Partnership for Children's Health: Evaluation of School Tobacco-free Policies

Background: Tobacco use among youth is a public health problem. The CDC has called for implementation and enforcement of tobacco free school (TFS) policies as a population-based approach to the problem. This study included statewide partners who explored the current status of TFS policies in statewide K-12 schools. Methods: Tobacco policy documents were requested from administrators of all K-12 school districts in a rural Northern Plains state. A checklist that uses the CDC guidelines for TFS policy was used to evaluate each district's consolidated policy materials. Follow-up interviews were conducted with superintendents (n = 5) from schools with either comprehensive or incomplete policies. Results: Policy materials were received from 121/152 public school districts (80% response). Policy evaluation scores could range from 0 to 26. Higher scores reflected stronger policies. The overall mean policy score was 10.8 (standard deviation 5.6). Public schools had the highest mean (12.1) followed by non-public (6.3) and tribal/Bureau of Indian Education schools (7.5). Strengths and limitations of policies were identified. Superintendent interviews identified barriers to strong TFS policy as time and staff expertise. Superintendents of schools with incomplete policy noted that tobacco use was neither a problem nor a priority locally. Facilitators of policy implementation were motivation and personal experience. Conclusions: There is variability in statewide TFS policies. To facilitate change, a report card with recommendations for improvement was given to each district and a school resource guide was disseminated. Public health and school health nurses are integral to quality tobacco free school policy development.