Tobacco prevention in North Carolina public schools.

The purpose of this study is to report on the extent of, and organization for, tobacco prevention education in North Carolina Public Schools. Moreover, issues for the diffusion of tobacco prevention curricula are discussed. A questionnaire examining tobacco education practices and curriculum within school districts was mailed to health education representatives in each of the North Carolina public school districts. One-hundred twenty-five usable questionnaires were returned for analysis (125/140 = 89.3%). Of the school districts responding to the survey, 101 (80.8%) reported having adopted a system-wide curriculum which includes tobacco-related instruction. Additionally, a large percentage of the school districts with an adopted curriculum were using commercially published materials (85.2%). Large tobacco producing counties in North Carolina were not significantly different than other counties in the adoption or public acceptance of school programs with a tobacco prevention component. However, school systems with an adopted, general tobacco use policy for the district were more likely to have adopted a district-wide tobacco education curriculum. Individual schools were also involved with multiple tobacco prevention curriculum and learning programs. In the sixth, seventh, and eighth grades, the sample reported using a total of twelve different programs. Many of these learning programs lacked necessary elements of effective programs. Key diffusion issues included the impact of multi-tobacco curricula use to the introduction of new and effective material, as well as the association between district-wide tobacco use policies and the adoption of curriculum.