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ACTIVITY 1:  Take a Tobacco and Nicotine Survey 

ACTIVITY 1:  Take a Tobacco and Nicotine Survey 

SKILLS

SKILLS: Assessing Risks and Consequences

Suggested Time Consideration

Suggested Time Consideration: 25 mins

RDRN Activity Page

This student survey is designed to help you launch your prevention unit and generate class discussion about the health impact of tobacco and nicotine. But first, be sure to read the Overview Booklet for Grades 5–9 . It provides all the information you need to know to successfully implement this material.

Survey, Parts One and Two

Part One of the activity asks students about their experiences with tobacco and nicotine. It consists of questions taken from the CDC’s National Youth Tobacco Survey (NYTS) 2023 Questionnaire — a survey that can be used to estimate current use of tobacco products and selected indicators related to tobacco use among U.S. middle school and high school students. These surveys are periodically done by the government to assess tobacco use. The complete survey and reports are available online here.

Part Two of the Survey includes open-ended questions that ask students what they think or know about the prevalence and health consequences of tobacco and nicotine use, quitting, and why young people use tobacco or nicotine products, including e-cigarettes/vapes, smokeless tobacco and nicotine pouches. Once you have completed all activities, please delete or dispose of all student surveys.

RATIONALE
Adolescents and young adults are uniquely susceptible to social and environmental influences to use tobacco and nicotine products like e-cigarettes (vapes) and smokeless tobacco. It’s a sensitive developmental period, with extraordinary brain changes and high levels of emotionality, impulsivity and risk-taking.1 During this time, they will get a lot of their information (or misinformation) from their friends, potentially causing them to make decisions they will later regret. Teaching students the health consequences of tobacco and nicotine use in this program is one important way to communicate the facts and help them make the decision to be tobacco and nicotine free. Since the survey asks students about their personal experience with tobacco and/or nicotine, it should be done independently and anonymously. Assure students that no personally identifying information will be included in the survey they email to you.
GETTING STARTED

Before starting the activity, ask your students:

  • What have you learned about tobacco and nicotine?
  • What/who has given you information about smoking, vaping or use of other tobacco and nicotine products? (e.g., television/media, magazines/books, parents/family members, teachers, peers/friends) 

Then, direct students to the online survey in the website by clicking “Launch Activity” below. We recommend emailing the link to your students, posting it on a class web page, projecting it on an interactive whiteboard, and/or writing it on a chalkboard.

Explain to your class that they are going to take a survey about tobacco and nicotine. Encourage them to answer the questions as honestly as they can. Let them know that the first eight questions ask them about their experience with tobacco and nicotine and are only going to be used by you to get a sense of what they have experienced. Tell them the survey will be entirely anonymous and no identifying information will be included in the responses they email to you. Inform students that once they have finished the survey, you will share some information with them related to Part Two. Explain that being informed is an important element of making the right decisions. Then, let students know that they will learn facts about tobacco and nicotine use and tips for coping with peer pressure in this unit, “Keeping Healthy.”

LAUNCH ACTIVITY
TALKING ABOUT IT

Once the survey is complete, share with your students the facts listed in the answer key part of the “Wrapping Up” section to dispel misperceptions they may have about tobacco and nicotine use and to reinforce the message that most young people don’t use tobacco or nicotine. Also, encourage students to volunteer answers during your discussion if they feel comfortable.

WRAPPING UP

Answers, part one
Answers will vary. Review the answers students provided for questions 1–8. This will give you a sense of your students’ experience with tobacco and nicotine, but it should not be shared with the students. 

ANSWERS, Part Two 
1–8. Explain to students that most young people do not smoke or vape. Only about 1 of every 100 middle school students (1.0%) reported that they had smoked cigarettes in the past 30 days, and 1 out of every 30 middle school students (3.3%) reported that they had used e-cigarettes/vapes in the past 30 days.2

Point out to students that the younger people are when they start smoking, the more likely they are to become addicted.

