Evaluation of the Tobacco-Use Prevention Education (TUPE) program in California

PLoS One. 2018 Nov 2;13(11):e0206921. doi: 10.1371/journal.pone.0206921. eCollection 2018.

Abstract

Background and aims: The California Tobacco-Use Prevention Education (TUPE) program promotes the use of evidence-based tobacco-specific prevention and cessation programs for adolescents within the school setting. Through a competitive grant process, schools are funded to provide programs for grades 6-12. This research evaluates the association between TUPE funding and tobacco prevention activities and tobacco use prevalence.

Methods: This study utilized two data sources: (1) 2016 California Educator Tobacco Survey (CETS), and (2) 2015-2016 California Student Tobacco Survey (CSTS). The CETS collected data from educators about school prevention efforts, priority of tobacco prevention, and confidence in addressing tobacco issues with students. A total of 3,564 educators from 590 schools participated in CETS. The CSTS collected data from 8th, 10th, and 12th graders in California on their exposure to, attitudes about, and utilization of tobacco products. A total of 47,981 students from 117 schools participated in CSTS.

Results: This study found that TUPE-funded schools were more likely to provide tobacco-specific health education programs, to place a priority on tobacco-prevention efforts, and to prepare educators to address tobacco use than non-TUPE schools. Educators at both types of schools felt better prepared to talk with students about traditional tobacco products than about emerging products such as e-cigarettes. Overall, students at TUPE-funded schools were more likely to report receiving anti-tobacco messages from school-based programs than those at non-TUPE schools. The former were also less likely to use tobacco products, even when the analysis controlled for demographics and school-level characteristics (OR = 0.82 [95% CI = 0.70-0.96]).

Conclusions: TUPE funding was associated with an increase in schools' tobacco-specific prevention activities and these enhanced activities were associated with lower tobacco use among students. This study also found that education and prevention efforts regarding emerging tobacco products need to be strengthened across all schools.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attitude
  • California / epidemiology
  • Child
  • Electronic Nicotine Delivery Systems
  • Female
  • Health Behavior
  • Health Education
  • Humans
  • Male
  • Nicotiana / adverse effects*
  • Schools / statistics & numerical data
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Smoking Cessation / methods
  • Smoking Prevention / trends*
  • Students
  • Tobacco Use / epidemiology
  • Tobacco Use / prevention & control*
  • Young Adult

Grants and funding

This study was jointly funded by the Tobacco-Related Disease Research Program (TRDRP) grant number 24GT-0040H, the California Department of Public Health (contract numbers CDPH-15-10249 and CDPH-18-10074), and the California Department of Education (contract numbers CN150358 and CN170384). The California Student Tobacco Survey (CSTS) was supported by a contract from the California Department of Public Health (contract numbers CDPH-14-10383 and CDPH-16-10109). The study funders did not play any role in design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.