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8th Grade Lessons:

Needed Materials and Preparations Lesson 8-1

* Worksheet: My Self-Improvement Plan

Lesson 8-2

* Worksheet: Where Do Those Ideas Come From?

Lesson 8-3

* D.A.R.E. Decision-Making Model * Worksheet: Big Movie Script

Lesson 8-4

* Refusal Skills Roulette game (two cube-shaped boxes that serve as a pair of dice, on which sentences are written on each side)

Lesson 8-5

* Pictures of packages from various types of tobacco products Clothes hangers, string, blank index cards * Tobacco product samples (pictures on CD) * Tobacco advertising samples (pictures on CD) * Worksheet: Staff Interview Form

Lesson 8-6

* Journeyworks, Inc. Pamphlet: Smokeless Tobacco: Spit it Out! * The ABCs of Smoking booklet and transparencies * Worksheet: Smokeless Tobacco * Cigarette packages wrappers showing the Surgeon General's warning messages * The Big Dipper video

Lesson 8-7

* Worksheet: The D.A.R.E. Decision-Making Process * Mechanical Smoker * Graphic: the Addiction Cycle

* These materials are included in the supply kit that accompanies

this curriculum, or in the case of handouts and worksheets, as PDF files on the accompanying CD. The PDF format should allow you to print the files directly from computer to printer, or you can print a single copy and make duplicates for your class.

8th Grade Lessons Materials List


Lesson 8-1

Our Character Traits and Self-Image Introduction: This lesson introduces the concepts of self-image and self-esteem, and explores the ways in which these are linked to behavioral choices. The conclusion students should come away with in this lesson is that our behaviors are very often shaped by how we see ourselves, and by how we think others see us. At the same time, the way we behave towards others is often shaped by how we see them. This leads directly into Lesson 8-2, which examines peer influence and peer behavior.

Lesson Objectives: By the end of Lesson 8-1, students should be able to: W

Recognize that character traits can be seen from three different perspectives: i i i

How they see themselves How they see other people How other people may see them

W

Understand that these different perspectives often influence their own behaviors, including how they behave towards others.

W

Identify some of their own strengths and characteristics they like about themselves

W

Choose one area they would like to improve and identify strategies toward this goal

W

Identify why this improvement is important to them

L81_SelfEsteem00

Materials: W

Self-Improvement Plan Worksheet

Key Terms: self-improvement: taking action to make ourselves better. strengths: Aspects of one's self of which one is proud or takes satisfaction, such as a particular skill, talent, behavioral trait, aspect of one's personality, or other special qualities. traits: Characteristics of one's personality or behavior.

Page 8.1.1


Lesson 8-1:

Our Character Traits and Self-Image

Procedures: 1.

Write the words positive characteristics on the chalkboard. Ask each student to name a person they know that they admire, and to describe the traits or characteristics that cause them to admire this person. As students list these traits, list them under the positive characteristics heading on the board.

2.

Explain that each person has positive characteristics. Positive characteristics are our strengths. These characteristics many include many things such as physical abilities (strong, good at sports), skills and talents (good at drawing, musical, creative, good skateboarder), personality attributes (friendly, confident), intelligence (smart, clever), communication skills (easy to get along with, someone to talk to), and more. Any positive aspect of a person can be considered

L81_Traits01

their strength. An important part of good mental health is to recognize our strengths. Often people are quick to identify their weaknesses, but they have a hard time realizing what their strengths are. Often, our strengths help us improve in those areas in which we are not very strong.

L81_Traits02

For example, a person who is a hard worker may not be a very good basketball player. But by practicing and working very hard—by using this strength—this person can become a better basketball player.

3.

Review with students the words that were used to describe people they admire. Ask students to add more positive characteristics to the list of traits they admire.

4.

Use the list of characteristics and traits in the following discussion: Ask students to think about these types of characteristics in themselves. Explain that these traits are rarely "all or nothing," but rather a matter of degree. Provide several examples as follows: W

Shy

W

Outgoing

W

Quiet

W

Talkative

W

Smart

Teacher’s Note: Be prepared to discuss, as appropriate, that the traits one might find positive in one particular circumstance (e.g., leadership of a student group) may be viewed negatively in another (e.g., the ability to exert power over others in, for example, a youth gang or bullying group). Point out that these characteristics can be seen as positives in some contexts and negatives in others. For example, being considered "brainy" might be complementary in the classroom, but more of a put-down ("nerd") outside the class; being "easy-going" might be a nice characteristic in a friend, but might be considered a negative comment about someone when describing their attitude on the playing field.

