100% Tobacco-Free School Policies in Southwest Virginia - The Amazing Snowball Effect

The Charge

In June 2012, the American Lung Association in Virginia received a Community Transformation Grant (CTG) to promote the benefits of 100% tobacco-free school environments to eight school districts located in Carroll, Henry, Patrick, Smyth, Tazewell, Wythe Counties and Galax and Martinsville Cities in Southwestern Virginia. This type of work in this target area, where tobacco farming has been a way of life for generations, presents a unique set of challenges. With significant historical ties to tobacco farming, many families have a parent or grandparent that has raised tobacco. The project manager for this CTG grant is no exception. This region of Virginia suffers from higher poverty rates and poorer health outcomes than other parts of the state.

The promotion of tobacco-free environments in an area so closely tied with tobacco might seem unpopular but little data exists to show the actual level of public support for the move to 100% tobacco-free school grounds. Previous statewide assessments on school policies showed only 33 of the 136 school districts across Virginia reporting that they have comprehensive tobacco-free policies.  To succeed with a project like this, the CTG Leadership Team sought the help of partners from past projects who have a passion for tobacco-free living. The community leadership team established for this work was passionate about making Southwest Virginia a healthy place for young people. The team subsequently took on the name Healthy Grounds for our Youth.

The Challenges

Many of the targeted counties of this initiative have adult smoking rates significantly higher than the state average of 20%. In this targeted region of Southwest Virginia, deaths from smoking-related diseases are higher than the state average and most families have personal experience with tobacco-related diseases like heart disease, cancer and COPD, making the impact of tobacco use very real. The number of residents that light up in public and/or openly use smokeless tobacco also creates a misperception that tobacco use is normative.

Youth smoking rates in Virginia are declining but far too many youth still use tobacco. The Centers for Disease Control and Prevention has recommended the use of comprehensive tobacco-free policies for schools as an effective way to prevent youth tobacco use as well as a way to reduce exposure to secondhand smoke.  After some research, the Healthy Grounds for our Youth team learned that the majority of targeted school districts used the Virginia School Board Association (VSBA) standard (which follows Virginia State law) to prohibit tobacco use indoors. This standard allows School Boards and Superintendents to issue additional regulations to designate smoking areas on school grounds.

The unexpected challenge came in the lack of understanding that school administrators had about what is meant by a 100% tobacco-free school. Two school districts were enforcing a strict interpretation of the suggested VSBA language. School signage promoted a tobacco-free school zone indoors and out. School sports events were no exception and visitors caught using tobacco products were asked to refrain from using the product or leave the premises. At the time, these school districts had not considered that technically the VSBA standard did not actually prohibit the use of tobacco products outdoors on the grounds of school facilities. This gap in understanding proved to be an unexpected step. Even school administrators that didn’t have tobacco-free signage thought their school district was tobacco-free. Healthy Grounds for our Youth realized the starting place was to educate the school superintendents that a true 100% tobacco-free school includes outdoor property, use of school property by community organizations, and even school events held off property. Therefore, Healthy Grounds leadership asked to speak at an upcoming Region 7 Superintendent’s meeting to discuss the work of the CTG grant. Permission was granted and it provided a good opportunity to explain what was meant by and the benefits of 100% tobacco-free school grounds and to promote the resources available for schools that adopted 100% tobacco-free grounds. A resource folder on the topic was later prepared to share with district Superintendents.

Gaining Momentum

The VSBA standard and state law do not meet the CDC definition of tobacco-free school in that they prohibit tobacco use indoors only and do not cover the outdoor grounds of a school or include school-sponsored events that are held on or off campus. Gaining support for the establishment of 100% tobacco-free school grounds could be especially challenging for this region of Southwest Virginia, where parents and families spend a large amount of time at school functions, activities and outdoor school sports events.

Fortunately, the Healthy Grounds for our Youth team was able to bring two school districts that were actively enforcing tobacco-free grounds into the coalition. Their experience and insight was invaluable and the superintendents of these districts were outspoken leaders in the team’s initial meetings. Healthy Grounds also enlisted the aid of Jim Martin, Director of Tobacco Prevention and Policy for the North Carolina Department of Health. With North Carolina’s success in achieving tobacco-free school grounds statewide and its being a neighboring tobacco state, their perspective was especially relevant for the tobacco-free schools work to be done in Virginia. Martin came to Southwest Virginia to share the successful strategies, written materials and online resources that were utilized during North Carolina’s eight year-long project.

Soon, the majority of targeted school districts joined the community leadership team with several school Superintendents attending our quarterly meetings. This level of interest and support from superintendents was considered a tremendous, early success! With two superintendents as champions and others actively discussing their policies, the team was encouraged. As a way to assist those school districts already enforcing tobacco-free grounds, Healthy Grounds had high-quality, durable signage produced for schools to use to help enforce and promote their policy. The signs began as a resource for those champion school districts for enforcing tobacco-free grounds, but ultimately they became an incentive and a “conversation starter” with school districts to educate them about 100% tobacco-free grounds.

Momentum continued for the team as more conversations occurred with school officials. The Healthy Grounds co-coaches and team members worked together to provide sample policy language that met the approval of the Virginia School Board Association. This was a critical piece of technical assistance as it can save each district time and resources. Additionally, team members met with individual district superintendents, presented at a regional meeting of superintendents and facilitated a round-table discussion at a regional community health training hosted by the Virginia Department of Health. With each engagement, it became clearer that there is growing support for the move to 100% tobacco-free schools in Southwest Virginia.

At the grant’s midway point, the Healthy Grounds team had two school districts, Tazewell and Patrick Counties that had adopted comprehensive tobacco-free policies. Three additional districts, Galax City, Carroll and Smyth County have since adopted a policy. These superintendents are informed, interested and engaged. Most importantly they are motivated to take action and the Healthy Grounds for our Youth team is poised, ready to assist them.

The Future

Healthy Grounds for our Youth was very encouraged when Grayson County Schools’ Assistant Superintendent reached out because the Superintendent heard the presentation at a Superintendent’s meeting and received the resource folder prepared by our leadership and distributed to all Superintendents. Grayson County was not a part of the targeted school districts for this grant. The Superintendent, Mr. Chalfant asked his assistant superintendent to attend a Healthy Grounds for our Youth quarterly leadership team meeting to learn more. Grayson County did make the decision to establish a comprehensive tobacco-free policy in July 2013. The coalition was delighted that its educational efforts were spreading beyond targeted school districts in Virginia.

When people in Southwest Virginia gather for school-sponsored events, the message of 100% tobacco-free school grounds spreads from the 49 schools in the target community to schools throughout the region, affecting visitors, staff members, students and their families. This work proves that even in the tobacco country of Southwest Virginia, progress can be made to encourage tobacco-free living. It is the hope of the team that the progress made through this initiative in Southwest Virginia will serve as a model and a catalyst for change for school districts across the Commonwealth.