California’s expanded school tobacco prevention initiatives are associated with a significant decline in youth smoking and vaping rates. A recent study published in the Journal of Adolescent Health indicates that schools receiving dedicated funding for tobacco prevention demonstrated enhanced educational outreach, increased student engagement, and a notable reduction in tobacco use among adolescents.
These findings stem from California’s long-standing commitment to tobacco control, notably through the Tobacco Use Prevention Education (TUPE) program. Established as a response to the state’s persistent tobacco challenges, TUPE expanded following the approval of Proposition 56 in 2016, which increased cigarette taxes to bolster prevention programs.
California’s Tobacco Prevention History
The roots of California’s tobacco prevention initiatives trace back to Proposition 99, a 1988 referendum that raised the cigarette tax by 25 cents. Revenue generated from this tax increase has since been allocated to enhance anti-tobacco efforts managed by both the California Department of Public Health and the California Department of Education (CDE). These agencies have implemented comprehensive public health campaigns, educational programs, and surveillance to monitor tobacco use across the state.
The CDE administers TUPE, focusing on reducing tobacco use among youth. The program operates through various funding mechanisms, including County Technical Assistance grants and competitive Tier 2 grants. The latter primarily supports extensive tobacco prevention interventions in selected school districts, which target grades 6 to 12 and cover a wide array of services, from prevention education to cessation support.
Impact of Proposition 56 on Funding
As tobacco usage decreased, so too did state tax revenues. To address the funding shortfall for tobacco prevention programs, California voters backed Proposition 56, which increased the tax on cigarettes by $2 per pack and imposed similar taxes on vaping products. This measure allocated an additional $55 million to TUPE between 2017 and 2019, enabling the expansion of state-level media campaigns targeting youth vaping.
Previous evaluations indicated that these campaigns were linked to increased cessation attempts among teenagers who vape, as well as decreased susceptibility to vaping among youth who had never smoked. Despite the increase in funding, TUPE still reached less than half of California’s public middle and high school students, raising concerns about the adequacy of resources for effective interventions.
The CDE opted to prioritize quality over quantity, selecting a limited number of schools to implement comprehensive tobacco use prevention programs. This decision facilitated a thorough comparison of outcomes between TUPE-funded and non-TUPE-funded schools.
Study Design and Findings
The study utilized data from the 2019–2020 California Student Tobacco Survey, which included responses from over 160,000 students across 358 schools. Among these, 49,244 attended TUPE-funded schools, while 110,862 were from non-TUPE institutions. Researchers applied statistical methods to assess the relationship between TUPE funding and reduced tobacco use among students.
Results revealed that students in TUPE-funded schools had access to more robust educational resources on the dangers of tobacco use. Approximately 71% of TUPE students received comprehensive messaging against all tobacco products, compared to around 64% of their non-TUPE counterparts. Furthermore, participation in tobacco prevention activities was higher among TUPE students, with 15% engaging in multiple school activities compared to 10% of non-TUPE students.
After accounting for various personal and school-related factors, the analysis indicated that tobacco use was lower among TUPE participants, with rates of 6.5% compared to 8% among those in non-TUPE schools.
The findings underscore the effectiveness of structured tobacco prevention education in schools, particularly in states like California that have established anti-tobacco messaging. As the study authors noted, while the presence of a statewide program complicates the assessment of TUPE’s singular impact, the data suggests a positive correlation between dedicated funding and reduced tobacco use among adolescents.
In conclusion, California’s expanded school-based tobacco prevention initiatives not only reflect a strategic public health approach but also demonstrate promising results in combating youth smoking and vaping. The ongoing commitment to funding and implementing these programs will be crucial in sustaining these gains and further reducing tobacco use among young people in the state.
