Relationship between school tobacco policies and tobacco-related youth outcomes

Background: School policies have the potential to reduce students' opportunities to smoke, decrease exposure to adult modeling of smoking, and change norms regarding the acceptability of smoking. Most studies of policy effectiveness have utilized survey data to indicate policy content. Only a few studies have systematically analyzed the written content of policies and linked those data with student outcomes. This study aimed to: 1) develop a coding system to measure the inclusion of specific policy components; 2) use the coding system to evaluate the comprehensiveness of school policies in a large sample of school districts; and 3) analyze the relationship between policy comprehensiveness and student outcomes. Methods: 130 school districts participating in the 2008 New York Youth Tobacco Survey provided tobacco policies, which were coded for the presence of specific components. A comprehensiveness scale was calculated for each school district. Logistic regression analyses were performed to 1) examine the relationship between 1) the single comprehensiveness scale and youth outcomes, and 2) each individual policy component and youth outcomes. Results: The comprehensiveness of a school district's tobacco policies was significantly associated with observations of other students smoking on school property. A one policy-component increase was associated with a 1.8% lower odds of reporting seeing other students smoking on school property in the past 30 days. Although not significant, a similar trend was present for reports of seeing adults smoking on school property. Conclusions: These findings are consistent with the small literature assessing the effects of school tobacco policies on student outcomes.