Page 8.1.2


Lesson 8-1: Our

Character Traits and Self-Image

Procedures (continued) W

Popular

W

Athletic

W

Artistic

W

Friendly

W

Easy-going

W

Nice

W

Wild

W

A leader

Point out that the way people feel or act sometimes varies with their situations. For example, some people may be shy when they are with strangers, or with hearing friends, but more outgoing with deaf friends or people they know well.

5.

Use the following five scenarios to discuss: W

How we see ourselves might influence our own behavior.

W

How we see others might influence how we behave towards them.

W

How others see us might influence how they treat us.

Scenario #1: W

Your teacher has asked you to join the school's Debate Club, but you don't think you're smart enough. Would the way you think of yourself influence the way you might respond in this situation?

Scenario #2: W

You like to think of yourself as wild and crazy, and your friend has just dared you to shoplift an item at the store. How might you react? What if you thought of yourself as an honest person?

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Lesson 8-1: Our

Character Traits and Self-Image

Procedures (continued) Scenario #3: W

There's a new girl at school that everyone talks about behind her back, saying she is weird and stuck up. One day she tries to start a conversation with you. Would you be anxious to start up a conversation with her? How would you act towards her?

Scenario #4: W

There's a new girl at school that everyone says is really cool. One day she tries to start a conversation with you. Would you be anxious to start up a conversation with her? How would you act towards her? Would your reaction be different from that in Scenario #3?

Scenario #5: W

You've gotten into trouble for breaking rules at school before, but you've decided to try and make a stronger effort to stay out of trouble. You've heard that last night, someone went into the teacher's lounge and trashed the room. Who do you think the authorities will question? Why? Do you think it is fair if they suspect you?

6.

Discuss with students that it can be difficult to change oneself, even when this is something we really want to do. But explain that while it is difficult, we can improve and change ourselves. It often requires considerable thought and effort to make the changes we want to make.

Page 8.1.4


Lesson 8-1: Our

Character Traits and Self-Image

Procedures (continued) Homework: Using the Self-Improvement Plan worksheet, ask students to W

Write one of their traits or characteristics that they would like to improve or change

W

Write why this improvement is important to them

W

Complete the statements as to how they feel this improvement can change their behavior or the behavior of others towards them.

After each student has recorded the area they would like to improve, ask them to write down two or three things they can do to help them achieve this goal. What difficulties might be encountered in making this change? Ask your students to consider how they can use their strengths to make this change.

Journal: Identify a person whose strengths you admire. What are their strengths? Why do you admire these characteristics?

Page 8.1.5


Lesson 8-1 Worksheet: Self-Improvement Plan

Name __________________________________

My Self-Improvement Plan My strengths are: (Use the back of this paper if you have more)

1. _________________________________________________________________________ 2. ________________________________________________________________________ 3. ________________________________________________________________________

One area I would like to improve is: ___________________________________________________________________________

I would like to improve because: ___________________________________________________________________________

To make this improvement, I can do the following:

1. _________________________________________________________________________ 2. ________________________________________________________________________ 3. ________________________________________________________________________

Making this improvement can change the way other people think about me by:

1. _________________________________________________________________________ 2. ________________________________________________________________________ 3. ________________________________________________________________________


Lesson 8-1 Worksheet: Self-Improvement Plan

My Self-Improvement Plan Strengths I have that will help me make these changes are:

1. _________________________________________________________________________ 2. ________________________________________________________________________ 3. ________________________________________________________________________


Lesson 8-2

Friends, Peers and Others Introduction: This lesson encourages students to recognize all of the different influences around them that may influence their decision-making. These include not just friend and peer influences, but also the influence of others such as parents, siblings, teachers and coaches; the influence of marketing-what they see in stores, on billboards or in magazines; the influence of media-what they see on television, in the movies, on the internet; and the influence of relative strangers, such as movie stars, or sports heroes.

Lesson Objectives: By the end of Lesson 8-2, students should be able to: W

Identify the ways—both positive and negative—in which their behaviors can be influenced by friends and peers;

W

Identify the ways—both positive and negative—in which their behaviors can be influenced by others around them who are not friends or peers;

W

Recognize that many of their behavioral choices are often shaped by other forces such as marketing and advertising.

