Martha Tingen is changing kids’ perceptions about alcohol, tobacco and drug use—one classroom at a time.
On a recent morning in January in a crowded fourth-grade classroom at Carver Elementary in Wadley, Ga., Dr. Tingen, a nurse researcher at the Georgia Prevention Institute, stood in front of the class and asked children to answer questions about their opinions and perceptions.
“Cigarette smoking can cause your skin to wrinkle. True or false?” she asked.
“Most teens smoke cigarettes. True or false?”
The questions are part of a study that will help determine whether a combination of classroom training and at-home reinforcement is the key to teaching children to make better health decisions.
Third- through fifth-grade students at the rural Georgia elementary school are undergoing LifeSkills training to educate themselves about the harsh effects of tobacco, alcohol and drug use, said Dr. Martha Tingen, the lead researcher on the study. This approach, an evidence-based intervention program that combines intensive two-day training for teachers and counselors with in-class and at-home exercises for children, is most focused on preventing and stopping tobacco use.
Young students are an important target group because the average age that children begin smoking in Georgia is 13, Dr. Tingen said.
The study, called Project WIN, also targets parental behavior that may affect children. Parents use a specialized version of the LifeSkills training at home to reinforce the interactive content presented in the classroom.
The home approach also encourages parents who smoke to kick the habit. Parents get culturally tailored education about the negative effects of tobacco as well as the effects of secondhand smoke on their children, Dr. Tingen said.
“Smoking is a social and learned behavior,” she said. “This study is giving parents and children the tools and opportunities to work together for effective decision-making that fosters and promotes healthy lifestyle choices.”
Through a collaborative effort with nursing professor Jeanette Andrews, parents who want to quit smoking are offered the option of the nicotine patch as well as healthy doses of motivation, in person and over the phone, by Dr. Tingen and other project coordinators.
“Smoking is still the number-one cause of preventable death in the United States,” Dr. Tingen said. “Children are three times more likely to start smoking if a parent smokes. If the parents quit before the child reaches middle school, the chances of their child initiating smoking decreases substantially. There is also an end to the damaging effects of secondhand smoke exposure on them, which is an important aim of the study as well.”
To impact children’s behavior, researchers must focus on intergenerational transmission—the process of children adopting their parents’ lifestyle behaviors, she said.
This intervention study should determine whether school-based tobacco prevention programs impact parents and their decision to promote non-smoking.
“Kids think that everyone smokes, but with this intervention, they are
provided not only information on how many kids smoke, but also information on
how many do not smoke,” Dr. Tingen said. “Interactive reinforcement of the
classroom content at home equips children with the necessary skills to make
better decisions and lifestyle choices. This approach also develops a positive
relationship between children and their parents, and research has shown that
parents who have good relationships with their children can influence the
decisions they make.”
In addition to using survey methods, Dr. Tingen and her research team also use biological measures. In the body, nicotine breaks down to cotinine and salivary cotinine—an indicator of secondhand smoke exposure and/or smoking status is measured in the children. Carbon monoxide—an indicator of smoking status – is measured in the parents.
Jennifer Hilliard