UNC study finds some schools better than others

North Carolina high schools that adopt Tobacco-Free School policies are making progress in protecting students, staff and visitors from the unhealthy effects of secondhand smoke by reducing smoking even during home football games, a new University of North Carolina at Chapel Hill study concludes. Schools can improve compliance with the policies further by communicating and enforcing them better, researchers say.

Doctoral student Eric Pevzner conducted the study as part of the Tackle Smoking Project under the direction of Dr. Kurt Ribisl, assistant professor of health behavior and health education at the UNC School of Public Health. The project is one element of a larger effort to promote and assess the impact of Tobacco-Free School policies across the state.

“We found that schools with a Tobacco-Free School policy had significantly fewer instances of smoking at football games than schools without such a policy,” Pevzner said.

Compliance varied widely between schools and from game to game, he said. Observed instances of smoking ranged from zero per game to 355. Compliance was highest when schools clearly communicated their policy using signs and public announcements.

Adults were responsible for about two-thirds of the smoking at games, the new study showed. That’s important, Pevzner said, because adults often are role models and influence the behavior of adolescents by the examples they set. “Previous studies have shown that when schools allow smoking on school grounds, they are sending a message to young people that smoking is acceptable,” Pevzner said. “Students think it is hypocritical for schools to teach that smoking is bad and then turn a blind eye to people smoking on school grounds. Tobacco-Free School policies are only effective when students perceive that they are consistently enforced.”

Rules against smoking are needed to protect everyone, including babies and children who are particularly susceptible to secondhand smoke, he said. “A significant number of babies and children were exposed to secondhand smoke while attending games,” Pevzner said. “For example, they were twice as likely to have been exposed while attending a football game at a school that did not have a Tobacco-Free School policy than at a school that did have one.”

The study assessed the amount of smoking at 132 N.C. high school football games at 66 schools representing 31 of the state’s 115 school districts, he said. Trained high school and UNC graduate students systematically assessed the amount of smoking at each of the games and recorded people lighting up 5,865 times. “North Carolina is moving in the right direction with 45 of 115 school districts adopting Tobacco-Free School policies,” Pevzner said. “Now schools need to focus on communication and enforcement, because just having a policy is like adopting a 20 mph speed limit for school zones and then ignoring the tens or even hundreds of people speeding past each school.”

The study clearly shows that the Tobacco-Free Schools movement is gaining momentum across the state, Ribisl said. Exit polls among spectators attending football games at Tobacco-Free schools showed strong support for the policies, he said. Overall, 76 percent of all respondents reported supporting them. “However, as we move toward all North Carolina schools adopting Tobacco-Free School policies, we have to remember that no enforcement amounts to no effect,” he said. “Tobacco-Free School policies must be continuously communicated and enforced to ensure that schools are smoke-free.”

Tobacco use is the leading preventable cause of death in the United States, Pevzner said. “Each year, cigarette smoking causes the deaths of more than 400,000 smokers and 35,000 nonsmokers who die because they were exposed to secondhand smoke,” he said.

The Association of Schools of Public Health and the American Legacy Foundation funded the Tackle Smoking Project. Important non-financial support came from the N.C. High School Athletic Association, the N.C. Tobacco Prevention and Control Branch and tobacco prevention and control advocates across the state.