California’s recent expansion of its school-based tobacco prevention program has resulted in significantly lower rates of smoking and vaping among adolescents. A study published in the Journal of Adolescent Health indicates that schools receiving dedicated funding for tobacco prevention reported stronger educational outcomes and increased student engagement, ultimately leading to reduced tobacco use among youth.
The state has long implemented a tobacco control program known as the Tobacco Use Prevention Education (TUPE). This program received a substantial boost in 2016 with the passage of Proposition 56, which aimed to enhance funding for tobacco prevention initiatives. The latest study assessed the impact of this expansion on youth tobacco control efforts across California.
Historical Context of Tobacco Prevention in California
California’s commitment to tobacco prevention dates back to 1988 with the passage of Proposition 99, which increased the cigarette tax by 25 cents. The revenue generated from this tax has been instrumental in strengthening anti-tobacco programs under the oversight of the California Department of Public Health and the California Department of Education (CDE). These agencies have successfully implemented educational media campaigns, surveillance of tobacco use, and program evaluations that have contributed to a notable decline in tobacco use in the state.
The TUPE program is structured to provide funding through various mechanisms, including county-level grants and district-level initiatives aimed at implementing tobacco-free policies and surveillance of student tobacco use. Most funding is allocated via Tier 2 grants, which support comprehensive tobacco prevention and cessation programs in schools targeting grades 6 through 12.
Impact of Proposition 56 and Funding Allocations
As tobacco use rates declined, tax revenues from tobacco products began to dwindle, prompting California voters to approve Proposition 56. This measure raised the cigarette tax by $2 per pack and increased taxes on vaping products. Consequently, an additional $55 million was allocated to TUPE between 2017 and 2019, allowing for enhanced media campaigns specifically targeting youth vaping.
Despite these efforts, TUPE funding covered less than half of public middle and high school students. The CDE prioritized quality interventions over broader coverage, selecting schools competitively to ensure effective program implementation.
To evaluate the effectiveness of TUPE, researchers compared data from TUPE-funded schools with non-TUPE-funded schools, utilizing information from the 2019–2020 California Student Tobacco Survey. This survey included responses from 160,106 students across 358 schools, with a focus on grades 8, 10, and 12.
The findings revealed that students in TUPE-funded schools were more likely to receive education on the harms of tobacco use and were more engaged in tobacco prevention activities compared to their peers in non-TUPE schools. Specifically, 71% of TUPE students received messaging opposing all forms of tobacco use, while only about 64% of non-TUPE students did.
After adjusting for various demographic and personal factors, the study indicated that tobacco use among TUPE students was 6.5%, compared to 8% among non-TUPE students.
This research underscores the importance of comprehensive tobacco prevention initiatives in schools. According to the study conducted by Zhu, S., Braden, K., Zhuang, Y., et al., exposure to anti-tobacco messaging—regardless of TUPE funding—was prevalent among students, potentially influencing overall attitudes toward tobacco use.
In summary, California’s expanded school tobacco prevention initiatives have shown positive results in reducing youth smoking and vaping rates. These findings highlight the effectiveness of structured, well-funded educational programs in combating tobacco use among adolescents. As California continues to address this public health challenge, the lessons learned from its tobacco prevention efforts may serve as a model for other regions seeking to reduce youth tobacco usage.
