10th Grade Lessons:
Needed Materials and Preparations Lesson 10-1
* Worksheet: What Do I Admire?
Lesson 10-2
* Tobacco advertising samples (provided on CD)
Lesson 10-3
* Worksheet: D.A.R.E. Decision-Making Process
Lesson 10-4
* Coffee stirrers (small, hollow straws) for an emphysema demonstration * The ABCs of Smoking Pamphlet and Transparencies * Mechanical Smoker * Journeyworks, Inc. pamphlets: How Tobacco Affects Your Body A Teen's Guide to Facts About Tobacco Smokeless Tobacco: Spit it Out! * What's in Cigarette Smoke? Partial list of chemicals in tobacco * One User's Story: Sean Marsee * Tobacco advertising samples (provided on CD) * The Big Dipper video
Lesson 10-5
* I Don't Want to Use Tobacco Pictionary Cards * One Addict's Story: Bryan Lee Curtis * Graphic: the Addiction Cycle * Worksheet: Reasons for Avoiding or Quitting Tobacco Use Contact your local chapter of the American Cancer Society or the American Lung Association if you need a guest speaker who is a smoker or former smoker.
Lesson 10-6
Internet or Phone Access * Web Addresses Anti-tobacco materials (collected by students from voluntary organizations and the state and local departments of health) * Anti-tobacco warnings for tobacco packaging (Pictures provided) * Journeyworks, Inc. pamphlet: 10 Best Reasons Not to Smoke While You're pregnant
Lesson 10-7
* Worksheet: The Facts About Smoking in Public Places
* These materials are included in the supply kit that accompanies
this curriculum, or in the case of handouts and worksheets, as PDF files on the accompanying CD. The PDF format should allow you to print the files directly from computer to printer, or you can print a single copy and make duplicates for your class.
10th Grade Lessons Materials List
Lesson 10-1
Self-Esteem: How Does It Shape Our Choices? Introduction: This lesson introduces students to the concepts of self-esteem and self-concept, and their link to behaviors and choices. Together with Lesson 10-2, which examines friends and peer relationships, this material provides students with basic tools for analyzing and making decisions, including those concerning tobacco use.
Lesson Objectives: By the end of Lesson 10-1, students will: W
Define the concepts of self-image and selfesteem
W
Understand how self-esteem may impact how they relate to different emotional states, such as stress or depression
W
Understand how self-esteem and self-concept often color the behavioral choices we make
W
See how they can use their understanding of self-esteem to make better decisions
W
Identify ways in which they can enhance their self-esteem
Plan Ahead! Lesson 10-6 asks students to access communitybased resources to assess existing anti-tobacco efforts, and to consider how they might design a similar effort to reach the Deaf. Many of these resources are available online, and we have provided web page addresses (see Lesson 10-6) that can serve as starting points. If appropriate, you may wish to assign certain web sites to groups of students to explore and present to the class, or the searching can be done as a class exercise. This contact should begin as early as possible to allow students to collect various anti-tobacco education materials. These should be available to students by the time they reach Lesson 10-6.
Materials: W
What Do I Admire? Worksheet
Key Terms: self-esteem: belief in one's worth; self respect; the value you place on yourself.
Page 10.1.1
Lesson 10-1: Self-Esteem:
How Does It Shape Our Choices?
Procedures: 1.
Initiate a discussion of self-esteem by asking the following: W
What is self-esteem? What do we mean by someone having high selfesteem? Low self-esteem? What are the characteristics of someone who has high self-esteem? Low self-esteem?
2.
Ask students: W
Does your self-esteem change according to your surroundings, e.g., when you are with your Deaf friends, or when you are with hearing friends? When you are here on campus, or when you are at the local shopping mall? Do you think you behave differently in these situations? In what ways?
W
In what ways do you think self-esteem is related to how someone acts when confronted with: k Making new Deaf friends k Making new hearing friends k Meeting Deaf people for the first time k Meeting hearing people for the first time k Dealing with bullying or teasing
Teacher’s Note: You can pose these situations at the left in terms of a person who has high self-esteem and then one who has low selfesteem.
k Joining a school club k Going to a party where people are smoking and drinking k Being asked by friends to smoke a joint/marijuana cigarette k Being asked by friends to help them buy cigarettes
3.
Make sure that students understand that self-esteem can be important in shaping people's responses to the above situations. Point out how higher self-esteem can sometimes be a protective mechanism, helping people to deal with stress or depression, or to avoid potentially harmful behaviors such as drinking, smoking or taking drugs.
Ask students: W
Are there instances where too much self-esteem may get one in trouble? For example, what if someone thinks they are invincible, or that their own opinions are always the best ones? What about people who are overly selfcentered or selfish?
Page 10.1.2
Lesson 10-1:
Self-Esteem: How Does It Shape Our Choices?
Procedures: (continued) 4.
Distribute the What Do I Admire? worksheet. Lead students through the exercise. From the list below (and on the worksheet), have students choose the seven qualities that they most admire in people their age: ____ Intelligent/Smart ____ Attractive/good-looking ____ Athletic/strong/good at sports ____ Artistic/talented/creative ____ Leader/someone that others look up to ____ Popular ____ Friendly/likeable ____ Kind/caring/sensitive/considerate of others’ feelings ____ Good sense of humor ____ Fun to be around ____ Has nice things/has money to spend ____ Doesn't worry about what others say ____ Tough/doesn't let others push them around ____ Respects teachers/parents ____ Dresses well/nice clothes/nice appearance ____ Calm and steady personality ____ Wacky and crazy ____ Not afraid to try new things ____ Knows what they want ____ Relaxed and easy-going Have students write these seven items in the appropriate spaces on the worksheet. Explain that these characteristics are ones we would most likely want to see in ourselves. Have the students rate on the accompanying scales the extent to which they think these traits apply to themselves. Explain to the students that their ratings are a quick picture of how they see themselves against a list of characteristics that they admire. Identifying differences between their current behaviors and thinking and the characteristics they think are ideal can be a start toward making positive changes. For example: W
I would like to be smarter and get better grades in school. 1. I can seek out more help from my classmates; communicate better with my teachers; or change my study habits so that I have more time to study. These choices would move me farther to the right on my scale, and closer to my ideal.
Page 10.1.3
Lesson 10-1:
Self-Esteem: How Does It Shape Our Choices?
Procedures: (continued) 2.
I could choose to be a little less critical about my academic performance. Perhaps I can recognize that although I struggle a bit in math, I actually do pretty well in science or art. Recognizing these strong points can help me to feel better about my overall academic performance.
Homework: For each of the items on their lists, have students draft a plan or set of goals for resolving the difference between how they see themselves and what they consider ideal; the way they would like to be.
Page 10.1.4
Lesson 10-1 Worksheet: What Do I Admire?
Name __________________________________
What Do I Admire? Step One:
x
From the following list, mark with an the seven characteristics or traits that you most admire in other people your age.
___ Intelligent, smart ___ Attractive, good-looking ___ Athletic, strong, good at sports ___ Artistic, talented, creative ___ Leader, someone that others look up to ___ Popular, well-liked by others ___ Friendly ___ Kind and caring, sensitive, considerate of others’ feelings ___ Good sense of humor ___ Fun to be around ___ Has nice things, has money to spend ___ Doesn’t worry about what others say ___ Tough, doesn’t let others push them around ___ Respects teachers and parents ___ Dresses well, wears nice clothes, has a nice appearance ___ Calm and steady personality ___ Exciting and energetic personality ___ Not afraid to try new things ___ Knows what they want, a go-getter ___ Relaxed and easy-going
Lesson 10-1 Worksheet: What Do I Admire?
What Do I Admire? Step Two: Write your seven items from the previous page into the spaces below. Mark on the accompanying scale how well each characteristic describes yourself.
Characteristic or Trait #1
Characteristic or Trait #2
Characteristic or Trait #3
Characteristic or Trait #4
Characteristic or Trait #5
Characteristic or Trait #6
Characteristic or Trait #7
This characteristic doesn’t describe me at all
This characteristic describes me well
This characteristic doesn’t describe me at all
This characteristic describes me well
This characteristic doesn’t describe me at all
This characteristic describes me well
This characteristic doesn’t describe me at all
This characteristic describes me well
This characteristic doesn’t describe me at all
This characteristic describes me well
This characteristic doesn’t describe me at all
This characteristic describes me well
This characteristic doesn’t describe me at all
This characteristic describes me well
Lesson 10-2
Why Tobacco? Introduction: This lesson asks students to examine many of the reasons why young people try smoking, including those directed at social relationships (friend and peer pressure) and affective changes (to deal with depression, boredom, or spur excitement); and the role of advertising and marketing in influencing how young people view smoking.
Lesson Objectives: By the end of Lesson 10-2, students will: W
Identify factors that encourage young Deaf people to use tobacco: self-esteem issues (including the desires to "look cool," "appear more mature," etc.); peer pressure (including the need to "fit in"); stress and depression; marketing efforts of tobacco companies; media images.
W
Recognize tobacco marketing strategies and their appeal
Materials: W
Tobacco advertising samples (provided on CD)
Key Terms: media: TV, radio, newspapers and other forms of mass communication restrictions: Laws and rules limiting a particular behavior billboards: Large outdoor signs used in advertising target marketing: Marketing that is geared to a particular group; for example, youth or a particular ethnic group
Page 10.2.1
Lesson 10-2: Why
Tobacco?
Procedures: 1.
Ask students to list all of the possible reasons they can think of that young people decide to smoke. Write these reasons on the board. These might include: W
curiosity or boredom: What is smoking all about? What is it like?
W
lack of knowledge about smoking: I didn't know smoking can harm my body, I didn't think I'd become addicted. W
L102_curious
friends' behavior: My friends were trying smoking, and I just went along. L102_FriendsDoIt
L102_Ignorance
W
family environment: My mom and dad both smoke, and my grandparents too.
W
relieve stress or depression: I found out that when I was feeling anxious,
L102_FamilySmokes
stressed or depressed, a cigarette helped calm me down or helped make me feel better.
