Integrating Tobacco Control into Curriculum for Excellence: Case Studies

INTEGRATING TOBACCO EDUCATION INTO CURRICULUM FOR EXCELLENCE:

CASE STUDIES

June 2012

ASH Scotland

8 Frederick Street

Edinburgh, EH2 2HB

tel: 0131 225 4725

fax: 0131 220 6604

e-mail: TTHH
web: HHTUTU

Contents

Introduction

Background

Smoking Prevention Action Plan

Curriculum for Excellence

Methodology

The aims of the case study collection

Fife

Local picture

Developing activities and resources for schools

Extent and importance of partnership involvement

Local response to activities

Reflections- challenges

Reflections - facilitating factors

Tayside

Local picture in Perth & Kinross and Dundee

Local picture in Angus

What tools, outputs or resources were produced?

Extent and importance of partnership involvement

Local response to activities

Reflections- challenges and facilitating factors

Reflections - facilitating factors

Greater Glasgow and Clyde

Local picture

Developing activities and resources for schools

Extent and importance of partnership involvement

Local response to activities

Reflections- challenges

Reflections- facilitating factors

Ayrshire

Local picture

Developing activities and resources for schools

Extent and importance of partnership involvement

Local response to activities

Conclusion

Smoking prevention and education in schools - key development factors

Introduction

In 2008 the Scottish Government provided £42 millionover three years to develop and deliver local activity across all local authorities and health board areas to support the implementation of the Smoking Prevention Action Plan.

The aim of these case studies is tohighlight the successful development of local activities within the last three years and to learn from the processes used to develop, deliver and sustain the work at a local level. Highlighting these local success stories will help to ensure thatthe lessons learned are not lost and encourage future development in other areas across Scotland.

Under the Smoking Prevention Action Plan clear freedom and autonomy for prioritised activity at a local level was keenly encouraged. In addition, the introduction of Curriculum for Excellence in 2004 placed a duty on individual schools to contribute to the development of young people’s mental, social, emotional and physical well-being.

Under such circumstances it is clear that a range of activities and programmes have been designed and used in order to undertake youth smoking prevention within schools at a local level.

Background

Every year 15,000 young people in Scotland start smoking[1]. Young smokers from the most deprived backgrounds are more likely to carry on smoking into adulthood [2]and therefore be most affected by the harm caused by smoking. The younger someone starts smoking, the more they smoke in adulthood, the more harm is done to their health, and the harder it is to quit[3].

Smoking is a childhood addiction. Two thirds of smokers become addicted under the age of 18, and 40% underthe age of 16[4].The tobacco industry is not ignorant of the fact that most of their future consumers will take up smoking before they are legally able to be sold cigarettes[5].

It is important to note that youth smoking in Scotland is declining. In 2010 Only 3% of both 13 year old boys and girls were regular smokers, whilst among 15 year olds, 13% were regular smokers (11% of boys and 14% of girls)[6]. These figures show thatsmoking prevalence among young people has dropped to the lowest since the survey began in 1982.

The single most important factor which turns an experimental smoker into a regular smoker is the addictiveness of nicotine in tobacco[7]. While nicotine may explain why people become and remain regular smokers, it is not the factor which drives someone to try a cigarette. Therefore if we are to be successful in stopping young people from becoming smokers we need to understand why they start to smoke in the first place. It is clear they do so for a variety of reasons. There is no single cause. Inevitably our choices are influenced by our surroundings. Parents, brothers and sisters who smoke are a powerful influence as are our peers[8]. The images of smokers and smoking portrayed in the media also have an impact[9], as does the community that we are brought up in[10].

Many young people who experiment with smoking think they can give up when they want to but underestimate just how highly addictive smoking is. It is essential that effective tobacco education in schools is embedded into Curriculum for Excellence and the wider school ethos, to ensure young people are informed of the addictiveness of nicotine and the harm caused by smoking/tobacco use.

