Let's Reduce Tobacco Use

Family physicians, parents, teachers and other healthcare providers visit classes to present the fourty-five minute interactive curriculum that focuses on the short-term, image-based consequences of tobacco use and how to think critically about tobacco advertising. At the conclusion of the presentation, students are encouraged to create posters that reaffirm the positive Tar Wars message. The posters are sent to the NCAFP/F, where a panel of physician judges selects a statewide winner. That winning poster is submitted into the Tar Wars National Poster Contest. You may view the nation's winning posters from the 2005-2006 school year at www.tarwars.org. The ultimate goal is to discourage tobacco use among the nation's youth through an interactive format, community involvement and education.

Description, Goals & Audience

The Tar Wars Program seeks to reduce the amount of children and youth who use tobacco products. Tar Wars focuses on the fourth- and fifth-grades. Targeting this age group is important for the following reasons:

• 18.4% of North Carolina middle school students and 38.3% of high school students are current users of a tobacco product. (NC Youth Tobacco Survey, 1999)
• The percentage of students reporting current tobacco use increases steadily with grade -- 10.6% of North Carolina 6th grade students report current tobacco use, compared to 45.2% of 12th grade students. (NC Youth Tobacco Survey, 1999)
• One in six students indicated having smoked their first whole cigarette before age 11. (NC Department of Public Instruction, 1995)

Several studies have shown that if students are reached at earlier ages, the rates of becoming a tobacco-user diminish considerably. Research from a 1998 University of North Carolina study indicated that there "is a need to begin smoking prevention classes very early, in elementary school, and a need to especially target disadvantaged youth". (Journal of Adolescent Health, 1998) Since 49% of North Carolina's fourth- and fifth-graders are disadvantaged, Tar Wars is an excellent tool to discourage tobacco use and help promote a healthy lifestyle for our state's youth. Tar Wars focuses its efforts on prevention by intervening prior to the onset of most tobacco use, in contrast to other programs that delay reaching youth until the teen years when tobacco use has already begun and is at a serious level.

Endorsements and Support

The Tar Wars curriculum has been approved by the NC Department of Instruction for use to meet teacher requirements to provide a unit on tobacco use for fifth-graders. Additionally, Michael Ward, State School Superintendent, has stated his endorsement and approval of Tar Wars.

North Carolina Tar Wars has been named an effective partner of the Focus on Success! North Carolina's Best program with North Carolina Public Schools. You may visit www.dpi.state.nc.us/ncbest/community/community_partners.html for more details on this partnership.

In 2002, the NCAFP Foundation was successful in establishing a Tar Wars collaboration with the NC PTA. Tannis Nelson, NC PTA President, has indicated her full support and is assisting the NCAFP to conduct presenter-training sessions for high school cadet teachers and PTA members across the state.

North Carolina Tar Wars has been supported in the past by several organizations, including the North Carolina Hospital Association/Duke Endowment, the North Carolina Medical Society, the North Carolina Pediatric Society, and Catawba Memorial Hospital.

Program Effectiveness & Impact

The effectiveness of the Tar Wars program was documented in an article posted in the November/December issue of the Journal of the American Board of Family Medicine (Cain et al, 2006).  The study described in the article evaluated the effectiveness of Tar Wars with both quantitative and qualitative measures.  Students participating in the quantitative measures were given a 14 question test before and after a Tar Wars presentation.  The test covered short-term and image-based consequences of smoking, cost of smoking, tobacco advertising and social norms of tobacco use.  A total of 2766 students completed both the pre and post test.  Analysis of these found that students’ knowledge of tobacco increased in general and was statistically significant.  The qualitative measure consisted of telephone interviews and focus groups with teachers, presenters and students.  The results of these found that the overall measure of Tar Wars was well received, previous tobacco knowledge was reinforced and new information was learned.  The article proves that Tar Wars is providing the desired effect in tobacco prevention education. 

Tar Wars also is consistent with the Centers for Disease Control and Prevention’s (CDC) guidelines for youth tobacco prevention programs, which was published in 2000 as “Guidelines for School Health Programs to Prevent Tobacco Use.”  The CDC provides seven implementation guidelines of which Tar Wars addresses five.  The five being instruction, curriculum, training, family involvement and evaluation.  The CDC also recommends including cost, social norms and advertising as part of youth tobacco prevention.  These three areas showed the greatest improvement in scores in the above article’s quantitative research. It has also been shown that instructional programs, like Tar Wars, significantly reduce smoking prevalence for up to five years after program completion.