W
to look older,
L102_Relax
more mature, cooler W
to be rebellious
L102_CoolGuy L102_Rebel
W
to fit in
L102_FitIn
Page 10.2.2
Lesson 10-2:
Why Tobacco?
Procedures: (continued) 2.
Examine friends' behavior. Ask the class to what extent they believe the behavior of their friends affects their own behaviors.
Ask students: W
Do you tend to think similarly to your friends? In what ways? Do you think you tend to make similar choices, for example, with respect to they type of clothing you wear, the music you
Teacher’s Note: Peer influence and peer pressure have been discussed in prior lessons 8-2 and 9-2. If your students have not been exposed to these lessons, you may want to review these important influences on tobacco use in this lesson.
listen to, and other choices you make? Do you think you tend to choose to behave in similar ways to how your friends behave? Point out that with respect to smoking, young people are much more likely to start smoking if their five best friends smoke.
Ask students: W
Why do you think this is so? When it comes to your own group of friends, how easy do you think it would be to resist smoking if your friends all smoked? Would you feel funny asking them not to smoke? What if your friends wanted to try smoking? How would you react? What would you say? How do you think you could avoid smoking in such a situation?
3.
Teacher’s Note: Point out to your students how their own attitudes towards tobacco use may be profoundly shaped by what they see: W if their parents smoke to reduce stress; W if they smoke to relax or enjoy a meal; W if they smoke to be sociable or have fun; OR: W if they’ve seen a parent ill from smoking; W if their parents’ smoking makes the home smell bad; W if there are arguments in the home about smoking, etc.
Examine family environment. Ask the class how many students have family members-parents, grandparents, siblings, other relatives-who smoke. Explain that research has also shown that those who grow up with family members who smoke are more likely to become smokers themselves than those who grow up in non-smoking families.
Ask students: W
Why do you think this is so? How do you think it would affect your own attitudes towards smoking if someone in your family smoked? Might growing up in a smoking household discourage smoking?
4.
Teacher’s Note: Examine relief of stress or depression: Young people often see smoking as a way to deal with stress or depression. This leads some young people to overlook the harmful effects of smoking.
Point out that while tobacco use may provide some relief of the symptoms of stress or depression (e.g., may make one temporarily feel better), it does little to address the underlying reasons why one feels depressed or stressed.
Page 10.2.3
Lesson 10-2:
Why Tobacco?
Procedures: (continued) Ask students: W
How effective do you think smoking is as a way to deal with stress or depression? What alternate ways can you use to deal with stress and depression? (Physical exercise, a hobby, meeting new people, etc.)
W
How many of you have friends or family members who smoke to deal with stress? How well do you think it works?
5.
Examine to look cool, more mature. Explain that teens sometimes believe that smoking will improve their image; that smoking can make them appear more mature or “cool.”
Ask students: W
Think of the teens you know who smoke. Do they seem more mature or attractive to you? How many of you think that smoking is attractive? How many would like to date someone who smokes? Marry someone who smokes? Live with someone who smokes? How many of you have been near someone who smokes? How does it make that person smell? What about their breath? Teeth? Fingers?
6.
Given how most people think about smokers and smoking, why do we still continue to see smoking as “glamorous,” “cool,” or “mature?” Write on the board: $11,2000,000,000 (11.2 billion dollars). Explain to students that cigarette companies spent this amount in 2001 to try to get people to smoke. Ask students why the tobacco companies spend such huge sums on advertising. W
To sell more cigarettes
W
To replace smokers who die each year
W
To get young people to start buying cigarettes so that they will become life-long customers.
What do they spend this money on? Everyone has probably seen traditional advertising by tobacco companies, such as this Camel Cigarettes magazine advertisement. Why do you think the makers of Camels chose this particular image? Who would it appeal to? L102_JoeCamel
Page 10.2.4
Lesson 10-2:
Why Tobacco?
Procedures: (continued) Tobacco advertising dollars are also used for in-store displays. How many of you have seen displays like these at corner grocery and liquor stores?
L102_InStoreAd
A great deal is also spent on special promotions, such as these mailed dollar-off coupons, giveaways, and purchase points that can be redeemed for other merchandise... L102_KoolRadio
L102_CamelPinups
L102_CapriAd
L102_Giveaway
...as well as on special promotional packaging for their products.
L102_NewportCoupon
Look closely at the Kool display and packaging for their “Soundtrack of the Streets� promotion. Who is the target of this appeal? What about the Stars packaging, with their flavored cigarettes?
L102_CamelGolf
L102_KoolDisplay
L102_StarsCollage
L102_SalemSlideBox
Page 10.2.5
Lesson 10-2:
Why Tobacco?
Procedures: (continued) Tobacco advertising dollars have also been used to sponsor sporting events, such as the Virgina Slims Tennis Championships, or Formula One racing...
L102_MarlboroRacing L102_Navratilova
...and for a host of promotional items including t-shirts, sports bags, toys, calendars, playing cards, and a multitude of other goods.
L102_CamelCalendar L102_CamelCards
L102_CamelToy
L102_KoolToys
L102_MarlboroBag
L102_CamelShirt
L102_CamelCup
Page 10.2.6
Lesson 10-2:
Why Tobacco?
Procedures: (continued) The tobacco companies have also used “stealth� marketing techniques, producing lifestyle magazines and using them as advertising vehicles. Who do you think these magazines appeal to?
L102_AlecBaldwin L102_AllWoman
L102_KoolMag
7.
Use the visual resources here and those from Lesson 9-3 to review with students the strategies used by companies to sell tobacco to teens. Make sure the students cover the following points:
8.
W
Fun & Pleasure
W
Good health
W
Adventure/Excitement
W
Money/Fame/Power
W
Beauty
W
Acceptance/Popularity
W
Romance
W
Brains/Intelligence/Wisdom
W
Free stuff!
Ask students to identify which of these strategies they are most vulnerable to and why. Ask if any of these approaches are particularly appealing to Deaf young people. Why?
Page 10.2.7
Lesson 10-2:
Why Tobacco?
Procedures: (continued) What kinds of situations do these cigarette advertisements depict? When students see these ads, what kind of ideas to they start to have about smoking? Do you think these advertisements might influence young people’s expectations for smoking? Ask your students to come up with adjectives to describe these scenes: for example, fun, excitement, friendship, exotic.
L102_NewportFun
L102_CamelCasbah
Source: www.trinketsandtrash.org
L102_CamelCasino
Source: www.trinketsandtrash.org
L102_KoolHipHop
Source: www.trinketsandtrash.org
L102_NewportRomance
Source: www.trinketsandtrash.org
Then ask students where the idea that “smoking is cool” comes from.
Source: www.trinketsandtrash.org
What about the idea that smoking is relaxing?
L102_SalemRelax
L102_ParliamentRelax
Source: www.trinketsandtrash.org
Or that smoking is romantic? Notice the effort to appeal to Spanish-language communities in this advertisement.
Source: www.trinketsandtrash.org
Page 10.2.8
Lesson 10-2:
Why Tobacco?
Procedures: (continued) What about the notion of smoking as being “manly” and “masculine”? How do you think these types of images will influence how teenaged boys will think about smoking? L102_VSlimsAppeal05
What is behind the s marketing of Virginia Slims Cigarettes, using the “You’ve come a long way, baby” tagline? Who is this advertising aimed at? How might it influence how young women think about smoking?
L102_CamelAviator
Why do you think some brands of cigarettes are marketed as “men’s” brands, while others are marketed as “women’s brands?” Aren’t cigarettes pretty much all the same?
L102_MarlboroCowboys
9.
Facilitate a group discussion of target marketing. Ask students about the places they've seen tobacco promoted: W
You saw an ad for cigarettes on a car racer's outfit. Who watches car races? Who do you think they are trying to reach? How does car
L102_VSlimsHistory
Valuable Resource: One interesting exercise may be to engage your students in “ad busting”—that is, to reveal the reality behind tobacco advertisements. An excellent outline for this exercise can be found at: www.cdc.gov/tobacco/sgr/sgr4kids/adbust.htm
racing affect your perception of smoking, or the type of person who smokes? W
You noticed a cigarette ad on a skimpy tank top. Who would wear that tank top? What does having an attractive or sexy person wearing tobacco brand names say about smoking?
W
An airplane flew over the beach with a cigarette logo on the side. Who is at the beach? You were at a sporting event, and saw a tobacco banner advertisement hanging on the wall. Who attends these sporting events?
Page 10.2.9
Lesson 10-2:
Why Tobacco?
Procedures: (continued) 10.
Ask the students to think about whether these advertisements and marketing efforts reach Deaf young people? What is it about the advertisements that makes them effective? What characteristics make them difficult for young Deaf people to interpret or understand?
11.
Explain to students that tobacco companies are legally forbidden from advertising directly to young people, but that they go to great lengths to show tobacco in ways that are very appealing to the young.
Ask students: Why is the teen market so attractive for tobacco companies? What are some of the ways companies might be able to make their advertising campaigns attractive to young people without actually showing young people in the advertisements? Make sure that the discussion covers the following points: W
Teens are one of the most powerful groups of consumers in the country; they tend to spend any money they have rather than save it as many older people do.
W
Teenagers will start to use a product, become loyal to it, and buy it for many years to come.
W
Tobacco companies make money by getting people addicted to their product. Younger smokers get "hooked" on cigarettes, and replace older smokers who die from smoking.
W
Teenagers influence other teens (peer pressure). If you wear a tobacco company's shirt, you are providing free advertising for the company to all of your friends.
W
What about advertisements showing young adults smoking and having fun? What about the use of cartoon characters such as Joe Camel?
Journal Have you ever bought something that you have been pressured to buy? What was it? Why did you feel pressured to buy it? How did you feel about this situation?
Page 10.2.10
Lesson 10-3
To Smoke or Not: It’s Your Decision! Introduction: The first two lessons in this unit explored many of the forces that encourage (or discourage) the use of tobacco. In the face of these forces, however, the individual still makes a decision to use or abstain from tobacco. This lesson teaches an explicit set of steps that students can use to analyze decisions and the consequences of choosing among different decisional choices, including the decision to use tobacco.