Materials: W

Where Do Those Ideas Come From? Worksheet

Key Terms: friend: someone whom we like and care about; in the context of this lesson, usually refers to others of a similar age.

peer influence: the indirect force that peers exert in shaping one's opinions, perceptions, desires and behavior.

peer: In the context of these lessons, generally meant as others of a similar age. Friends are usually peers, but not all peers are friends. The term goes beyond schoolmates to include people the same age seen in the community, and portrayed in various media such as magazines, in film and on television.

peer pressure: the more direct force that friends and peers often use to shape one's opinions, perceptions, desires and actions.

Page 8.2.1


Lesson 8-2:

Friends, Peers and Others

Procedures: 1.

Write the terms friends and peers on the board. Discuss with your students the meaning of each term. Facilitate the discussion by asking questions, such as: W

What do we mean by a peer? Are all of your friends peers? Are all of your peers friends?

W

What about your schoolmates? How about other 8th graders at other schools?

W

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What about kids your age that you see at the mall, but don't know? What about kids you see portrayed on television shows, music videos, or in the movies? In magazine advertisements?

W

What about an adult family friend? What about a teacher you like?

2.

Teacher’s Note: The sign used for the word “friend” should NOT be used for the word “peer.”

Ask your students to discuss the following questions: W

Thinking about your friends, in what ways do you think they influence your decisions. Let's take, for example, clothing. Do your friends have any influence over what clothes you want to buy and wear? In what ways can they influence your choices?

W

Who else influences what clothes you choose to wear? What about your parents and brothers and sisters? What about the school? What about other students you see around you but don't really know?

W

With clothing, how do you decide which styles are “cool” or “dorky”? How do you know?

Make sure that the students cover the following: W

The influence of their own circle of friends

W

The influence of others like themselves that they see at school, outside of school, on television, in the movies, in magazines and elsewhere

W

Family influences (e.g., parents choosing the clothes they wear, or forbidding them from wearing certain styles of clothing)

W

School influences (e.g., banning certain types of clothing)

W

Marketing influences, e.g., “I choose types of clothing based on what I see in advertisements.” L82_Advertising

Page 8.2.2


Lesson 8-2: Friends,

Peers and Others

Procedures (continued) Point out that all of these different influences come into play; sometimes they act together, sometimes they act in opposition (e.g., you want a nose ring because all your friends have them and it looks really cool on that person on TV, but your parents say, “No way!�)

Explain to your students: All of these relationships affect your choices, in many different ways. The influences may be direct (e.g., what your friends say to you) or indirect (e.g., what your friends wear, what you see others wearing, what you see advertised on television or at the mall). The key thing to recognize is that, consciously or not, these multiple and varying influences come into play whenever you make a decision. Point out that often it is their friends who can influence what styles of clothing they desire or choose to wear; but that what they see on others around them (their peers) may also have a great deal of influence as well. These influences are often called peer influences.

3.

Introduce the following term to the class: Peer Pressure: Social or other forces compelling someone to adopt a particular type of behavior, dress, or attitude to be accepted as part of a group, or so as not to be excluded from a group. Ask the class to discuss these concepts and to think of ways they have been influenced by peer pressure. Prompt the students using the following types of questions: W

What would people say if someone came to school with their hair dyed green? Would you ever do something like that? Why or why not?

W

Have you ever behaved a certain way because your friends around you were acting the same way? What if your friends were doing something you thought was wrong, and they wanted you to go along?

W

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What other types of situations can you think of where peer pressure comes into play?

W

In what ways do you think you are different from others? Is it hard to be different in this way?

L82_take-a-smoke

Page 8.2.3


Lesson 8-2: Friends,

Peers and Others

Procedures (continued) 4.

Explain that sometimes peer influence and peer pressure can have both positive and negative effects, sometimes influencing us to make positive decisions, and sometimes influencing us to make negative decisions. Ask students to come up with their own examples they have experienced in which peer influence or peer pressure led to positive decisions. For example: W

Seeing others doing well in class makes you study harder and do better yourself.

W

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Your close friends tell you that smoking smells bad and is a stupid habit.

W

In PE class, your best friend challenges you, saying he will beat your time in the one-mile run.

W

Your friends tell you that you have talent and really should try out for the school play.

W

Your close friends are planning to volunteer at a local children's hospital.

5.

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Ask students to come up with their own examples they have experienced in which peer influence or peer pressure might lead to negative decisions. For example: W

Everyone makes fun of the new girl at school because of the clothes she wears.