Smoking Prevention Action Plan

In 2008 the Scottish Government published ‘Scotland’s Future is Smoke-free: a smoking prevention action plan’. This action plan set out 27 ambitious measures to prevent the uptake of smoking by young people. The plan illustrated the role a wide range of individuals and organisations (including NHS boards, local authorities, third sector bodies and the business sector) could play by delivering health promotion and education, and by reducing the attractiveness, availability and affordability of tobacco products. The key actions relevant to smoking prevention and education in schools are:

  • Action 1:To facilitate the adoption of a holistic approach to health and well-being in Scottish schools to be fostered through the Health Promoting School and a Curriculum for Excellence, which will be aimed at ensuring the school ethos, policies, services and extra-curriculum activities all foster the health and wellbeing of all the pupils.
  • Action 2:To produce advice, guidance and proposals aimed at helping schools and authorities via an expert steering group looking at substance misuse education in schools, to achieve the improvements sought through Curriculum for Excellence and The Schools (Health Promotion and Nutrition) Act 2007 (taking into consideration the key findings of the Evaluation of the Effectiveness of Drugs Education in Schools), particularly so that appropriate teaching materials are available and are being used most effectively, and education is planned and delivered in partnership with inputs from health, the Police and the community.
  • Action 5:To encourage all those responsible for smoking prevention activity aimed at children and young people to actively involve children and young people themselves in the planning and delivery of services and programmes to ensure their perspective is fully reflected in the approaches adopted and to encourage active citizenship.
  • Action 9:To encourage schools and all youth work/community settings where young people gather to adopt clear no smoking policies and in addition we ask that they reinforce messages concerning the addictiveness and health risks associated with smoking.
  • Action 14:To encourage all organisations and agencies who come into contact with children and young people, including NHS organisations, local authorities and care providers, to have a health leadership role and beat the vanguard of changing smoking cultures in Scotland, by, for example, introducing smoke free policies in external areas frequented by children and young people such as playgrounds.

Curriculum for Excellence

Curriculum for Excellence aims to nurture young people as successful learners, confident individuals, effective contributors and responsible citizens. In doing so, curriculum for excellence provides a structure for 3 – 18 year olds in nursery, primary school, secondary school, college, workplaces or community learning. It enables learners to experience a broad, deep, general education to S3, with options in senior phase to specialise and go on to further study, improve skills and get work experience

Teachers are expected to make connections between subjects, helping children and young people make sense of the world. Rigorous progression for learners through meeting the experiences and outcomes set for young people should facilitate active learning to encourage young people to think, question, research and work together rather than being fed information.

Curriculum for Excellence encompasses eight curriculum areas, each containing a range of subjects:

  • Health and Wellbeing
  • Expressive Arts
  • Mathematics
  • Literacy and English
  • Science
  • Religious and Moral education
  • Social Studies
  • Technologies.

Tobacco education is a rich subject area. Each and all of these curriculum areas provide a perfect framework to embed smoking prevention into the curriculum and wider school ethos.

Methodology

Representatives from health boards across Scotland with a responsibility for co-ordinating and developing smoking prevention and education activities in schools were asked to complete an online survey. The survey included a number of core questions that were designed to highlight common practices across different areas while at the same time recognising specifically local experiences and activities. As a result, participants were able to reflect upon and share their experiences of activities, techniques and resources that have been particularly effective and others that have proved to be more challenging. The case studies have been constructed using the reflective responses provided by survey participants.

The aims of the case study collection

The primary use of the case studies is to share learning across Scotland with those who are already developing smoking prevention and education activity in schools or looking to do so. The case studies on smoking prevention and education activities in schoolswill:

  • identify and highlight some of the challenges and mechanisms in developing smoking prevention and education activities for schools
  • detail some of the lessons learned through a number of local experiences in developing and delivering smoking prevention and education activities for schools
  • identifyto what extent smoking prevention and education activities can be embedded into Curriculum for Excellence.

The following localised case studies provide examples of prevention and education activities in schools that have contributed to local co-ordinated tobacco control action plans. These examples demonstrate how activities have been developed or adapted through the provision of smoking prevention funding that was provided by the Scottish Government in 2008 and illustrate the achievements brought about by partnership working.

Fife

Local picture

In Fifethe Youth Tobacco Issues Group (YTIG) is led by NHS Fife Health Promotion Tobacco Team and attended by a broad range of stakeholders and interested partners. These include Fife Council Trading Standards, Fife Council Education Services, CHP Tobacco Services, Voluntary Organisation Rep and Community Safety (including Fire andRescue).

Developing activities and resources for schools

YTIG was developed prior to the Prevention Action Plan. The group created a local tobacco prevention plan for Fife by adapting the national Prevention Action Plan in order to respond to issues that were specific to Fife.

Moving forward, the working group hoped to create a continuum of curriculum-based tobacco prevention programmes from P5/6 to S1 and into the upper school. They felt that providing smoking prevention and awareness education at key transitional stages would delay and prevent the uptake of smoking amongst young people in Fife. As a result, the Smoke Free Class Competition was introduced to S1 and Smoke Factor was developed for P5/6, 6 and 7.

