By Janet Reilly, NP
Tobacco use is the leading cause of preventable death among Wisconsin residents.1
According to the U.S. Centers for Disease Control and Prevention (CDC), 75% of smokers become addicted to nicotine before they turn 17.2 It would make sense, then, that convincing Wisconsin teenagers to quit using tobacco products - or to avoid taking that first puff or chew - could save lives.
Health care providers have demonstrated that certain health education strategies can vastly improve patient morbidity and mortality. Since nurse practitioners excel at health promotion and disease prevention, they should be on the front lines of smoking cessation education.
Measuring Tobacco Use Among Young People
Attitudes toward tobacco and its use by middle- and high-school students were surveyed in the year 2000 nationally, state by state and locally. Data from the 2000 CDC Youth Tobacco Risk Assessment and the Wisconsin Youth Tobacco Survey (WYTS) provided clear indications of youth tobacco use in the United States and Wisconsin. This report summarizes the data collected in a rural county of central Wisconsin, Waupaca County, and compares and contrasts it to the national and state data for the same year.
The Youth Tobacco Survey questionnaire was developed and supported by the CDC Office on Smoking and Health. It provided the first state-by-state data on youth tobacco use.3 During the second half of 2000, this coordinated initiative surveyed 35,828 students from 324 schools in 29 states across the nation. Sample sizes of young people surveyed ranged between 583 and 33,586 students.4
The state of Wisconsin implemented the WYTS in 82 randomly chosen public schools. Students across the state in grades 6, 7 and 8 (middle schools) and grades 9, 10 and 11 (high schools) were given the WYTS survey in spring of 2000. Local results from 413 high-school students and 1,191 middle-school students in Waupaca County were collected in May of 2000 by members of the Waupaca County Tobacco Reduction Coalition and the Waupaca County Human Services, Public Health Division. Unfortunately, data from approximately 200 high-school students surveyed in Waupaca County were inadvertently lost over the summer of 2000 during a move to a newly constructed high school.
The CDC weighted and analyzed data from the local high schools and middle schools in Waupaca County. Analysis of local, state and national survey student data was completed using a two-stage cluster sample design. Standardized survey administration guidelines were followed with all students. All surveys were administered during one class period. Students were assured privacy and anonymity in their answers.
Core questions in the national, state and local surveys included similar topics: tobacco use, secondhand smoke exposure, smoking cessation, school tobacco and drug curriculum, ability of minors to purchase or obtain tobacco products, attitudes and knowledge about tobacco, and media messages about tobacco products. These surveys defined "tobacco use" as the use of any of the following products:
- bidis - Tobacco wrapped in a leaf and hand tied with thread, these small brown cigarettes are often made by poor native women for minimal wages. Fruit extracts added to the tobacco enhance the flavor and attract young users.
- kreteks - Kreteks are cigarette papers wrapped around tobacco mixed with clove extract. The sweeter flavor also appeals to young users.
- smokeless or chewing tobacco
The local high-school students' overall response rate was 84.75%. The local middle-school students' overall response rate was slightly better, at 92.19%.