Background: Previous research suggested an association between cigarette smoking and poor academic performance among youth. However, the association between secondhand smoke exposure and academic performance is unclear. We examined the prospective association between secondhand smoke exposure and subsequent academic performance in US youth.

Methods: We analyzed data from the Population Assessment of Tobacco and Health (PATH) Study Waves 2 and 3 surveys. Respondents who reported not using any tobacco in the past 30 days at Wave 2 were included (n=8,749). At Wave 2, we assessed the number of hours respondents were exposed to secondhand smoke in the past seven days. At Wave 3, we assessed respondents’ self-reported academic performance (1=mostly F’s; 9=mostly A’s). Weighted linear regression models were used to test the association between secondhand smoke exposure at Wave 2 and academic performance at Wave 3, adjusting for demographics, past-year internalized and externalized problems, and past-year substance use at Wave 2. We further stratified the analysis by race/ethnicity.

Results: At Wave 2, among US youth non-tobacco users, 26.6% and 5.3% reported exposing to secondhand smoke for 1-10 hours and >10 hours in the past seven days, respectively. Hours of secondhand smoke exposure were similar between non-Hispanic black, non-Hispanic white, and non-Hispanic other youth, but lower in Hispanic youth (p<0.05). Overall, US youth who exposed to more hours of secondhand smoke in the past seven days at Wave 2 reported lower academic performance at Wave 3 (adjusted regression coefficient [ARC] for 1-10 hours: -0.24, 95% CI=-0.33, -0.15; ARC for >10 hours: -0.67, 95% CI=-0.84, -0.50). The association was statistically significant in all race/ethnic groups (p<0.05).

Conclusions: Secondhand smoke exposure predicts subsequent academic performance in US youth. The results highlight the importance of protecting youth from secondhand smoke through implementing comprehensive smoke-free policies at public places and at home.

Background. While the prevalence of smoking is lowest among Asian/Pacific Islanders (API), ethnic-specific data show Koreans (20%) and Vietnamese (16.3%) having higher prevalence compared to the general population of California (12.3%). A grant from the California Tobacco Control Program supported the API Regional Initiative to Reduce Tobacco-related Disparities. The initiative includes an innovative youth-led campaign to pass a smoke-free outdoor dining policy and a smoke-free multi-unit housing policy in four Los Angeles County jurisdictions.

Methods. Members of a program for at-risk youth were invited to participate in the initiative as the API Youth Coalition to assist with outreach and evaluation activities. The API Youth Coalition participated in three 2-hour training sessions held by the project staff and members of the evaluation team. Trainings focused on increasing knowledge about cigarette smoking and its health effects, policies governing smoking behavior, and the youth’s integral role in the initiative. Youth also participated in capacity-building exercises related to ethical research practices, community engagement, data collection, and safety assurances. They were also responsible to come up with a name for the campaign, thus creating a sense of ownership.

Results. A total of 15 male youth participated in the training sessions and ranged in age from 14 to 18 years. The trainings produced a cadre of youth who are ready to engage in tobacco control efforts and assist with evaluation activities, which include door-to-door and street intercept surveys, and observations of tobacco use in outdoor dining areas.

Conclusion. Youth participation promotes leadership and produces the next generation of tobacco control advocates. Partnering with an existing youth program facilitated coalition building and heightens the capacity for community-engaged work among youth participants and participating organizations, as the outreach and evaluation skills gained from the initiative are transferrable to other projects.

Although Philadelphia youth smoking rates have experienced a decline from 30.6 percent in 1997 to 7.2 percent in 2015, e-cigarette use has increased dramatically, reaching 26.7 percent in 2015 (YRBS, 1997-2015). Misconceptions about the dangers of e-cigarette use, coupled with aggressive targeting of youth and communities of color through marketing and media campaigns by tobacco companies put our youth at serious risk of tobacco related morbidity and mortality.

Health Promotion Council’s (HPC’s) Advocacy Institute (AI) is a youth training program that works to engage and empower Philadelphia’s most at-risk youth to not only resist these hostile tobacco marketing campaigns, but to build their own tools for countering the tobacco companies and educating their peers on the dangers of tobacco, especially e-cigarette, use. AI is anchored in theories of empowerment and innovation, and is designed to inspire and support participants to create sustainable change in their communities. This framework is especially important for vulnerable populations, such as the low-income minority youth AI serves. AI’s education delivery model is partially peer-led and encourages participants to be self-driven. It also ensures the youth’s advocacy is relevant to their community and culture, which facilitates a greater impact. HPC integrated AI’s core concepts of policy, media, and community-level advocacy and public health education with tobacco-specific training (tobacco control policy, point of sale tactics, health impacts and tobacco as a social justice issue) to create a targeted, unique curriculum. AI programming culminates with youth participants planning and implementing an advocacy event immediately preceding graduation.

To increase the model’s sustainability in at-risk communities, AI includes an Alumni Network (AIN), which provides additional support for students interested in developing their leadership skills. AIN members master advanced advocacy concepts, serve as mentors for incoming students, and have access to internship, job and scholarship opportunities.

Analysis of data collected from Advocacy Institute youth participants revealed that all participating youth felt that overall the Advocacy Institute was a good or excellent experience, with 86 percent of them reporting that it was excellent, that it was empowering, and that they took action! A one-month follow up survey demonstrated every participant had either participated in the AI alumni network or planned to participate soon; of those who participated to date, half or more reported enhanced skills in communication (75%), problem solving (50%), and action planning (50%) due to participation in the alumni network. Lastly, seven out of every eight participants (87.5%) reported they would be interested in receiving additional training and/or resources in advocacy.

Presenters will discuss AI’s core values and key components of the training curriculum. We will also demonstrate AI’s benefits on youth participants, their peers and surrounding communities through youth participants’ projects, and will highlight some of AI’s recent successes, which include: a successful social media campaign, #Philly1st, an annual peer-led Youth Summit, meetings with numerous community leaders and elected officials, and being named the 2018 Campaign for Tobacco-Free Kids Youth Advocate of the Year Group Award winner.

Issue: The Food and Drug Administration has recognized schools as a key location where students are using e-cigarettes. When a student in Maryland is caught using or possessing an e-cigarette, the Maryland Guidelines for a State Code of Discipline recommend that the school refer the student to the local health department (LHD). The Guidelines are only effective if the LHD offers a cessation program for youth, particularly one focused on vaping cessation. Some LHDs do offer such programs; many do not. This leaves the school with little alternative but to impose discipline rather than offer treatment.

Description: When a student is caught vaping in school, administrators and educators can refer students to local programs as an alternative to suspension or other punitive discipline. LHDs are qualified to teach these programs, with staff who are both knowledgeable in tobacco cessation programs and the particular needs of the community. One Maryland county combined various evidence-based and evidence-informed programs to create a cessation program with a focus on e-cigarettes that is evaluated and amended after each session. Since its inception in 2016, the program has only seen one repeat offender. LHDs in at least three of the 24 counties in Maryland regularly run similar programs that cater to youth.

Lessons Learned: More than 3.6 million middle and high school students regularly use e-cigarettes. A critical analysis of LHD programs will show the potential that they have in combatting the youth e-cigarette epidemic.

Recommendations: LHDs should run e-cigarette cessation programs that are (1) free of charge; (2) evidence-based; and (3) evaluated to meet the needs of the students.