To date, 4696 S1 pupils have taken part in Smoke Free Class and 2234 P5/6, 6 and 7 have taken part in Smoke Factor.

YTIG focused strongly on what they wanted achieve and identifying the key partners that would help them to achieve this. This helped them to create Smoke Factor, which consisted of the‘Smoke Free Revolution’ interactive theatre production along with lesson plans and extension activities. They consulted regularly with Education Services, pupils and teachers to make sure that they created resources that were appropriate for both.

YTIG in Fife looked at the breadth of subject areas covered by Curriculum for Excellence and the outcomes and experiences at each level for the age group being targeted. This meant that they could chart what outcomes and experiences needed to be met and promote both Smoke Factor and Smoke Free Class as cross curriculum packs that could be delivered by integrating it into existing work programmes.

The success of this approach is illustrated by the fact that 82% of S1 (sample 456) thought Smoke Free Class helped them to see that smoking was not the norm amongst their peers. 64% were encouraged to continue talking about the benefits of not smoking. 44% of those did so with a teacher and 29% with a friend and 21% with a parent/carer.

Extent and importance of partnership involvement

Partnership working was crucial to the success of the Young Persons Tobacco Issues Group. For example the development of the theatre production brought together people with very different knowledge and skills, such as script writers, actors, teachers, health promotion officer, an NHS Young People's tobacco worker, Trading Standards and young people. Although it wasn't always easy to work with such diverse interests the result was a high quality production and teacher-friendly resource that was relevant and engaging for young people.

Local response to activities

YTIG have had very good feedback from teachers who like the Smoke Factor resource:

  • 100% thought it helped pupils to see that smoking is not the norm.
  • 100% thought it was age appropriate.
  • 100% thought it was effective to start discussion about the benefits of not smoking.
  • 100% thought pupils enjoyed learning about tobacco.
  • 100% thought it was appropriate to delay the onset of smoking.

Reflections- challenges

In bringing together the people who wrote and made the DVD it was difficult to agree on the messages, explicit and implicit in the film.

Getting the balance right between dramatic impact and educational resource was sometimes difficult. For example the choice between having a lot of the characters in the film smoking or taking up smoking could give an opportunity to discuss the issues. However, it could also give too strong a message that smoking is acceptable.

Reflections - facilitating factors

The short life working group recognised the importance of partnership working at an early stage and maintained this throughout the life of the project. It must be stressed that the partnership with Fife Council Education Services was crucial in the success that has been achieved.

Regular consultation with pupils and teachers provided a strong focus on delivering a resource that was up to date and appropriate to their needs.

YTIG developed a resource that would facilitate progress on the experiences and outcomes across the Curriculum and not solely Health and Wellbeing.

Tayside

Local picture in Perth & Kinross and Dundee

In the Perth & Kinross local authority area the Tobacco Alliance Group (TAG) was formed from key representatives from Youth Services, Education Services, Trading Standards, Live Active and NHS Tayside. TAG primarily co-ordinate and organise a broad range of educational activities for young people in Perth & Kinross, although they carry out work in the Dundee City Council and Angus Council areas.

Primary aged children are engaged via P7 workshop dramas that were originally developed by Dundee College and which continue to be delivered by the Smallpetitekline project is The project delivers 34 one day workshops offered and available to the cluster area schools of Perth High, Perth Grammar, Perth Academy, St Johns’s Academy and Blairgowrie High School.

A drama production has been developed by Business Source Actors who were employed by the Space at Dundee College to write and develop a drama production that was taken into all high schools to show S1 pupils what big business tobacco is, how it damages health and the impact smoking has on lifestyle and choices available to pupils as individuals.

A S2 peer education project delivers knowledge on tobacco and other safe choices to a selection of S1 classes in each of the cluster area high schools schools in and also provides a stall and information event at transition days for all P7 classes within the Perth area clusters. This service is co-ordinated and run by Youth Services staff from Perth & Kinross Council jointly with NHS Tayside and Youth Services. Young people involved on the peer education project achieve Dynamic Youth Awards or work towards achieving a Bronze Youth Achievement Award.

At S3 level Trading Standards are piloting a peer education project that focuses on underage tobacco sales and illicit tobacco with young people from the previous S2 Peer Education project. and takes them through the process of under-age tobacco sales. As part of this project young people will also progress towards achieving a Bronze Youth Achievement Award.

In addition, Business Source Actors have collaborated with Dundee College on another another drama production that engages with S3 pupils from schools across Perth and Kinross and Dundee in order to tackle the issues of smoking, self harm, cyber bullying, domestic abuse, sexuality and drugs.