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"Organizers need to know information about key audiences; strategies more likely to succeed and be effective; materials available for use; guidelines for producing and pretesting educational materials; and suggestions for tobacco control activities appropriate in conjunction with the materials." |
Challenges to Tobacco Prevention Efforts Despite the addictive nature of tobacco, individuals continue to smoke. Most know the health consequences of smoking but lack the motivation, social support, and resources to quit. Some individuals feel no sense of urgency about preventing disease and show little concern for the long-term consequences of negative health habits (25). Consequently, getting individuals to stop smoking and developing effective, culturally relevant smoking cessation programs still represent major public health challenges. Perhaps especially so, smoking prevention and cessation remain a primary public health objective. Information on the negative consequences of tobacco use should be available to everyone throughout their lifecycle regardless of income, culture, and economic level. Racial/ethnic minority groups must be reached wherever they are and within the context of their daily lives. Programs and materials must be culturally relevant and sensitive to the lifestyles of minority groups, and the materials should reflect a positive image of them as consumers (24). Tobacco prevention and cessation programs should be offered toward lower-income and minority groups who bear a disproportionate burden of tobacco-related disease in the U.S. Such programs should provide practical information about the health consequences of tobacco use, resources to help people quit, and specific techniques for quitting. Programs should be developed specifically for adult smokers who are not deterred by increases in tobacco prices. More research should address how to change the cultural, psychosocial, and environmental factors that influence tobacco use, and how to determine the best strategies to prevent and control tobacco use among racial/ethnic minority groups. Existing programs also need to be evaluated. Racial/ethnic minorities need to understand how culture, media, and advertising influence tobacco use, decision making, and overall health. Tobacco education programs, messages, and strategies should emphasize individual and community empowerment.
Developing Effective Tobacco Prevention Materials and Programs There are general guidelines, suggestions, and recommendations that apply for effective tobacco use prevention programs; however, some are specific to minorities only. Materials Arkin and colleagues (1995) conducted a national study to identify and obtain copies of tobacco control and prevention materials designed for use in the community and to identify gaps in available materials and strategies. Of 207 sampled items, 188 were acceptable according to the review criteria. Reasons for unacceptability included outdated information, inaccurate information, hyperbole (especially in advocacy materials), and very poor writing or production quality. Little evidence suggested that the materials were developed based on sound communication principles, behavior change models, and knowledge of how to prevent and control smoking. Reviewers also noted that, in some cases, the information so strong-ly leaned toward advocacy that accuracy and credibility were questionable. Many of the materials intended for adolescents relied heavily on questionable fear-arousal techniques such as graphic pictures of diseased mouths and lungs. Some of the materials reviewed did not appear to be connected to any articulated public health strategy. A review of numerous tobacco use prevention brochures suggested that no assess-ment was made to determine if the intended audience would be addressed most effect-ively through presentations, self-instruction, games, or other instructional methods. Gaps were noted in the availability of materials for certain audiences. Most materials were intended for youth ages 11 to 19. Few materials existed for elementary-age children, ethnically diverse groups, and community settings, or for health professionals to use with their clients. The quality of materials ranged from very high to very low. Materials produced by community groups were of poorer quality than those produced by national groups. Reviewers identified other potential problems such as:
Health education theory and models should guide the development of tobacco education programs and materials. However, existing theory and models may not necessarily be appropriate for racial/ethnic groups. Community groups produce and will continue to produce their own materials, so their organizers should design and implement programs to support a planned strategy to educate, change attitudes, or motivate the group. To improve community-level access to effective tobacco prevention educational materials, state and national clearinghouses and automated databases should be developed. Tobacco control advocates should have access to information about relevant educational programs and materials. Because of the current availability of materials, producers should consider if existing materials will suffice before they develop new materials on the topic. Thus, they can take advantage of well-developed materials and use their limited resources to meet specific needs for their communities (18). The Center for Substance Abuse Prevention of the Substance Abuse and Mental Health Services Administration offers these guidelines for developing effective prevention materials (24):
Suggested Methods of Outreach
Lessons Learned from Experience
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