L82_Teased L82_Decisions01

W

Your friends dare you to jump off a high wall on your skateboard.

W

Your good friends have decided to take up smoking after school.

W

You want to join a new secret club at school, but you have to steal something from the nearby store to prove you can be a worthy member. L82_Friendsmoke

6.

Ask students to evaluate their experiences above, as well as the following examples. Is the peer pressure positive or negative? Why? Write the items on the board one at a time and discuss each one. Remember that socially, some of these may be very appealing to students; take time to discuss these issues as well.

Page 8.2.4


Lesson 8-2: Friends,

Peers and Others

Procedures (continued) W

Some kids from your class invite you to study with them.

W

Your roommate in the dorm asks you to watch a movie that won't end until 1:30 in the morning.

W

You are trying to lose weight A girl in your class asks you to go running with her.

W

You are interested in learning about computer graphics. An older boy will teach you if you help him improve his Science grades.

W

A kid in your class invites you to a party on Tuesday and someone you really like will be there. Your mom already told you that you are not allowed to go to parties on weeknights.

W

An older kid who you think is cool invites you to have a cigarette after school. You want to impress him.

W

You are not good at shooting free throws in basketball. A teammate offers to help you improve your foul shot if you come to practice early each day to work with him/her.

W

A neighbor your age who lives down the street is out with her friends one night. You don't know most of them, and they don't really sign, but they offer you a cigarette. If you smoke, maybe they will be your friends.

W

Some of your friends are going to get their tongues pierced. You know your Dad said, “No,� but you want to get your tongue pierced anyway.

7.

Encourage your students to think about influences beyond their friends, family and peer network-especially the influences of media and marketing. W

Why is it that a particular style or brand of clothing suddenly becomes popular?

W

Who is behind what you see in the malls, or what you see on television and in the movies?

Homework: Pass out the Worksheet, Where Do Those Ideas Come From?

Journal: Many teenagers wear similar clothing and hairstyles. What is positive about looking similar to your peers? What is negative about looking similar to your peers?

Page 8.2.5


Lesson 8-2 Worksheet: Where Do Those Ideas Come From?

Name __________________________________

Where Do Those Ideas Come From? “Hey, when I smoke, I feel older and cooler. Smoking is a nice way to relax and have fun!”

L82WS_Cool

“Yuck! Smoking is disgusting. It makes your clothes, hair and breath smell bad. And most smokers don’t seem very relaxed, and most don’t look like they’re having much fun.”

Young people commonly express these ideas about smoking. Where do you think these ideas come from? Is one statement more correct than the other? In what ways? Write your thoughts below:

L82WS_Stinks

__________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________


Lesson 8-3

Tobacco Use and the Influence of Others Introduction: The purpose of this lesson is to strengthen students’ understanding of the different influences that may affect decisions such as whether or not to smoke; and that the influences of peers and friends operate within a broader set of forces (e.g., familial rules and expectations, as well as social forces including prohibitions and regulations, tobacco marketing, communal attitudes towards smoking, etc.). The choice to use tobacco (or alcohol or drugs) is made amidst different, and many times conflicting, influences. Students should become aware that their decision to use (or abstain from) tobacco is often influenced by unrecognized forces, such as the imagery promoted by tobacco companies, family expectations, friend expectations and perceived peer norms.

Lesson Objectives: By the end of Lesson 8-3, students should be able to: W

Identify the influences (friends, peers, advertisers, family, society) that affect decision-making

W

Identify the ways that peer pressure affects decision-making

W

Review the D.A.R.E. Decision-Making Model

W

Identify reasons why young people choose to smoke or not to smoke

W

List healthy alternatives to smoking

Materials: W

Tobacco advertising samples (provided on CD)

W

Anti-tobacco advertising samples (provided on CD)

W

D.A.R.E. Decision-Making Model (See Lesson 7-3)

W

Big Movie Script Worksheet

Key Terms: alternatives: the options or choices one has when confronted with a decision. decision making: the process of assessing choices and consequences when considering a decision to be made.

Page 8.3.1


Lesson 8-3:

Tobacco Use and the Influence of Others

Procedures: 1.

Review with your students how friends and peers can influence a person's decisions.

Ask your students: How do you think friends and peers might influence a person's decision to smoke or not? For examples of friends and peers encouraging smoking: W

Friends may smoke themselves; may suggest smoking to you; may have attitudes that favor smoking (“That looks so cool!” or “Try it, it gives you a nice little buzz!”).

