Ethnic similarities and differences in early elementary teachers' responses to tobacco prevention

Journal of Cultural Diversity, Summer, 2002 by Vivien Carver, Bonita Reinert, Lillian M. Range, Catherine Campbell

Abstract: To explore ethnic differences in teachers' responses to tobacco prevention, 604 teachers, 26.6% of whom were African American (AA), attended an initial workshop, and 502 completed a four-week follow-up. Class sizes were equivalent, but AA teachers reported teaching relatively more AA students and fewer White students. On initial and follow-up questionnaires, AA teachers less often reported that their school had a tobacco-free policy. At follow-up, both groups reported using tobacco prevention materials and thought that they helped students. Despite less organizational support, AA teachers were as positive as White teachers about tobacco prevention for their K-3 students.

Key Words: Tobacco, Ethnic, Teachers

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Tobacco use is the leading cause of preventable death in the United States (Centers for Disease Control and Prevention [CDC], 1994). The majority (82%) of daily smokers began smoking before age 18 (CDC, 1994). Although recent tobacco prevention programs are having some positive impact (i.e., Tobler & Stratton, 1997), youth tobacco use continues to be problematic in every demographic category. In 1997, among youth aged 12 to 17, 22% of White Non-Hispanics and 15% of African Americans had smoked in the past month (National Center for Health Statistics [NCHS], 1999). Among youth aged 18 to 25, 45% of White, non-Hispanics and 30% of African American non-Hispanics smoked in the last month (National Center for Health Statistics, 1999). Among African American youth, alcohol use has been relatively stable over time, but, sadly, cigarette and marijuana trends are increasing (Wallace. et al., 1999). Further, African American youth may respond more inconsistently to tobacco questions than White youth, raising the possibility that they may resemble Whites in tobacco use more than statistics suggest (Siddiqui et al., 1999). Thus, tobacco use is a concern for both majority and minority youth. Schools, therefore, are the ideal settings for tobacco prevention efforts designed to reach the maximum number of youth (CDC, 1994), and teachers are the logical providers of tobacco prevention programs.

Many school-based tobacco prevention programs target late elementary through high school students from diverse backgrounds. For example, students targeted for health promotion may be predominantly White and middle-class (Botvin et al., 1995), southern and rural (Basen-Engquist, 1994), Native American (Schinke, Moncher, & Singer, 1994), urban/suburban (Kellam & Anthony, 1998), or African American (Cherry et al., 1998; Kaufman et al., 1994). Additionally, a few prevention programs that indirectly target tobacco use are culturally specific. One cancer risk reduction program for Native American adolescents was based on a legend for the Seneca Nation (Schinke et al., 1994). Another substance abuse prevention program among African American fifth and sixth graders was Africentric, defined as philosophically reflecting basic African values and in harmony with authentic needs and social priorities of the African community (Cherry et al., 1998). The assumption is that tobacco prevention programs need to fit the cultural background of the youth they are targeting.

Unfortunately, school-based tobacco prevention research has some gaps. One gap is the age group that is targeted. Tobacco use begins as early as elementary school, and Centers for Disease Control and Prevention guidelines (CDC, 1994) suggest that tobacco prevention education begin in Kindergarten. However, with a few exceptions (Carver, Reinert, Range, & Campbell, 2001), research focuses on children older than early elementary age. Another gap is that little information is available on the practicality and feasibility of training teachers and other personnel who implement school-based tobacco prevention programs. This point is particularly important because of the time and paperwork demands already placed on teachers both inside and outside the classroom. Still another gap is that information on teachers who implement school-based programs is scarce. For example, tobacco prevention investigators have heretofore provided no information about the ethnic background of the teachers who actually deliver the tobacco prevention programs (Botvin et al., 1995; Kellam & Anthony, 1998; Cherry et al., 1998; Kaufman et al., 1994; Elder et al., 1996; Flynn et al., 1992). This omission is especially odd because the ethnic background of sender may influence acceptance of the health message. For example, a standard public health service tape was more effective with minority women when the speaker was an African American woman than when the speaker was not matched ethnically (Kalichman et al., 1993). Likewise, a videotape about breast self examinations was more effective with minority women when the speaker was an African American rather than a White physician (Smith, 2000). Further, minority women tend to have less access and appear less responsive to smoking cessation programs aimed at the majority culture (Unger, 2001). Thus, the ethnic background of the role model is important in the efficacy of AIDS, breast cancer, and tobacco cessation programs for adults, so ethnic background of the teacher may also be important to tobacco prevention for youth.