Lesson Objectives: By the end of Lesson 10-3, students will: W
Identify the different factors (self-esteem, friends, parents, peers, marketing) that influence the decision to use tobacco or not
W
Use the D.A.R.E. Decision Making Process to analyze how decisions are made in light of these different factors
W
Understand some of the ways in which they can influence others’ decision-making
Materials: W
D.A.R.E. Decision-Making Worksheet
Key Terms: D.A.R.E. Decision-Making Process: A series of steps taught to youth to help them define important decisions and analyze the options and consequences involved in each decisional choice. The components of the D.A.R.E. process are as follows:
decision making: the processes used in making a choice, especially with regard to behavioral choices.
(D) define the decision: What is the decision to be made? What are the issues? Do you understand them? (A) assess: What options are being considered for the decision? What are the consequences of each of the different options, for yourself as well as others around you? (R) respond: Choose which option is the safest for you, or has the most favorable impact. (E) evaluate: How good was the decision that was made? What were the impacts?
Page 10.3.1
Lesson 10-3:
To Smoke or Not: It’s Your Decision!
Procedures: 1.
Review the factors discussed in Lesson 10-2 that contribute to the decision to smoke. Some of these include curiosity or boredom; lack of knowledge about smoking; friends’ behavior; family environment; to relieve stress or depression; to look older, more mature, cooler or to fit in; to be rebellious. Point out that sometimes these factors can help kids decide not to smoke; for example, family members may be opposed to smoking; friends may discourage rather than encourage smoking. Or, students may decide not to
Teacher’s Note:
smoke because they know all about the dangers of smoking. In addition, there may be other forces discouraging smoking: local
Some good examples of how these factors exert both a “push” and a “pull” with respect to tobacco use can be found in Lesson 8-3, Friends, Peers and Others and Tobacco Use.
ordinances prohibiting smoking in public places, restaurants and bars; school regulations forbidding smoking on campus; the high cost of cigarettes; and so on. Nevertheless, young people still make the decision to try to smoke.
2.
How can we make better decisions? Review with students the D.A.R.E. Decision Making Process. Point out that the D.A.R.E. process encourages us to think carefully about the different aspects of making a decision-from defining what our actual choices are and why the decision is important, to identifying the consequences of our possible decisions. If we understand how friends, peers, family and others influence our decisions, we can more clearly identify our choices, assess their consequences,
Teacher’s Note: If your class has never covered the D.A.R.E. decision-making process before, you may need to take some time to review the steps with your students. The model can be found in Lesson 7-3, which uses the decision-making model of the Drug Abuse Resistance Education (D.A.R.E.) program, the pioneer prevention effort established in 1983. Given the widespread use of D.A.R.E. programming in the elementary grades, there is a significant likelihood that your students will have been previously exposed to the D.A.R.E. decision-making model. If not, the concepts underlying the model are relatively straightforward and are reviewed in Lesson 7-3.
and make wise decisions.
3.
Use the following situation and the D.A.R.E. Decision Making worksheet to demonstrate how the process can be applied. W
Jane is a good student. Her teachers like her very much. Lately, she has felt distressed because she is not getting the grades she would like. She is curious about cigarettes. Smoking looks like fun. Over the past few weeks, several of her friends have taken to sharing cigarettes after school. They’ve asked Jane if she would like to join them, but she knows the school has strict rules against smoking. Still, she sees kids her age at the mall smoking, and she thinks that maybe she'd like to try smoking just out of curiosity. Her smoking friends have also told her that cigarettes help them to relax.
Page 10.3.2
Lesson 10-3: To
Smoke or Not: It’s Your Decision!
Procedures: (continued) Jane’s mother has always told her that smoking is a nasty habit, and she has other friends who think that smoking is "yucky." Jane knows from class that smoking can cause health problems, but she thinks that not much will happen to her if she just tries smoking once or twice. Ask students to use the D.A.R.E. Decision Making Process worksheet to analyze the types of choices Jane faces, and the types of consequences she might face with whatever choices she makes.
L103_SmokingStinks
L103_Decisions03
L103_Decisions01
4.
Discuss with your students the way other students might have influenced Jane’s decision to smoke, both positively and negatively. Ask your students if they feel they can influence the decision-making of others: sisters or brothers, parents, friends, etc. Students should describe how they influence others and the way the feel about this responsibility.
Homework You are invited to a party where some of your classmates and some older kids are present. As everyone stands around talking, some people light a cigarette. They look cool and relaxed and very grown up. You are offered a cigarette. You have never smoked, and you know your parents don’t want you to start. Your closest friends find smoking “yucky,” but they are not at the party. What would you do? Complete the D.A.R.E. Decision-Making worksheet to explain your decision.
Page 10.3.3
Lesson 10-3 Homework: D.A.R.E. Decision-Making Process
Name __________________________________
Decisions, Decisions! The D.A.R.E. Decision-Making Process Worksheet
Instructions: Making decisions can be easier if you have a plan. Use this worksheet to decide how you would act if you were in the following situation. Once you’ve completed the worksheet, think about important decisions you’ve had to make, and how you would think about them now. You are invited to a party where some of your classmates and some older kids are present. As everyone stands around talking, some people light a cigarette. They look cool and relaxed and very grown up. You are offered a cigarette. You have never smoked, and you know your parents don’t want you to start. Your closest friends find smoking “yucky,” but they are not at the party. What would you do? Complete the D.A.R.E. Decision-Making worksheet to explain your decision.
Fill out the D.A.R.E. steps on the following page.
Lesson 10-3 Worksheet: D.A.R.E. Decision-Making Process
Name __________________________________
Decisions, Decisions! The D.A.R.E. Decision-Making Process Worksheet
Instructions: Making decisions can be easier if you have a plan. Use this worksheet to help Jane make some decisions about using tobacco. Once you’ve completed the worksheet, think about important decisions you’ve had to make, and how you would think about them now. Jane is a good student. Her teachers like her very much. She is also on the school basketball team, although she is not one of the starting five. Lately, she has felt distressed because she is not getting the grades she would like. She is curious about cigarettes. Smoking looks kind of fun. Over the past few weeks, several of her friends have taken to sharing cigarettes after school. They’ve asked Jane if she would like to join them, but she knows the school has strict rules against smoking. Still, she sees kids her age at the mall smoking, and she thinks that maybe she’d like to try smoking just out of curiosity. Her smoking friends have also told her that cigarettes help them to relax. Jane’s mother has always told her that smoking is a nasty habit, and she has other friends who think that smoking is “yucky.” Jane knows from class that smoking can cause health problems, but she thinks that not much will happen to her if she just tries smoking once or twice.
Fill out the D.A.R.E. steps on the following page.
L103_SmokingStinks
L103_Decisions03
L103_Decisions01
Lesson 10-4
The Consequences of Tobacco Use Introduction: In this lesson, students are introduced to the health and other impacts of tobacco use. These are divided into the classic long-term health effects (damage to the body’s respiratory and cardiovascular systems) as well as the short-term effects that are more likely to be relevant to young people. The concept of addiction is introduced, and will be explored in greater depth in Lesson 10-5.
Lesson Objectives: By the end of Lesson 10-4, students will: W
Identify the undesirable health and other consequences of tobacco use
W
Counter the myths that often characterize youth tobacco use
W
Understand the addiction cycle
Materials: W
Coffee stirrers (small, hollow straws) for an emphysema demonstration
W
The ABCs of Smoking Pamphlets and Transparencies
W
Mechanical Smoker
W
Journeyworks Inc. pamphlets: How Tobacco Affects Your Body A Teen’s Guide to Facts About Tobacco Smokeless Tobacco: Spit it Out!
W
What’s in Cigarette Smoke? Partial list of chemicals in tobacco
W
One User’s Story: Sean Marsee Handout (also on CD under “WebPages” folder
W
Tobacco advertising samples (provided on CD)
W
The Big Dipper video
Key Terms: health consequences: the physiological results, both immediate and long-term, of tobacco use
smokeless tobacco: chew, chewing tobacco and other tobacco products that are consumed orally, but not smoked.
social consequences: the results of tobacco use that pertain to relationships with others; compliance with school and community laws and regulations; economic impact; and other non-health considerations.
warning labels: messages on tobacco products or advertisements that are designed to discourage use of the product by explaining the health impact of using tobacco products.
Page 10.4.1
Lesson 10-4: The
Consequences of Tobacco Use
Procedures: 1.
Teacher’s Note:
Some long-term health consequences of tobacco use. Ask your class to list some of the most important health consequences of tobacco use. Students will probably list the most obvious, which are the long-term consequences of smoking and tobacco use: Respiratory system: Describe briefly the function of the lungs: with every breath, oxygen is extracted from the air
Some of the most frequently cited health consequences of tobacco use are discussed in Lessons 7-5, 8-6 and 9-4. These include the health effects on the respiratory system and lung function, and the resulting diseases of emphysema and lung cancer; the effects on the cardiovascular system, including atherosclerosis, heart disease and stroke; as well as more immediate effects on endurance, lung growth, and other health impacts. Students should be prompted to raise these health consequences at a minimum. This lesson also includes several participatory demonstrations of some of these health consequences. If your students have not done these in a prior lesson, they can be performed here.
and transferred to the bloodstream, which carries the oxygen to every cell in the body. At the same time, carbon dioxide, a waste product, is extracted from the blood and exhaled from the lungs. This gas exchange takes place in little air sacs called alveoli. Inhaled air also carries dirt, germs and other contaminants into the lungs. To clean these particles from the lungs, the lungs produce mucus, a thick fluid, which traps these foreign particles. This mixture of mucus and particles is then moved out of the lungs by little hair-like structures, called cilia, that line the lungs and airways, and that move back and forth to push the mucus out of the lungs. Whenever you cough or clear your throat, you are actually clearing some of this contaminantladen mucus out of your body. What does smoking do to the lungs? First, the smoke damages the cilia that moves mucus out of the lungs, making it more likely that germs, dirt and other contaminants (together with the mucus) will get trapped in the lungs. The more and the longer you smoke, the greater the damage done to these cells until they lose almost all of their ability to clean the lungs. The result is often “smoker's cough,” the hack-
Teacher’s Note: If your students have previously completed the 8th grade unit of this curriculum, they may have already studied the health and social consequences of tobacco use. If so, you may choose to present an abbreviated version of the material presented here.