W

Peers: if you believe that most of the kids around you smoke; if you see a lot of kids around you smoking; if you see characters

L83_Friendsmoke

your age in movies or on TV who are portrayed as cool with cigarettes, drugs or alcohol use; if you view smoking peers as “cool” or looking “more mature.” For examples of friends and peers discouraging smoking: W

Friends may keep you from smoking; may express attitudes opposing smoking (“That stinks, yuck!” or “Smoking: What a stupid thing to do!”).

W

Peers: if you believe that most of your peers do not smoke; if you don’t see many peers around you smoking; if you see peers who choose not to smoke as making smart and independent decisions; peers in anti-smoking ads.

2.

L83_SmokingStinks

What about the influence of others besides friends and peers? For examples of others encouraging smoking: W

Influence of others around you: if a family member like a parent smokes; if parents argue their right to smoke (“So what if I smoke around my kids? It’s not like I’m putting a cigarette in their mouth!”); if another family member such as a brother, sister or cousin gets you started on smoking, or buys you cigarettes;

L83_FamilySmokes

if you see teachers smoking around you. For examples of others discouraging smoking: W

Influence of others around you: if your parents are firmly against smoking; if a family member has asthma, or someone you know has cancer from smoking; if your teachers or other adults you know used to smoke but quit. L83_FamilyNoSmoke

Page 8.3.2


Lesson 8-3: Tobacco

Use and the Influence of Others

Procedures (continued) 3.

What about other influences? For examples of other influences that encourage smoking: W

Other influences you might not be aware of: tobacco advertising in magazines, on billboards, at sporting events, on clothing or hats; favorite movie stars or sports figures who smoke or use smokeless (chewing) tobacco; candy cigarettes or cigars; smoking or tobacco use that looks attractive or cool in movies or on television. L83_KoolAd

Source: www.trinketsandtrash.org

For examples of other influences that discourage smoking: W

Other influences you might not be aware of: anti-tobacco advertisements; if a famous model or sports figure tells you that you shouldn't smoke; laws or rules against smoking on school grounds, or in restaurants, public places, work places, etc.

Ask your students: How do you think rules such as those prohibiting smoking at school, in restaurants, at the park, in offices, etc. might affect your decision to smoke or not? Do you think those rules have any impact on how “easy” it would be to find opportunities to smoke? How about laws

L83_JackieChan

Source: www.cdc.gov/tobacco/pubs1.htm#posters

designed to make it difficult for you to purchase cigarettes? What about smoking at school? Does anyone know if there are rules about smoking on campus? What happens to students who violate those rules? Has anyone ever seen anyone breaking those rules on campus? Students? Teachers? Staff? Do these rules make a difference? Are they important? In what ways?

4.

Provide your students with the following information: W

Every day 2,000 teenagers in the US begin to smoke regularly.

W

Still, most people in the United States—including most young people—do not smoke.

W

Scientists say there are many reasons why young people start to smoke. Four reasons that young people commonly give for starting to smoke are (write these on the board):

Teacher’s Note: This is an opportunity to raise the issue that smoking may seem "cool" because that's how the habit is often portrayed in advertising, in movies and on television. For tobacco companies that sell cigarettes, their goal is to associate the product with positive images. Thus, cigarette advertisements often portray smiling, healthy people engaged in fun activities; or romantic situations; or show their product linked to desirable qualities such as strong will, decisiveness, intelligence, independence, risk-taking or power. See Procedure 6 below.

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Lesson 8-3: Tobacco

Use and the Influence of Others

Procedures (continued) To be accepted To solve problems or relieve stress To have fun To appear older Ask students to list other reasons why they think teenagers decide to start smoking.

5.

Divide the class into four groups and ask each group to consider one of the four reasons for starting to smoke listed above. Ask the group to brainstorm positive alternatives to smoking that will help them accomplish these results (e.g., acceptance, problem solving/stress reduction, having fun, or appearing more mature) without resorting to tobacco use, drug use or alcohol. Share ideas with the group.

6.

Have students discuss their homework assignment from the previous lesson. Ask your students how their own perceptions of smoking affect their choice to smoke or not. For example, they may believe that smoking makes their breath smell bad or yellows their teeth; OR, they may think that smoking can make them look more sophisticated, older, or cool; or would impress friends or other people.

