including those at highest risk of tobacco use.

The goals of this curriculum are for adolescents to:

• Increase their knowledge about e-cigarettes and the harms they can cause
• Gain awareness of strategies manufacturers and sellers of e-cigarettes employ to increase use among adolescents, such as deceptive and creating marketing strategies
• Gain skills to refuse experimentation and use of e-cigarettes
• Reduce and prevent e-cigarette use of any type, including nicotine, cannabis/THC, and/or non-nicotine products

Youth Risk‑Behavior Surveys (YRBS) are developed to monitor health behaviors that contribute to the leading causes of death, disability, and social problems among youth in the U.S. Implementation and data collection from this survey will assist your district in creating programs that address the needs of your students and families, as well as in monitoring progress toward achieving health objectives and improved academic outcomes.

The Youth Risk-Behavior Survey (YRBS) is a free tool developed by the Center for Disease Control and Prevention (CDC), designed to collect data on health-related behaviors for students in grades 6-12. The survey is typically updated and used by districts throughout the US every two years. The YRBS covers many different areas broadly related to health and wellness, including diet and physical activity, alcohol, tobacco, and other drug use; sexual activity, access to food and housing; bullying and school safety; anxiety; stress, and suicidality. In addition, the YRBS measures assets, such as a sense of belonging and healthy relationships which have the power to protect youth from engaging in risk behaviors and help keep them safe, healthy, and successful. 

YRBS data can be used to: 

• Describe student health behaviors, risks, and experiences
• Plan, monitor, and evaluate school health interventions
• Inform school policies and practices
• Support health-related policies, legislation, and laws
• Provide information and support for funding requests
• Support faculty/staff professional development

Terry Herring, Erie 1 BOCES coordinator, can assist your school district to administer the YRBS survey and analyze the results. Participation is voluntary, and students can opt out of the survey if they or their parents choose. One class period is needed to complete the survey; most students finish the survey within approximately 35 minutes. The results of the survey are combined and summarized to provide meaningful information while protecting students' privacy and anonymity. A report summarizing the results can be used to track health behaviors and risks in area counties and help communities apply for funds in areas of greatest need. State-level results help policymakers assess how well New York is doing in the areas of youth wellness and to develop or enhance programming to meet today's needs. 

Supportive Quit Coach Training: This training equips school personnel with basic knowledge of substance use and nicotine withdrawal. Participants learn to recognize warning signs, use supportive and empathetic language, and connect students with appropriate resources.