Valuable Resource: Other facts and figures regarding smoking and young people can be found at: http://tobaccofreekids.org/research/ factsheets/index.php
Check This Out!: A wonderful interactive animated presentation of the effects of tobacco on different organ systems in the body can be found at: http://www.cdc.gov/tobacco/sgr/ sgr_2004/sgranimation/flash/ index.html
ing, mucus-laden cough that long-time smokers often experience, especially on awakening in the morning. If the lungs and airways become inflamed and clogged with mucus, this can lead to chronic bronchitis, making it difficult to breathe.
Page 10.4.2
Lesson 10-4:
The Consequences of Tobacco Use
Procedures: (continued)
Teacher’s Note:
Second, the smoke itself contains many harmful chemicals and contaminants that can damage the lungs. These chemicals are often referred to collectively as tars. Use the Mechanical Smoker to demonstrate the accumulation of tars in the lungs. Tar is like a thick, dark and sticky film that coats the inside of the lungs. Contact with the chemicals can cause damage to the lung tissue, eventually resulting in lung cancer, a disease that causes the
The chemical soup that makes up tobacco smoke (and tobacco juice) is discussed in greater detail in Lesson 9-4. If your students have not received this information previously, you may want to present it here, using the What’s In Cigarette Smoke? handout and the materials supplied with this curriculum.
destruction of healthy lung tissue. Smoking is the number one cause of lung cancer, and lung cancer
Demonstration:
is one of the leading causes of death in the United
Purpose: To demonstrate what it feels like to have emphysema.
States. More than 85% of people who get lung cancer die within five years. The more you smoke and the longer you smoke, the greater your chances of getting lung cancer. This risk is especially high for those who started smoking when they were young. Smoking also damages the alveoli, the little air sacs
Materials: Coffee stirrers (hollow) or very small straws Procedure: Have students place a coffee stirrer in their mouths. Explain that for the next two minutes, they can breathe ONLY through the coffee stirrer. After students have recovered, repeat the exercise, but this time ask students to walk around the room and try to talk with each other, again without inhaling anything except through the straw.
where gas exchange in the lungs takes place. This damage means that your lungs become much less able to perform the gas exchange that brings oxygen into your body. In some people, this damage goes on to become a disease called emphysema, where the lungs have lost most of their ability to absorb oxygen. In addition, smoking causes the airways (the lungs and the tubes leading to them) to overreact to
Explain: This is the way it feels ALL THE TIME if you have emphysema. No matter how hard you breathe, your body cannot get the oxygen it needs. Have students note how much worse it felt if they had to move around. Point out that any exertion—even just walking around—becomes very difficult for a person with emphysema.
harmful substances, causing them to tighten up ("constrict"), and leading to wheezing and shortness of breath. This can be especially serious for those people who already suffer from asthma.
Note that the disease is progressive—that is, it gets worse and worse over time—and has no cure. The disease is almost always fatal, but not before a long period of wasting and fatigue.
All of these physical changes impair the function of the lungs. Other Cancers Smoking is not only linked to cancer of the lungs, but cancer in other parts of the body as well. Cancer is actually several different diseases affecting different parts of the body, but having one characteristic in common—cancer cells reproduce in a wild and uncontrolled fashion, and crowd out and destroy healthy cells in the process.
L104_Alveoli
Page 10.4.3
Lesson 10-4:
The Consequences of Tobacco Use
Procedures: (continued) A healthy lung normally has a smooth surface. Compare the healthy lung with this diseased lung of a smoker. This lung shows lung cancer, the grayish-white bumps on the lung.
L104_HealthyLung
L104_LungCancer
Lung cancer is the most common cause of cancer death in both men and women. One of the reasons is that by the time it is discovered, the cancer has spread to different organs and tissues in the body. Smoking is the number one cause of lung cancer.
L104_BladderCancer
Chemicals from tobacco eventually end up in the urine, which then collects in the bladder. The bladder is then bathed in these cancer-causing chemicals, which can cause bladder cancer.
Oral cancers include those of the tongue, mouth, cheek and lips. One of the most important causes of oral cancer is tobacco, both smoked and chewed. Here, a sore on the tongue is cancer which, if not removed, may spread to other tissues.
s
L104_LiverCancer
Because the liver filters the body’s blood, it is a common site for cancer to spread. Smoking is the cause of laryngeal cancer, or cancer of the voicebox which is located in your throat.
L104_Larynx
L104_OralCancer
Page 10.4.4
Lesson 10-4:
The Consequences of Tobacco Use
Procedures: (continued) Cigarette smoking is the single most preventable cause of cancer. Cigarette smoke is known to contain at least 60 substances that can cause cancer in the body. Many of these substances are produced when tobacco is burned (and then inhaled into the body), but some of these substances are also present in unburned tobacco (which is why smokeless, or chewing, tobacco also causes cancer.)
Teacher’s Note: You may want to mention to your students that they can also be exposed to these chemicals through secondhand smoke (environmental tobacco smoke) from someone else’s smoking. This is discussed in Lesson 9-4.
Smoking and smokeless tobacco have been linked to cancer throughout the body, including cancers of the mouth, nose, throat, esophagus, salivary glands, bladder, kidney, pancreas, colon, rectum, cervix and vulva in women, the penis in men. It is also possibly linked to cancer of the stomach, prostate gland, and certain skin and blood cancers. How does this happen? When you use tobacco, either by smoking it or chewing it, your body absorbs (through the lungs, mouth, throat and eye tissues, and the skin) the chemicals that cause cancer. These chemicals then circulate in the bloodstream throughout the body. Cardiovascular Diseases
One User’s Story: If your students are not yet familiar with the story of Sean Marsee, you can present it here. The actual story illustrates the tragic consequences of chewing tobacco for one young man. The story can be found at: http://whyquit.com/whyquit/ SeanMarsee.html The story can also be found on the accompanying CD (in the “WebPages” folder, titled “Sean Marsee’s Message”). You might want to consider reviewing this story as a class exercise, or having students read it as part of a homework or journal exercise.
Smoking can also damage your heart and arteries. Your heart is responsible for pumping blood throughout your body. This blood is 1.
pumped through the lungs to pick up oxygen, and then
2.
pumped through a network of arteries, or tubes, that carry oxygenated blood to every cell in the body; and then
3.
through veins, that return the blood (now carrying carbon dioxide wastes) back to the lungs, where the carbon dioxide waste is exchanged for fresh oxygen.
How does smoking damage this system? 1.
Smoking causes atherosclerosis, a gradual clogging
L104_HeartDetail
and narrowing of the arteries that carry freshly oxygenated blood to the body's tissues and organs. If the arteries that supply the heart with oxygen become narrowed and clogged, the heart tissue can become damaged or destroyed, leading to a heart attack.
Page 10.4.5
Lesson 10-4:
The Consequences of Tobacco Use
Procedures: (continued) 2.
Smoking also increases blood pressure, or the amount of force the heart needs to exert to pump blood through the body. High blood pressure can also damage the heart and arteries.
3.
The resulting damage to the arteries that supply the heart may also lead to more gradual destruction of heart tissue, leading to a disease called congestive heart failure, where the heart is no longer fully able to pump blood.
4.
The damage to other arteries in the body, particularly those that supply the brain with oxygen, can also lead to strokes, in which narrowing or a clog in the arteries stops the blood flow to certain areas in the brain. The resulting lack of oxygen
L104_Atherosclerosis
causes these brain tissues to die, often leading to paralysis, loss of function (speech, walking, motor skills, etc.) and death. Smoking can also damage the skin, from the outside (direct exposure to cigarette smoke or tobacco juice and their harmful chemicals) and the inside (through damage to the blood vessels that supply the skin with oxygen and nutrients. When skin cells are exposed to smoke, and are unable to receive the oxygen and nutrients they need, one result is wrinkling. You can see this particularly in the lines around smokers’ mouths and eyes. In addition, the skin’s normal repair functions are affected, meaning that wounds—cuts and other skin injuries—heal much more slowly. These are just SOME of the effects of smoking on the body. Smoking also affects the body’s bones, leading to weaker bones more prone to breakage in old age; is linked to cataracts in the eye that can lead to blindness; can damage one’s sense of taste and smell; can interfere with the body’s normal immune function, making a person more susceptible to colds and disease; etc.
2.
Immediate Health Effects of Tobacco Use Tobacco use not only has long-term health consequences. It also has immediate health effects. W
Smoking interferes with the normal growth and development of the lungs as young people grow. If you smoke in your teens, chances are you are preventing your lungs from growing to their full potential.
W
Smoking causes more phlegm production and coughing, and other respiratory symptoms such as shortness of breath.
Page 10.4.6
Lesson 10-4:
The Consequences of Tobacco Use
Procedures: (continued) W
Smoking hurts physical fitness, especially endurance.
W
Smoking may make you more susceptible to colds and minor illnesses, meaning that young people who smoke tend to be less healthy than those who do not.
W
Smokeless, or chewing, tobacco can lead to mouth sores and gum disease, even at an early age.
Perhaps most important about this faulty belief (that a person can just smoke for a little while and cause no long-term health damage) is that most people who smoke "for a little while" end up addicted and smoking for many many years.
3.