Ask your students: Where do these perceptions come from? For example, why would we think that smoking might make us look more sophisticated or older? More cool? More impressive to others? Why might we think that smoking is bad for us? Where does this information come from? What feelings or impressions do you get when you look at these advertisements? What associations do the people behind these ads want you to make with their product?

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Source of all images: www.trinketsandtrash.org

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Lesson 8-3: Tobacco

Use and the Influence of Others

Procedures (continued) 7.

Point out that the D.A.R.E. process encourages us to think carefully about the different aspects of making a decision-from defining what our actual choices are and why the decision is important, to identifying the consequences of our possible decisions. If we understand how friends, peers, family and others influence our decisions, we can more clearly identify our choices, assess their consequences, and make wise decisions.

8.

Teacher’s Note:

Review the D.A.R.E. decision-making process.

If your class has never covered the D.A.R.E. decisionmaking process before, you may need to take some time to review the steps with your students. The model can be found in Lesson 7-3, which uses the decisionmaking process of the Drug Abuse Resistance Education (D.A.R.E.) program, the pioneer prevention effort established in 1983. Given the widespread use of D.A.R.E. programming in the elementary grades, there is a significant likelihood that your students will have been previously exposed to the D.A.R.E. decision-making model. If not, the concepts underlying the model are relatively straightforward and are reviewed in Lesson 7-3.

Hand out the Big Movie Script Worksheet. Describe the following situation to the class: You have been asked by a famous movie director to help make a movie. In the movie, the star, Cody, must make a very important decision. The director doesn't know the ending to the movie yet. He wants you to decide how the movie will end. Using the D.A.R.E. decision-making process, create an ending to the movie script. Read the script and write the ending. Remember you must show how Cody makes his decision. Students can plan the script in small groups or individually. The class

L83_DARE

will vote on how well each script uses the D.A.R.E. process.

Journal: Children of parents who smoke are at higher risk (twice as likely) to become smokers. Why do you think this is true? If most young people do not use tobacco products, where does the pressure to do so come from?

Page 8.3.5


Lesson 8-3 Worksheet: Big Movie Script

Name __________________________________

Lights! Camera! Action! Scene: As Cody leaves school on Tuesday, his friends Jim and Jon talk to him.

Jim:

Ellen's mom and dad are out of town, so she's having a big party tonight!

Jon:

This is great! My brother said he would buy us cigarettes and beer if we give him money. (At first Cody thinks this a party is a great idea. As John starts talking about cigarettes and beer, he realizes that the party might not be such a great idea.)


Lesson 8-4

Tobacco Use: Resisting the Influences to Smoke Introduction: This lesson is designed to help students learn ways to assess and resist the various types of influence to smoke.

Lesson Objectives: By the end of Lesson 8-4, students should be able to: W

Understand the concept of resistance, how they resist, and how others resist them;

W

Classify different types of resistance (i.e., passive, aggressive, assertive);

W

List and practice different ways of saying "No" to tobacco.

W

Gain an understanding why these resistance strategies may often be difficult in practice.

Materials: W

Refusal Skills Roulette game (Two cube-shaped boxes, to serve as a pair of dice, on which sentences will be written on each side)

Key Terms: refusal skills: tools which one can use against friend or peer pressure to do something that one finds undesirable, unsafe, or wrong. refusal strategies: ways of expressing refusal, divided here into three major types: passive, aggressive and assertive. Passive: refusal in a non-confrontational manner without actually saying “No.” Tends to be non-committal (“Um...maybe”), and often involves leaving an issue unresolved. Aggressive: refusal expressed by using confrontational strategies. Assertive: Refusal in a firm, clear, but non-threatening manner.

L84_SayNo

Page 8.4.1


Lesson 8-4:

Tobacco Use: Resisting the Influences to Smoke

Procedures: Teacher’s Note: 1.

Review with your students the ways in which different people and situations influence—or try to influence—behavior. Point out that the class has also discussed that it is up to each person to make his or her own decisions, and how using the D.A.R.E.

Refer to the D.A.R.E. decision-making model (Lesson 7-3 and 8-3) to consider the possible interpersonal "consequences" of refusing to do what others want us to do.

Model can help clarify this process.

2.

Discuss with your students why refusing to go along with others—including people whose ideas and opinions are important to us—can be difficult to do.

3.

Explain that when we want to refuse to do something that others want us to do, it is useful to have some ideas about how to refuse.

4.

Discuss the different types of resistance that people use. Ask your students to consider situations that may have relevance to everyday situations: For example: W

Your friends ask you to join them behind the gym to smoke cigarettes.

