Foreword

The Substance Abuse and Mental Health Services Administration (SAMHSA) is pleased to present to the field Reducing Tobacco Use Among Youth: Community-Based Approaches--A Guideline for Prevention Practitioners. This is the first such handbook to be generated from a series of prevention guidelines planned by the Center for Substance Abuse Prevention's (CSAP's) Division of State and Community Systems Development under its Prevention Enhancement Protocols System (PEPS).

CSAP established PEPS in 1992 as one of its efforts to strengthen the substance abuse prevention systems in the States and territories. In a nutshell, the PEPS guidelines attempt to answer often-asked questions, such as:

• Which interventions alone or in combination work in preventing substance use?

• Under what circumstances do they work?

• How does a practitioner choose one intervention over another?

• How can a chosen intervention be implemented?

Using the "evidence-based" methodology, the PEPS guidelines identify and analyze all the research as well as practice knowledge available in order to synthesize it and develop recommendations for practice. In this process, PEPS taps the expertise of a wide array of researchers, practitioners, and policymakers to increase the utility of its recommendations. Lessons learned from the research and practice evidence are supplemented with recommendations based on the considerable experience of the experts who participate in the development of the guides. When such recommendations are made, the source of advice is clearly identified so readers can better assess how their own situations relate to the example mentioned.

Besides providing sound advice for program planners and practitioners, a formal program, such as PEPS, that systematically assesses prevention research and practice has many advantages for the field. First, it results in efficient use of limited resources. Second, it directs our focus to the need to continuously collect data on the content, processes, and outcomes of prevention programs in order to measure their effectiveness. Third, by illuminating areas in which there is insufficient evidence, it encourages research to fill those gaps and spur the development of innovative practices. And, finally, it promotes the accumulation of knowledge as more and more practitioners try out approaches and exchange information. This last step is critical in the development and solidification of the field.

This guide is designed to stimulate and support the prevention activities of State and local agencies and community-based organizations, including grassroots efforts affiliated with schools, churches, workplaces, and other community institutions. Individual practitioners, such as school teachers, health personnel, justice and law enforcement officials, lay and religious leaders as well as youth leaders, may also find this document useful in addressing tobacco use among youth in their communities.

SAMHSA and CSAP selected this topic for several reasons: First, tobacco use among youth has been repeatedly documented as a priority public health problem. Second, focusing on underage smokers and users of smokeless tobacco also supports one of the goals identified in Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Finally, and most importantly, this guide responds to the needs of the States in meeting the Synar Amendment to the 1992 Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act. The amendment requires all States to document good-faith efforts to inhibit access by youth to tobacco products and report on their results each year. Among its mandates, the amendment requires all States to enact laws prohibiting any manufacturer, retailer, or distributor of tobacco products from selling or distributing such products to anyone under the age of 18. The amendment also requires all States to document good-faith efforts to inhibit access by youth to tobacco products and report on their results each year.

The Synar Amendment is a substantial complement to the August 1996 publication of the final rule on tobacco in the Federal Register, which charges the Food and Drug Administration with regulating the sale and distribution of cigarettes and smokeless tobacco to children and adolescents. Both the Synar Amendment and the FDA rule buttress the efforts of the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention, which has been active in efforts to modify risk factors regarding tobacco, nutrition, and physical activity and to encourage comprehensive prevention approaches, including school health education, community health promotion, and prevention centers. Other related Federal Government activities include the National Institute on Drug Abuse, which produces numerous publications in prevention and treatment research, epidemiology, behavioral research, and health services research.

CSAP would like to thank the PEPS Planning Group, the Federal Resource Panel, and the Expert Panel for their contributions to the development of the PEPS program and this guide.

Nelba Chavez, Ph.D.
Administrator
SAMHSA

Stephania J. O'Neill, Acting Director
Center for Substance Abuse Prevention
SAMHSA