Social Consequences of Smoking Ask your students if anyone can think of any reasons—other than harmful health impacts—that would discourage people from smoking. Prompt your students using some of the following examples: bad breath, burn holes in clothing, yellow teeth, harming others (secondhand smoke), causing fires, upsetting parents or friends, "grossing out" others, punishment for breaking "no smoking" laws or regulations, financial cost of smoking, etc. Compile answers into categories such as the following: consequences concerning how one appears to others (bad breath, dirty, smelly, etc.); those concerning relationships with others (parents, friends, etc.); those concerning rules and regulations; those concerning financial considerations (the costs of smoking). Also, as the health consequences of tobacco use have become better known, more and more people in our society and elsewhere have come to recognize these dangers and have decided to actively fight against smoking. There are increasing numbers of rules about where one can and cannot use tobacco products. Smoking is now prohibited in many workplaces—including schools, hospitals, airplanes, and public buildings. In some places it is difficult for smokers to get jobs because their smoking would expose other people to harm through the smoke from their cigarettes, cigars and pipes.
4.
Do these health and social consequences prevent young people from using tobacco products?
Teacher’s Note: You may want to mention to your students that they can also be exposed to the chemicals in tobacco smoke through secondhand smoke (the smoke from someone else’s burning cigarette). This is discussed in Lesson 9-4.
Sadly, very often the answer is “no.” Many of the health effects of tobacco use take a long time to develop. They are primarily problems of middle and older age. Young people don’t think about what
Page 10.4.7
Lesson 10-4:
The Consequences of Tobacco Use
Procedures: (continued) can occur later in their lives. Consequently, they don’t really think that these longterm consequences have anything to do with them. Moreover, young people do not often think about the immediate health and social consequences of tobacco use, until after they’ve begun to smoke or use smokeless tobacco. Often children and teenagers who start to smoke think that they will smoke for just a little while and then quit. They believe that they can quit any time they want. Even if they recognize the health and other consequences of tobacco use they believe that they will not be smoking long enough to experience these problems. Indeed, surveys have found that many young people—7 out of every 10 who have started to smoke—want to quit. Young people begin to experience the immediate health and social problems of tobacco use, often very soon after they start to smoke or chew tobacco. They may begin to think about the long-term problems that can occur, about how they are being manipulated to smoke, and may worry about the money they are spending to buy cigarettes. But when they try to quit, they often find that they are “hooked”—that it is difficult to stop. It may be difficult for them to resist peer and other pressures to smoke that got them started in the first place. Most important, they run into a characteristic of tobacco use that makes it difficult to quit—that tobacco use is highly addictive.
Homework: Pass out the story of 19 year-old Sean Marsee. Have students write about their reaction to the story. If you consider this assignment as too disturbing for your students, you may opt to use this story as an in-class exercise.
Page 10.4.8
Lesson 10-4
What’s in Tobacco Smoke?
What’s in Tobacco Smoke? Cancer Causing Agents Nitrosamines Crysenes Cadmium Benzi (a)pyrene Polonium Nickel P.A.H.s Dibenz Acidine B-Naphthylamine Urethane N. Nitrosonomicotine Toluidine
Metals Aluminum Zinc Magnesium Mercury Gold Silicon Silver Titanium Lead Copper
Acetone Nail polish remover
Acetic Acid Vinegar
Ammonia Floor and toilet cleaner
Arsenic Insecticides and poisons
Butane Cigarette lighter fluid
Cadmium Rechargeable batteries
Carbon Monoxide
Car exhause fumes
DDT/Dieldrin
Insecticides
Ethanol
Alcohol
Formaldehyde
Body tissue preservative
Hexamine
Lighter fluid
Hydrogen Cyanide
Gas chamber poison
Methane
Swamp gas
Methanol
Rocket fuel
Naphthalene
Moth balls
Nicotine
Insecticides
Nitrous Oxide Phenols Disinfectants Candle wax Solvents
Source of information: American Lung Association
Nineteen Year Old Sean Marsee's Tobacco Message
Talihina High School's most outstanding athlete, Sean Marsee had won 28 track medals in the 400 meter relay while running the anchor leg. His classmates honored him with a walnut plaque. After a ten month battle with rapidly spreading cancer that started on his tongue, Sean Marsee died at age 19.
A smokeless tobacco user since age 12, Sean refused to believe his mother's warnings that tobacco was hazardous, smoke or no smoke.
It was early on February 25th. Sean Marsee smiled a tired smile at his sister, pointed his index finger skyward, and an hour later, at age 19, Sean
Marsee was dead. Just ten months earlier, Sean, an 18 year-old high school senior and star of the school track team, was just a weekend away from competing in the state track finals, and just a month away from graduation. It was then that Sean opened his mouth and showed his mother an ugly sore on his tongue. His mother, a registered nurse, took one look and felt her heart sink. A user of smokeless chewing tobacco and snuff since age 12, rarely was Sean without a dip. Living from nicotine fix to nicotine fix, he went through a can of snuff every day and a half. When Sean's mother finally discovered his secret she hit the roof. She tried explaining just how hazardous that tobacco was for him, smoke or no smoke, but Sean Sean Marsee before the final battle. refused to believe her. He argued that other boys on the track team were dipping. He argued that his coach knew and didn't seem to care. He argued that high profile sports stars were using and marketing smokeless tobacco. How could it be dangerous, he pleaded. In the end, his mother simply dropped the subject. But now, an angry red spot with a hard white core, about the size of a half-dollar, was being worn by his tongue. "I'm sorry, Sean," said Dr. Carl Hook, the throat specialist. "It doesn't look good. We'll have to do a biopsy." Sean was stunned. Aside from his addiction to nicotine, he didn't drink, he didn't smoke and he took excellent care of his body; watching his diet, lifting weights and running five miles a day, six months a year. Now this. How could it be? "But I didn't know snuff could be that bad for you," Sean said. "I'm afraid we'll have to remove that part of your tongue, Sean," Dr. Hook said. The high school senior was silent. "Can I still run in the state track meet this weekend?" he finally asked. "And graduate next month?" Dr. Hook nodded. On May 16th, Dr. Hook performed the operation. More of Sean's tongue had to be removed than was anticipated. Worse yet, the biopsy results were back and the tumor tested positive for cancer. Arrangements were made for Sean to see a radiation therapist, but before therapy began, a newly swollen lymph node was found in Sean's neck. It was an ominous sign that the cancer had spread. Radical neck surgery had now become necessary. Dr. Hood gently recommend to Sean that he undergo the severest option: removing the lower jaw on the right side, as well as all lymph nodes, muscles and blood vessels except for his artery. There might be some sinking, he explained, but the chin would support the general planes of the face. His mother began to cry. Sean was being asked to approve his own mutilation. This was a teenager who was so concerned about his appearance that he'd even swallow his dip rather than be caught spitting tobacco juice. They sat is silence for ten minutes. Then, dimly, she heard him say, "Not the jawbone. Don't take the jawbone." "Okay, Sean, " Dr. Hook said softly. "But the rest; that's the least we should do." On June 20th Sean underwent his second surgery. It lasted eight hours.
At school, 150 students and teachers assembled in June to honor their most outstanding athlete. Sean could not be there to receive their award. His Coach and his assistant came to Sean's home to present their gift, a walnut plaque. They tried not to stare at the huge scar that ran like a railroad track from their star performer's earlobe to his breastbone. Smiling crookedly out of the other side of his mouth, Sean thanked them. With five weeks of healing and radiation therapy behind him, in August Sean greeted Dr. Hood with enthusiasm, plainly happy to be alive. Miraculously, Sean had snapped back. He really believes his superb physical condition is going to lick it, Dr. Hook thought. Let's hope he's going to win this race too. But in October Sean started having headaches. A CAT scan showed twin tentacles of fresh malignancy, one snaking down his back, the other curling under the base of his brain. In November, Sean underwent surgery for the third time. It was the jawbone operation he had feared - and more. After 10 hours on the operating room table, he had four huge drains coming from a foot long crescent wound, a breathing tube sticking out of a hole in his throat, a feeding tube through his nose, and two tubes in his arm veins. Sean looked at his mother as if to say, "My God, Mom, I didn't know it was going to hurt like this." The Marsees brought Sean home for Christmas. Even then, he remained optimistic until that day in January when he found new lumps in the left side of his cheek. His mother answered the phone when the hospital called with the results of the biopsy. Sean knew the news was bad by her silent tears as she listened. When she hung up, he was in her arms, and for the first time since the awful nightmare started, grit-tough Sean Marsee began to sob. After a few minutes, he straightened and said, "Don't worry. I'm going to be fine." Like the winning runner he was, he still had faith in his finishing kick. One day Sean confessed to his mother that he still craved his snuff. "I catch myself thinking," he said, "I'll just reach over and have a dip." Then he added that he wished he could visit the high-school locker room to show the athletes "what you look like when you use it." His appearance, he knew would be persuasive. A classmate who had come to see him fainted dead away. Shortly before Sean's death he told his mother that there must be a reason that God decided not to save him. Sean's mother believes that Sean's legacy is in having his story spread and hopefully "keeping other kids from dying." When Sean became unable to speak, a friend asked him if their was anything he wanted to share with other young athletes. With pencil in hand Sean wrote, "Don't dip snuff." On the morning of February 25th, Sean Marsee, age nineteen, exhaled his last breath.
Compiled using photos, facts and extensive quotations from an October 1985 Reader's Digest article by Jack Fincher, entitled "Sean Marsee's Smokeless Death," located at pages 107 through 112. Compiled by John R. Polito, Founder WhyQuit.com, June 2000
Youth Nicotine Addiction Warning Signs
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Last Updated on October 8, 2002 by John R. Polito
Lesson 10-5
Hooked! The Process of Addiction Introduction:
This lesson expands on the concept of addiction, and explains the mechanism of the addiction cycle. The lesson emphasizes the relative quickness with which addiction can occur; and the importance of prevention (that is, avoiding any tobacco use at all) because of the difficulty of quitting once an addiction has formed.
Lesson Objectives: By the end of Lesson 10-5, students will: W
Plan Ahead!
