1.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Section B Prevention Is Critical

2.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Protective Factors Against Youth Tobacco Use Individual, family, and environmental factors can guard against risky behaviors  Close communication with parents  Parental support  High self-esteem  Regular church attendance 2 Source: American Academy of Pediatrics. (2001).

3.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Counseling Parents Advise parents to...  Express disapproval of tobacco use  Discourage friends who are smokers  Keep the home smoke free—even if parents smoke  Make tobacco products inaccessible  Limit access to pro-tobacco media 3

4.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Smoking Bans Home smoking bans are more effective with teens than smoking bans in public places Odds ratios for association of smoking restrictions with 30-day smoking prevalence, high school students 4 Source: Wakefield, M.A., Chaloupka, F.J., Kaufman, N.J., Orleans, C.T., Barker, D.C., Ruel, E.E. (2000). “Effects of restrictions on smoking at home, at school, and in public places on teenage smoking: Cross sectional study.” British Medical Journal 321: 333-337. OR95% CIP value Total home ban0.790.67-0.91<.001 Some home restrictions0.850.74-0.95<.01 School ban0.990.85-1.13.86 Enforced school ban0.860.77-0.94<.001 Other public reservations0.910.83-0.99.03

5.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Counseling Youth Youth should be encouraged to never even try smoking Youth should be educated regarding the current and future health risks The realities of smoking should be emphasized: Most youth do not smoke and smoking takes away autonomy Youth should be shown how media and advertising influence their behavior 5

6.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Counseling Youth Is Not Enough Youth who live in households with smoking bans, where tobacco advertising is highly restricted, where there are local smoking bans, and where the cost of tobacco is higher are less likely to smoke Family, community, and policy efforts are critically important to prevent the youth from smoking 6

7.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Counseling Youth Smokers Detailed recommendations for how to assist teens in stopping smoking are found in other presentations on this Web site 7

8.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Available Resources 8

9.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Lebanon World No Tobacco Day, 2008 9 Image source: http://www.emro.who.int/tfi/wntd2008/countries_activities_lebanon.htm

10.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence 2009 10 Image source: http://www.who.int/tobacco

11.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Examples of Prevention Programs OVX is a high-school aged, youth-led movement against tobacco to educate, inform, and empower teens to reduce smoking among their peers The teens that started OVX created the name and the goals that guide the movement:  Educate and inform  Empower and show peers how to express views  Take action against the exploitation by the tobacco industry  Encourage positive behavior in all aspects of life  Help reduce tobacco use among peers  www.ovx.org A similar program in the same state (Vermont) is for youth in grades five through eight, Vermont Kids Against Tobacco 11

12.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Teen On-Line Prevention Programs Many programs have been created for youth prevention and cessation There is little evidence that websites are effective, due to difficulties in measurement However, they are readily accessible and many have excellent information 12

13.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Online Smoking Cessation Resource for Youth 13 Image source: http://www2.mdanderson.org/depts/aspire/site.html

14.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Online Smoking Cessation Resource for Youth 14 Image source: http://www2.mdanderson.org/depts/aspire/site.html

15.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Online Smoking Cessation Resource for Youth 15 Image source: http://www2.mdanderson.org/depts/aspire/site.html

16.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Online Resources 16 Source: Tobacco Reality Unfiltered, http://www.realityunfiltered.com/

17.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Online Resources 17 Image source: http://www.thetruth.com/

18.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Online Resources 18 Image source: http://nosmokingroom.org

19.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence Conclusions Youth tobacco prevention is critically important Youth who initiate smoking are at high risk of continued smoking due to addiction Multifaceted approaches for tobacco prevention are necessary 19

20.  2009 Johns Hopkins Bloomberg School of Public Health; American Academy of Pediatrics Julius B. Richmond Center of Excellence 20 Image source: www.aap.org/RichmondCenter American Academy of Pediatrics