Impact Data - 2 Smart 2 Smoke Theatre Programme for Children
Date
Methodologies
A pretest-posttest design with two sequential groups was used to evaluate the effectiveness of the 2 Smart 2 Smoke productions. Data was collected by teachers of the students before the play's performance and after the completion of the post-play activities. The time interval between surveys was one to two months. The surveys from students were anonymous and confidential.
Two questionnaires were developed for the 2 age groups. The questionnaires were designed based on previous work with these age groups, such as the Child and Adolescent Trial for Cardiovascular Health, and assessed intentions to smoke and factors that were associated with smoking onset as well as factors addressed in the theatre production. The surveys measured intentions to smoke in the future, normative expectations (perceptions of the number of adults and teenagers who smoke), the expected outcomes of smoking, attitudes and knowledge about smoking, the functional meanings of smoking (the meanings young people place on smoking), and self-reported behaviour.
Two questionnaires were developed for the 2 age groups. The questionnaires were designed based on previous work with these age groups, such as the Child and Adolescent Trial for Cardiovascular Health, and assessed intentions to smoke and factors that were associated with smoking onset as well as factors addressed in the theatre production. The surveys measured intentions to smoke in the future, normative expectations (perceptions of the number of adults and teenagers who smoke), the expected outcomes of smoking, attitudes and knowledge about smoking, the functional meanings of smoking (the meanings young people place on smoking), and self-reported behaviour.
Knowledge Shifts
Students who were evaluated before and after seeing the play agreed on the following points: They would never smoke a cigarette, smokers are a dying breed, nicotine is more addictive than heroin, smoking costs a lot of money, smoking makes your teeth yellow, smoking makes your clothes stink, it is cool to be a non-smoker. Students generally understood the messages that the play was trying to convey, 97.3% of the students in grades 1-3 identifying that the Big Bad Wolf was a smoker and could not blow hard, and 96% of the students in grades 4-6 reporting that the cigarette company executive was seeking out new cigarette customers. Of the grade 4-6 respondents, the mean of those in the post-test group that knew that "smoking costs lots of money" was 85.8% vs. 62.8% in the pre-test group; the mean that believed that "nicotine is more addictive than heroin" was 54.5% vs. 23.3% in the pre-test group. There were also significant differences in the reasons given not to smoke (grades 4-6): "That there are other ways to have fun" was 88% for the post-test vs. 81.7% for the pre-test; that "I might get addicted" was 71.7% in the post-test vs. 65.3% in the pre-test; and that it "costs too much money" was 64.5% in the post-test vs. 46.8% in the pre-test.
Practices
Among the students in grades 4-6, 76% reported that they learned about alternatives to smoking and 56% practised ways to say "no" to cigarette offers. The results were felt to be short-term changes, but very important ones for this age group, as intent is often the biggest indicator of future smokers. The hope was that the messages delivered through the 2 Smart 2 Smoke plays would counterbalance the impact of attractive cigarette advertising and promotional activities around the smoking issue. The use of theatre to deliver anti-smoking messages warrants further research as part of community-wide efforts to promote healthy habits for young people.
Attitudes
It was felt that the theatre production did affect intentions to not smoke in the future for all of the students. This type of attitude is crucial, as "intentions are among the strongest predictors of subsequent smoking onset". Students in grades 4-6 also had significantly more negative attitudes and expected outcomes of smoking, and more reasons not to smoke as a result of the production. Of the grade 4-6 respondents, the mean of those in the post-test group who thought "smoking is dumb" was 92.4% vs. 89.3% in the pre-test group; the mean of those who thought "billboards get you to try smoking" was 77.2% vs. 70.6% in the pre-test group.
Increased Discussion of Development Issues
The supplementary assignments for home and classroom developed as part of the theatre package initiated discussion between parents/children and teachers/students on the dangers of smoking and consequences of being a smoker.
Access
The students from 17 elementary schools in the Twin Cities metropolitan area were a random sample to measure the impact of the 160 Minnesota schools that staged the play in the 1997/98 school year. About 71% of the sample were white, 7.5% Asian American, 6.0% African American, 1.6% Hispanic, 4.3% American Indian, and 9.6% from other racial/ethnic groups.
Source
"An Evaluation of a Theatre Production to Encourage Non-Smoking Among Elementary Age Children: 2 Smart 2 Smoke". Cheryl L Perry, Kelli A Komro, Bonnie Dudovitz, Sara Veblen-Mortenson, Robert Jeddoloh, Rhonda Koele, Ian Gallanar, Kian Farbakhsh, Melissa H Stigler. Tobacco Control 1999; 8:169-174 (Summer).
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