Describe early tobacco use as a strong
This lesson calls for having a guest speaker who can give a first-person narrative of how difficult it is to quit smoking. To find such a person, contact your local American Lung Association or American Cancer Society to see if they can suggest a volunteer to speak to your class. Such volunteers might include smokers who have tried (and failed) to quit, or former smokers who have successfully quit.
predictor of prolonged addiction W
Review the following concepts: addiction, cessation, and withdrawal
W
Identify reasons that people quit smoking
W
Define the term relapse
Materials: W
I Don't Want to Use Tobacco Pictionary Cards
W
One Addict’s Story: Bryan Curtis Handout (also on CD in the “WebPages” folder)
W
Graphic: The Addiction Cycle
W
Reasons for Avoiding or Quitting Tobacco Use Worksheet
Key Terms: addiction: Extreme physiological and psychological dependence on a substance such as tobacco, alcohol or other drug, that has progressed beyond voluntary control. People who are addicted often feel sick when they stop using this substance. cessation: In terms of tobacco use, the process of stopping all tobacco use, particularly after one has already become addicted.
relapse: In terms of tobacco, starting to smoke or chew tobacco again after an attempt at quitting has been made; to take up tobacco use again after a period of abstinence. withdrawal: The range of unpleasant physiological and emotional reactions of the body in response to withholding a drug (such as nicotine in tobacco products) that the body has become addicted to.
Page 10.5.1
Lesson 10-5: Hooked!
The Process of Addiction
Procedures: 1.
Ask students to define the terms addiction and withdrawal.
2.
Ask your students:
Teacher’s Note: If your class has not learned these terms in a prior unit (e.g., Lesson 9-5 in the 9th grade curriculum) review the following procedures as necessary. If your class has covered these concepts, skip to Activity 5.
What is addiction, and how does it happen? Explain to students that people often use the word “addiction” in a very general way. They’ll say, “I’m addicted to pizza,” or “I’m addicted to that television show,” referring to any behavior someone might find pleasurable and doing excessively. However, when it comes to behaviors such as tobacco use or drug use, “addiction” means something very different. With true addiction, the following things happen: W
The substance produces a pleasant feeling.
W
Over time, you need to use more and more of the substance to obtain this pleasant feeling.
W
If you stop using the substance, you will feel unpleasant feelings called withdrawal symptoms. You will feel better only if you can use more of the substance.
W
You will continue to use this substance to pursue this pleasant feeling and avoid feeling bad, even if you know the substance is harming your body.
3.
Show the graphic of the Addiction Cycle. In tobacco, the drug nicotine is the substance that causes addiction to smoking and other tobacco use. Nicotine is found in all tobacco products: cigarettes, cigars, pipe tobacco, smokeless (chewing) tobacco, bidis, kretek, etc. Let’s examine the addiction cycle: that is, how a young person like you can quickly become addicted to tobacco. Pleasant feelings Smoking a cigarette may cause some initial dizziness or nausea as a person becomes accustomed to inhaling smoke. But it also produces a pleasant sensation almost immediately. This sensation is caused by nicotine. Within seconds of inhaling tobacco smoke (or placing a plug of smokeless tobacco in the mouth), nicotine is absorbed into the bloodstream where it quickly travels to the brain. Here, the nicotine causes chemical changes in the brain that produce the pleasant sensation. This pleasant feeling wears off quickly, and the smoker must inhale more smoke to experience that pleasant feeling again. The desire for these sequences of little nicotine “hits” is what encourages more regular use.
Page 10.5.2
Lesson 10-5:
Procedures: (continued)
6
So you smoke another cigarette. And the cycle starts over again.
Hooked! The Process of Addiction
1
Within seconds of inhaling, nicotine speeds its way to your brain.
5
2
Over time, your brain becomes accustomed to nicotine stimulation. Once this happens, you experience unpleasant withdrawal symptoms if your nicotine craving is not satisfied.
4 Your brain starts to crave
another “hit� of nicotine— telling you to smoke another cigarette.
In your brain, nicotine causes the release of a chemical called dopamine which stimulates feelings of pleasure and relaxes you.
3
But as soon as you stop smoking, this stimulation wears off as the nicotine level in your body falls. L87_AddictionCycle
The need to use more and more As a person starts to use tobacco (and nicotine) regularly, their brain and body become less sensitive to the pleasurable effects of nicotine. This is called building up tolerance, and means that the smoker or smokeless tobacco user needs to smoke (or chew) more, and more often, in order to receive the same pleasurable sensations as he did before. Withdrawal symptoms As the body becomes accustomed to nicotine, body and brain cells become dependent on the nicotine in tobacco. While nicotine may produce pleasurable sensations in the body, withholding nicotine starts to cause a number of unpleasant sensations, which range from mild to severe: W
Feeling restless
W
Feeling irritable, moody or tense
W
Insomnia
W
Headaches or dizziness
W
Sweating and unsteadiness
W
Nausea or physical illness
Page 10.5.3
Lesson 10-5:
Hooked! The Process of Addiction
Procedures: (continued) These physical symptoms are known as withdrawal symptoms. Withdrawal can be a very uncomfortable feeling, and is the reason why most people find it so difficult to quit smoking after becoming addicted to nicotine. To relieve these withdrawal symptoms, the smoker or tobacco user must smoke another cigarette, or place another plug of smokeless tobacco in their mouth. Hooked! Addiction can happen very quickly, especially in young people. Some teenagers start experiencing withdrawal symptoms, even if they feel they are just “playing around” and smoking a few cigarettes a week! When a person is dependent on nicotine, they feel that they don't have a choice about using tobacco anymore. They feel they must use tobacco. They must plan where they go and what they do so that they will be able to use the drug nicotine. It is like carrying a ball and chain. Addiction creates a feeling of need—a craving-in your body and your brain. People who are addicted to nicotine in tobacco will continue to smoke, even if they know they are doing great harm to their health. This is why you often hear smokers say, “I know I should quit. But I can’t.”
4.
Most people who experiment with, and begin to casually use, tobacco, plan to quit when they get older. But most people find it very difficult to quit once they've become addicted. Research shows that nicotine is as addictive as cocaine and heroin. Ask students to think about what this means.
5.
Why is preventing tobacco use so important? Review with your students some of the reasons why young people try smoking (from Lesson 10-2): W
curiosity or boredom: What is smoking all about? What is is like?
W
lack of knowledge about smoking: I didn't know smoking can harm my body, I didn't think I'd become addicted.
W
friends’ behavior: My friends were trying smoking, and I just went along.
W
family environment: My parents smoke; My siblings smoke.
W
relieve stress or depression: I found out that when I was feeling anxious, stressed or depressed, a cigarette helped calm me down or helped make me feel better;
W
to look older, more mature, cooler; to fit in
W
to be rebellious
Page 10.5.4
Lesson 10-5:
Hooked! The Process of Addiction
Procedures: (continued) Ask your students: W
Teacher’s Note:
These are some of the most common reasons for why young people start to smoke. But what about someone your age who already smokes regularly? What do you think are some of the most common reasons for why kids continue to smoke or use other tobacco products?
Students may volunteer a number of different answers, including those on the previous page. But make sure that one important answer—addiction— is mentioned. “I smoke because I can’t quit.”
If none of your students mentions addiction, present the following fact. W
When researchers talk to young people who smoke regularly, more than 7 out of 10 say they wish they’d never started smoking. So why do they continue to smoke?
Emphasize that the list of reasons why people-including young people-continue to use tobacco products is different than the list of reasons why they started using tobacco in the first place. Any list of reasons for continuing tobacco use MUST have ADDICTION at the very top. Help students to recognize that prevention—never starting to use tobacco products in the first place—is very important because of the addictive nature of nicotine at all ages. Remind students that many young people believe that if they just smoke a little, they will not become hooked. Yet once a person starts smoking, it’s difficult to continue smoking “just a little.” Smoking “just a little” can quickly lead to “smoking a lot” and addiction.
6.
What are some of the reasons why people should quit smoking, or avoid smoking in the first place? Have the class play the I Don't Want to Smoke Pictionary game. Divide the class into two groups. Using Pictionary cards, have the teams play accordingly: W
One person from Team A is chosen to select a card and read it silently. If he or she does not understand the card, the
One User’s Story: Another tragic story of the difficulty of quitting smoking can be found at: http://whyquit.com/whyquit/BryanLeeCurtis.html The story can also be found on the accompanying CD (in the “WebPages” folder, titled “Smokin Kills: Bryan’s message”). You may want to use this story as a class exercise, or a homework or journal exercise. Make sure you ask students to pay attention not only to Bryan’s smoking, but also to that of his family members, who find it difficult to stop, even in the face of Bryan’s illness.
teacher can explain it. W
The person will draw the reason for quitting or avoiding smoking on the board. Team A has 45 seconds to correctly guess the reason. If they are successful, they will receive 5 points.
W
If Team A cannot guess the picture within the allotted time, Team B gets a chance to guess the answer for 3 points.
Page 10.5.5
Lesson 10-5:
Hooked! The Process of Addiction
Procedures: (continued)
7.
W
Team B draws and guesses.
W
For bonus points, teams can come up with more ideas.
Explain to students that while some people quit smoking and or chewing tobacco successfully the first time, others cannot quit and begin smoking again. This is called relapse. Some smokers quit and relapse many times before they successfully quit forever. Some people never quit. Have the class discuss the following statement: “Death is the cure for smoking.”
8.
Guest Speaker: The purpose of the guest speaker is to provide a first-person narrative of the difficulties of quitting an addictive behavior such as smoking. Contact the local branch of the American Cancer Society, the American Lung Association, the American Heart Association, or other similar agency for assistance in identifying a smoker or ex-smoker who has attempted to quit smoking and experienced relapse. If possible, the Guest Speaker should be deaf to facilitate communication with the class. Invite the Guest Speaker to come to class and discuss the factors involved in the decision to quit smoking, the process of quitting, and the circumstances of his or her relapse.
Homework: Ask students to complete the Reasons for Quitting or Avoiding Smoking worksheet, to list reasons why people should quit smoking if they smoke, or why they should avoid smoking in the first place if they've never tried before. Encourage your students to add their own circles to the worksheet if they have ideas that are not already listed.