4. Ask students if they want to volunteer answers about why young people use tobacco. Note their answers on the board. Explain to students that some of the reasons young people try or start to use tobacco include:4, 3

They don’t feel good about themselves (low self-esteem and self-image). 
They don’t know about the health consequences of smokeless tobacco. 
They think lots of people smoke or vape (overestimating number of people who smoke/vape). 
They don’t realize that they can become addicted (not understanding the addictive potential of nicotine).

5. Ask students if they want to volunteer answers about why they think young people choose to be tobacco and nicotine free. Explain that some people may choose to be tobacco and nicotine free because:4, 5

Their friends don’t use tobacco or nicotine products. 
They know about the health consequences. 
They want to be tobacco and nicotine free.

6–7. Explain to students that some young people try tobacco because of a “lack of self-efficacy in the ability to refuse offers to use tobacco,”4 or they don’t know how to tell their friends they don’t want to try it. 

Explain to students that people their age are sometimes pressured to use tobacco or nicotine products, and that pressure can be difficult to handle. Let them know that in this unit, they are going to learn some ways to say “no” and cope with peer pressure so they can be tobacco and nicotine free.

If students volunteer stories, remind them not to use names. Listen to their concerns and explain to students that feeling pressure from friends happens, but that they will learn some ways to deal with the pressure.

8. Explain to students that there are health consequences related to tobacco use. According to the Surgeon General, symptoms such as coughing, shortness of breath, nausea, and phlegm production can develop in young people who smoke.4 Youth and young adults are also uniquely at risk for long-term, long-lasting effects of exposing their developing brains to nicotine. These risks include nicotine addiction, mood disorders, and permanent lowering of impulse control. Nicotine also changes the way synapses are formed, which can harm the parts of the brain that control attention and learning.4 Tell them that they will learn more about the health consequences in Activities 2 and 3. If students want to volunteer answers, write them on the board and then revisit the list when you read Activity 2. 

9. Students might have heard that quitting tobacco and nicotine is difficult, but they may not know why. Read to your students the following passage from the Surgeon General’s Report “Preventing Tobacco Use Among Young People”:4

Most young people who smoke regularly are already addicted to nicotine, and they experience this addiction in a manner and severity similar to what adult smokers experience. Most adolescent smokers report that they would like to quit smoking and that they have made numerous, usually unsuccessful attempts to quit. Many adolescents say that they intend to quit in the future and yet prove unable to do so. Those who try to quit smoking report withdrawal symptoms similar to those reported by adults.4

Students will learn more about addiction in Activity Three. 

10. Answers will vary. However, explain to your students that a survey of teens reports that 65% of teens strongly dislike being around smokers.6

For additional information on factors that influence young people to use tobacco and nicotine for reasons most of them abstain, review the Overview Booklet

To end the lesson, display the “Tobacco & Nictoine: Myth or Reality?” poster in the “Materials” section and review the content with your students. The poster will reinforce the message that most young people are tobacco free. 

SURVEY DATA COLLECTOR

To assist you with evaluating your students’ anonymous responses to this tobacco survey, we have created a data-collection spreadsheet that will allow you to input and view quantitative and qualitative measures. Click here to access the downloadable survey-response spreadsheet. You’ll also find it in the “Materials” section below.

SOURCES

1 CDC. Smoking & Tobacco Use. Fact Sheet—Youth and Tobacco Use: Estimates of Current Tobacco Use Among Youth. Referenced 2017. www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/

2 Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future National Survey Results on Drug Use, 1975-2015: Volume I, Secondary School Students. Ann Arbor: Institute for Social Research, The University of Michigan. Referenced 2017. www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2015.pdf

4 U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; Washington, D.C., 2012. Referenced 2023. https://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf

5 CDC. Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. MMWR 1994; Vol. 43, No. RR-2; 1-18. Referenced 2023. https://www.cdc.gov/mmwr/PDF/RR/RR4302.pdf

6 U.S. Department of Health and Human Services. Preventing Tobacco Use among Young People: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994.

LAUNCH ACTIVITY

GO!