Journal: Have you ever made changes in your life that you considered an improvement, and then fallen back into your old habits—for example, lost weight and gained it back, or improved your grades and then failed again? Describe what happened and how it made you feel. Alternative Journal Question: Some people have sued cigarette companies because they smoked and got cancer or emphysema. These people feel that the cigarette companies are responsible for their disease. What do you think about this? Who is responsible if a smoker gets sick from smoking?
Page 10.5.6
Lesson 10-5 Graphic: The Addiction Cycle
The Addiction Cycle 6
So you smoke another cigarette. And the cycle starts over again.
1
Within seconds of inhaling, nicotine speeds its way to your brain.
5
Over time, your brain becomes accustomed to nicotine stimulation. Once this happens, you experience unpleasant withdrawal symptoms if your nicotine craving is not satisfied.
4
Your brain starts to crave another “hit” of nicotine— telling you to smoke another cigarette.
2
In your brain, nicotine causes the release of a chemical called dopamine which stimulates feelings of pleasure and relaxes you.
3
But as soon as you stop smoking, this stimulation wears off as the nicotine level in your body falls.
Smoking Kills
"He Wanted You to Know"
On the day of Bryan's death, June 3, wife Bobbie and son Bryan keep a bedside vigil. The recent photo of father and son is on the bed. [Times photo: V. Jane Windsor]
by Sue Landry
Bryan Curtis started smoking at 13, never thinking that 20 years later it would kill him and leave a wife and children alone. In his last weeks, he set out with a message for young people.
ST. PETERSBURG -- Cigarette smoke hangs in the air in the room where Bryan Lee Curtis lies dying of lung cancer. His head, bald from chemotherapy, lolls on a pillow. The bones of his cheeks and shoulders protrude under taut skin. His eyes are open, but he can no longer respond to his mother or his wife, Bobbie, who married him in a makeshift ceremony in this room three weeks ago after doctors said
there was no hope. In Bryan's emaciated hands, Bobbie has propped a photograph taken just two months ago. It shows a muscular and seemingly healthy Bryan holding his 2-year-old son, Bryan Jr. In the picture, he is 33. Bryan Lee Curtis, then 33, holds son Bryan He turned 34 on May 10. Jr., 2, in this March 29 photo. Curtis would die about two months later.
[Photo: Curtis
Family]
A pack of cigarettes and a lighter sit on a table near Bryan's bed in his mother's living room. Even though tobacco caused the cancer now eating through his lungs and liver, Bryan smoked until a week ago, when it became impossible. Across the room, a 20-year-old nephew crushes out a cigarette in a large glass ashtray where the butt joins a dozen others. Bobbie Curtis says she'll try to stop after the funeral, but right now, it's just too difficult. Same for Bryan's mother, Louise Curtis. "I just can't do it now," she says, although she hopes maybe she can after the funeral. Bryan knew how hard it is to quit. But when he learned he would die because of his habit, he thought maybe he could persuade at least a few kids not to pick up that first cigarette. Maybe if they could see his sunken cheeks, how hard it was becoming to breathe, his shriveled body, it might scare them enough. So a man whose life was otherwise unremarkable set out in the last few weeks of his life with a mission.
*** Bryan started when he was just 13, building up to more than two packs a day. He talked about quitting from time to time, but never seriously tried. Plenty of time for that, he figured. Older people got cancer. Not people in their 30s, not people who worked in construction, as a roofer, as a mechanic. He had no health insurance. But he was more worried about his mother, 57, who had smoked since she was 25. "He would say, "Mom, don't worry about me. Worry about yourself. I'm healthy,' " Louise Curtis remembers. "You think this would happen later, when you're 60 or 70 years old, not when you're his age." He knew, only a few days after he went to the hospital on April 2 with severe abdominal pain, how wrong he had been. He had oat cell lung cancer that had spread to his liver. He probably had not had it long. Also called small cell lung cancer, it's an aggressive killer that usually claims the lives of its victims within a few months. While it seems unusual to the Curtis family, Dr. Jeffrey Paonessa, Bryan's oncologist, said he is seeing more lung cancer in young adults. "We've seen lung cancer earlier and earlier because people are starting to smoke earlier and earlier," Paonessa said. Chemotherapy sometimes slows the process, but had little
effect in Bryan's case, he said. Bryan also knew, a few days after the diagnosis, that he wanted somehow to try to save at least one kid from the same fate. He sat down and talked with Bryan Jr. and his 9-yearold daughter, Amber, who already had been caught once with a cigarette. But he wanted to do more. Somehow, he had to get his story out. When he still had some strength to leave the house, kids would stare. "They'd come up and look at him because he looked so strange," Louise Curtis said. "He'd look at them and say, "This is what happens to you when you smoke.' "The kids would say, "Oh, man. I can't believe it,' " Louise Curtis said. In the last few weeks, Bryan's mother has been the agent for his mission to accomplish some good with the tragedy. She has called newspapers and radio and television stations, seeking someone willing to tell her son's story, willing to help give him the one thing he wanted before he died. Bryan never got to tell his story to the public. He spoke for the last time an hour before a visit from a Times reporter and photographer. "I'm too skinny. I can't fight anymore," he whispered to his mother at 9 a.m. June 3. He died that day at 11:56 a.m., just nine weeks after the diagnosis. Bryan Lee Curtis Sr. was buried at Memorial Park Cemetery in St. Petersburg on June 8, a rare cloudy day that threatened rain. At the funeral service at nearby Blount, Curry and Roel Funeral Home, Bryan's casket was open and 50 friends and relatives could see the devastating effects of the cancer. Addiction is more powerful. As the graveside ritual ended, a handful of relatives backed away from the gathering, pulled out packs of cigarettes and lit up.
Originally Published on June 15, 1999 in the St. Petersburg Times Posted at www.WhyQuit.com on July 15, 1999
January 23, 2001 - "It's almost been 2 years now. We set and watch home movies of us. His son is missing him too. Christmas was the worst. He had to go outside and show his dad what he got for Christmas. That really tore me up." Bobbie Jo Curtis
February 28, 2002 - Bobbie indicates that Bryan's mother was able to quit smoking following her son's death. Bryan Jr. will turn six on August 23, 2002, at which time he will have been fatherless for more than half his life. Email Bobbie and Bryan Jr.
Have you met Noni? Have you heard 19 year old Sean's message ... ... or from those lucky enough to survive the worst scare of their life! Why do two million middle-aged smokers smoke themselves to death each year? Will you be one of them? Knowledge is power!
WhyQuit.Com | About Us | Contact Us | Link to Us | What's New?
Last Updated on August 10, 2003 byJohn R. Polito
Lesson 10-5: Pictionary Game
“I Don’t Want to Use Tobacco” An Anti-Tobacco Pictionary Game
“My friend has been smoking cigarettes again, and his breath smells really bad.”
“Basketball and smoking don’t mix.”
“Food smells and tastes much better if you don’t smoke.”
“Kissing a smoker is like licking an ashtray.”
“My girlfriend thinks it’s sexy when I spit out tobacco juice.”
“Smoking makes me look cool— yellow teeth, brown fingers, and holes in my clothes!”
“Cigarettes or: movie tickets; a new book; video games; new clothes”
“I want to be a good role model for my younger brother and sister.”
Lesson 10-5: Pictionary Game
“I Don’t Want to Use Tobacco” An Anti-Tobacco Pictionary Game - Page Two
“I wonder why my friends all get up and leave whenever I light up a cigarette?”
“Yes, smoking makes you look older—it causes your skin to wrinkle.”
“Coach told me if I smoke, I’m off the team.”
“My parents would kill me if they caught me smoking.”
A fool says, “I smoke everyday because I want to. I can quit anytime I want!”
“Smoking hurts your endurance.”
“Your smoke makes me choke!”
“If you smoke while you’re pregnant, you can hurt your unborn child.”
Lesson 10-5 Worksheet: Reasons for Avoiding or Quitting Smoking
Name __________________________________
Reasons for Avoiding or Quitting Tobacco Use Family
Friends
___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________
___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ Money
Instructions: Provide reasons why you should avoid or quit tobacco use.
Health ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________
___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ Other ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________
Lesson 10-6
Convincing Others Not to Smoke Introduction: This lesson introduces students to the world of social action,
especially the tobacco control movement that has arisen in response to the large amount of information now available about the dangers of smoking, the hazards of secondhand smoke exposure, and the lengths to which tobacco companies have gone to keep this information from public view. The marketing strategies of tobacco companies have also been an impetus for social action, particularly for young people.
Lesson Objectives: By the end of Lesson 10-6, students will: W
Investigate a smoking prevention program
W
Contact community-based voluntary organizations to collect prevention, cessation and other anti-tobacco information directed to youth.
W
Access information and resources on the web. This can include, for example the Tobacco Free Kids website (www.tobaccofreekids.org), the
Plan Ahead! This lesson asks students to access community-based resources to assess existing anti-tobacco efforts, and to consider how they might design a similar effort to reach the Deaf. Many of these resources are available online, and we have provided web page addresses that can serve as starting points. If appropriate, you may wish to assign certain web sites to groups of students to explore and present to the class, or the searching can be done as a class exercise. Samples of anti-tobacco educational materials can also be obtained free of charge from:
Truth campaign (www.thetruth.com), the
www.journeyworks.com
American Legacy Foundation (www.americanlegacy.org), and Canada's anti-tobacco website (www.infotobacco.com). W
Discuss why the government would require cigarette companies to put a warning label on their product.
W
Write "BE SMART, DON'T START" letters aimed at younger students
W
Teacher’s Note: You may want to start this lesson by reviewing statistics about the proportion of young people in different grades who have tried smoking. This information is presented in Lesson 8-5.
Organize a "BE SMART, DON'T START" campaign at school.
Materials: W
Internet or Phone Access
W
Web Addresses
W
Anti-tobacco materials (collected by students from voluntary organizations and the state and local departments of health)
W
Anti-tobacco warnings for tobacco packaging (U.S., Canada and Brazil)
W
Journeyworks, Inc. Pamphlet: 10 Best Reasons Not to Smoke While You’re Pregnant
Page 10.6.1
Lesson 10-6:
Convincing Others Not to Smoke
Procedures: 1.
Ask students to think about what messages would help young people and adults on campus to be more resistant to smoking or to help them quit. Students should think about the kinds of components an effective program would have.
2.
Ask students to use the internet to contact the American Cancer Society, the American Lung Association, TobaccoFreeKids and other organizations listed above, to obtain information and materials they might be able to use to promote an anti-tobacco program on campus.
3.
Review the anti-tobacco advertisements provided and any materials that were collected by students. Gather the class around a table and lay out the anti-tobacco materials . Ask the students to group them by the educational approaches used, e.g., those that address the health impacts of tobacco use; those that address the cosmetic aspects (makes your clothes, hair, breath smell bad, etc.); those that address some of the other physiological impacts of smoking (eg., the link to impotence in males); those that address tobacco executives, tobacco marketing, and the profit motives in pushing tobacco; etc. Ask the students to discuss the relative merits of each of these approaches: W
Do you think this is a good way to get kids to not smoke?
W
Why do you think this approach would work? What about for Deaf youth?
W
Are the messages clear and understandable for Deaf youth?
W
Do you think that telling young people about the health effects of tobacco use really "works" to discourage this use?
W
What kind of messages do you think work best?
Some anti-tobacco messages focus on the health effects of smoking.
L106_Insides
L106_DebVoicebox
Page 10.6.2
Lesson 10-6: Convincing
Others Not to Smoke
Procedures: (continued)
L106_EKG
L106_Fingernails
L106_ChemotherapyScares
s These ads also touch on the health impacts of tobacco use.
L106_Limp
L106_MindIfISmoke
L106_BlewAway
L106_ChronicCoffin
Page 10.6.3
Lesson 10-6: Convincing
Others Not to Smoke
Procedures: (continued) These advertisements focus on the harmful ingredients in tobacco products, cigarette smoke and secondhand smoke.
L106_BugSpray
“Many bug sprays contain nicotine. All cigarettes do.”
L106_Frog
“The same formaldehyde that preserves dead frogs is found in cigarettes.”
L106_RatPoison
“Cyanide is the deadly ingredient in rat poison. And just one of the many in cigarettes.”
L106_SmokeFree
L106_HighChair
s L106_SmokeFree02
These advertisements focus on the people who are affected by secondhand smoke exposure.
L106_DaddysEyes
Page 10.6.4
Lesson 10-6: Convincing
Others Not to Smoke
Procedures: (continued)
L106_ButtsGross
These advertisements poke fun at the notion that smoking is cool and attractive.
L106_UtterFool
L106_GoodLooks
L106_BrookeShields
L106_ChewingMales
Page 10.6.5
Lesson 10-6: Convincing
Others Not to Smoke
Procedures: (continued)
L106_ChristyBeauty
L106_tonyhawks
L106_ChristysLungs
L106_ImproveGame
L106_JackieChan
L106_Boyz2Men
These advertisements rely on celebrity endorsement of being smoke-free.
L106_Sosa
Page 10.6.6
Lesson 10-6: Convincing
Others Not to Smoke
Procedures: (continued)
L106_SweetProducts
s
L106_CoverUp
4.
These anti-tobacco advertisements take direct aim at the tobacco industry and their marketing and advertising practices.
Provide each student with an empty cigarette package. Discuss with your students who the Surgeon General is, and what the various warning labels say. List these warnings on the board. Ask your students to identify who is targeted by each of the Surgeon General's warnings.
5.
L106_RealMarlboro
Discuss with your students the reasons that the government would require warning labels on cigarette packs. Provide your students with a brief accounting of how these labels came to be placed on cigarette packages. Ask your students the following: W
Do you think these warnings are effective? How about for young people like yourselves?
W
When you look at the packages from Canada, what differences do you notice from those of the United States? Do you think the explicit pictures of diseased lungs, oral cancer, and such would dissuade young people like yourselves from starting to smoke? Why or why not?
W
Do you think the warnings on cigarette packages from the United States should be stronger? In what ways?
Page 10.6.7
Lesson 10-6: Convincing
Others Not to Smoke
Procedures: (continued)
L106_SGLabels
L106_Brazil01
L106_Brazil04
L106_Brazil03
Cigarette warning labels required on tobacco products sold in Brazil
L106_Canada03
L106_Canada05
L106_Canada07
L106_Canada04
Cigarette warning labels required on tobacco products sold in Canada
Page 10.6.8
Lesson 10-6: Convincing
Others Not to Smoke
Procedures: (continued) 6.
If the students could design warning labels that would appeal to Deaf youth like themselves, what would those labels look like? Divide the class into groups and ask them to prepare a health alert message to put on cigarette packages and other tobacco products, into pamphlets, in videos, or on posters. Ask students to think about how they would appeal specifically to Deaf young people like themselves. Would they use the same message in each of these places? Why or why not? Have the students present their messages to the class.
7.
Using the 10 Best Reasons Not To Smoke While You're Pregnant pamphlet by Journeyworks Publishing Inc., internet and library resources, have students identify the harmful effects that smoking has on the unborn child. List these on the board.
8.
Review with the class the current Surgeon General's warning labels that refer to pregnancy and smoking. Have them discuss the following: W
Do you think this message is powerful?
W
Compare this label with those required by other countries. Do you think the existing labels required by the U.S. government for pregnant women are strong enough, or should they be stronger? Why or why not?
9.
Explain to students that they are going to undertake a project to influence younger students to NOT smoke. W
They will start a program called BE SMART, DON'T START.
W
They will each write a letter to a younger student.
W
The purpose of the letter is to convince the younger student NOT to smoke. The letters should include information about the effects of smoking on the body, decision-making, and refusal skills.
W
Teacher’s Note This project can be undertaken as an imaginary one, or you may think about implementing this to target students in the lower grades.
Students can then work in groups to design a poster for the BE SMART, DON'T START project.
Journal: Think about the materials you have reviewed. If you were in charge of providing an anti-tobacco program for your school, what would you do? Why?
Page 10.6.9
Lesson 10-7
No Smoking Allowed! Anti-Tobacco Regulations Introduction:
This lesson introduces students to laws and policies that limit smoking in various locations. These grew out of the grassroots Non-Smokers’ Rights movement.
Lesson Objectives: By the end of Lesson 10-7, students will: W
Be aware of some of the rules governing smoking in their community.
W
Research their community’s laws about public and workplace smoking using the internet and other sources.
Materials: W
The Facts About Smoking in Public Places Worksheet
Key Terms: Non-Smokers' Rights: Non-smokers have sought to achieve smoke-free places where people are not exposed to secondhand smoke. By mobilizing political support through education and legislation, this movement has produced laws and policies which prevent smoking in many places such as schools, government buildings and workplaces.
Data Resource: It is useful to be familiar with the ordinances governing smoking and tobacco use in your local community. Your community’s ordinances may be listed on sites such as the following: www.no-smoke.org/lists.html In addition, some state and local governments and other private agencies maintain state-specific lists, such as the following for New Jersey: www.njgasp.org Additional information by state can be found using the American Lung Association’s database on stateby-state tobacco control legislation at: http://slati.lungusa.org/about.asp Many states and local departments of health also have special offices concerned with tobacco control. In California, this office is housed in the Tobacco Control Section of the California Department of Health Services: www.dhs.ca.gov/ps/cdic/ccb/tcs/Index.htm In New Jersey, the state-level office is the Comprehensive Tobacco Control Program of the New Jersey Department of Health and Senior Services: www.state.nj.us/health/as/ctcp/ By doing some preliminary research into appropriate agencies in your community, you can provide your students with a valuable starting point for their research.
Page 10.7.1
Lesson 10-7:
No Smoking Allowed!
Procedures: 1.
Explain to students that in recent years, many communities and states have established rules about where people can and cannot smoke.
2.
Develop with your students a list of voluntary organizations, and state and local government agencies, that can provide them with information about smoking control, and rules and regulations regarding tobacco control in their community and state. Start with the websites listed in Data Resources above.
3.
Distribute the Fact Finding form to students. The class will work together to learn the answers to the questions on the form. You can divide the questions among your students or investigate each one as a class.
4.
Students will share information so that each student has a complete and accurate form.
5.
Ask your students to identify who makes these rules in these places?
6.
Facilitate a class discussion about the student's opinions of these restrictions on smoking. Do students support the restrictions? Why or why not?
7.
Discuss some of the other ways besides legislating smoke-free areas that governments have sought to control smoking: W
Media campaigns: Anti-tobacco advertising
W
Bans on tobacco advertising on television in particular; and more recently, striking agreements with tobacco companies to bar advertising from billboards, public transit, magazines with a large youth readership, etc.
W
Taxation of tobacco products: Governments require taxes on the sale of tobacco products. What effect does raising (or lowering) these taxes have on the price of cigarettes? How might this affect smoking rates?
W
Controls on the sale of tobacco products: Governments have sought to exert more control over how and where tobacco products can be sold. These include the proximity of sales outlets to schools and other areas where young people congregate; enforcing minimum age requirements for the sale of tobacco products; outlawing the sale of cigarettes in vending machines; etc.
W
Requirements for health warnings on all tobacco packaging and advertising.
Page 10.7.2
Lesson 10-7:
No Smoking Allowed!
Procedures: (continued) Journal: Do you think that restrictions on smoking areas help people to quit smoking? Why or why not?
Page 10.7.3
Lesson 10-7 Worksheet: The Facts About Smoking in Public Places
Name __________________________________
The Facts About Smoking in Public Places Instructions: Do any of the following places allow smoking? Who makes the rules in each of these places? Use the internet, telephone, library, interviews with local, state and national officials, contacts with voluntary agencies, and any other means available to you to find out the following information. Be sure to write your source of information for each item.
Allows Smoking? Location Schools Restaurants Shopping Malls 7-11 Stores Movie Theatres Basketball Arena Baseball Stadium Bowling Alleys Grocery Stores Office Buildings Hospitals College Campuses Government offices (such as the Post Office or City Hall) Airplanes and Airports Parks and Beaches
Yes
No
Source of Information