W

Your friend asks you to cover for him and tell his parents he was at your house last night.

W

Your friend wants you to try smoking.

W

Your boyfriend is pressuring you to have sex.

W

A teacher asks you to stay after school for extra tutoring.

W

Your friends dare you to shoplift a small item at a convenience store.

L84_SayNo

As students describe the ways that they resist (e.g., I ignore my friends’ invitation; I shrug my shoulders; I say, ‘Maybe next time.”; I giggle and then look away, etc.), write them on the board.

L84_Passive

Passive Resistance Explain to your students that some of these strategies can be termed passive resistance; when we avoid our friend, when we say “um...maybe” or simply shrug our shoulders or laugh when he asks us to try smoking, we are resisting passively. We avoid confrontation by neither agreeing or disagreeing, walking away, or ignoring the issue.

Ask your students: What other types of situations can you think of where you've used passive resistance?

Teacher’s Note: Advantages might include avoiding conflict; disadvantages might include not resolving the problem, or not making your decision clear to others.

Page 8.4.2


Lesson 8-4:

Tobacco Use: Resisting the Influences to Smoke

Procedures (continued) Aggressive Resistance L84_Aggressive

Some strategies can be termed aggressive resistance. These usually involve a more confrontational tone, such as taking a cigarette that someone has offered you and crushing it in your hands, saying, “Get that stuff out of my face!”

Ask your students: What other situations can you think of where someone might use aggressive resistance?

Teacher’s Note: Advantages might include being clear and forcefully direct; disadvantages might include sparking a fight or argument, or causing bad feelings.

Assertive Resistance A third resistance strategy is sometimes called assertive resistance. L84_Assertive

Assertive resistance usually involves making your resistance known in a direct but non-confrontational manner. For example, “No thanks, I don’t smoke,” or “Let’s NOT get into your parents’ liquor cabinet—why don’t we find something else to do instead?”

Ask your students: What other situations can you think of where someone might use assertive resistance?

5.

Teacher’s Note: Advantages might include being direct; disadvantages might include causing bad feelings.

What type of resistance strategy is most effective when confronted with pressure to do something—such as smoke a cigarette, try marijuana, have sex, get drunk—that we are afraid to do, or don't think we should do? Explain to the class that different situations may require different strategies. What is important to know is that there are several different ways to say “No.” Have your students examine the following techniques. How well do they think they would work in different situations?

1. Be direct

L84_Refusal01

Page 8.4.3


Lesson 8-4:

Tobacco Use: Resisting the Influences to Smoke

Procedures (continued)

2. Change the subject

L84_Refusal02

3. Think of a clever response

L84_Refusal03

4. Make a joke

L84_Refusal04

5. Blame an adult

L84_Refusal05

6. Walk away or avoid the situation

L84_Refusal06

Page 8.4.4


Lesson 8-4:

Tobacco Use: Resisting the Influences to Smoke

Procedures (continued) 6.

Encourage your students to think about resistance from another perspective: Often you are the one trying to convince someone else to do something they may not want to do. How might that person react to you? For example: W

You tell your friend to skip tomorrow's party and go with you to a movie instead.

W

You want to convince your mom to let you get your tongue pierced.

W

You ask your parents to let you go to a movie with your friends on a school night.

W

You hound your parents to buy you a dog.

Which of the strategies do your students encounter when they try to pressure others to do something?

7.

Discuss why it is sometimes difficult to undertake resistance strategies. For example, resistance may start an argument or fight; might hurt someone's feelings; might embarrass oneself; or might get someone in trouble.

8.

Present situations and ask how students would respond? Which types of responses are easiest? Which types are hardest? W

You are at the store. Your friend grabs a CD and hides it in her bag. She tells you to shoplift one as well.

W

You go to your friend's house where you find him

L84_Shoplift

in the garage, smoking marijuana. “Here,” he says, “Try some.” L84_Marijuana

W

Tom is a friend of yours. During a break in class, he hands you a pack of cigarettes. “Hey, be a pal,” he says. “Keep this for me until this afternoon.”

9.

Have students play Refusal Skills Roulette. L84_HideCigs

Page 8.4.5


Lesson 8-4 Game: Refusal Skills Roulette

Refusal Skills Roulette Directions: 1.

On each side of the first die, write the following:

Be Direct Change the Subject Think of a Clever Response Joke Walk Away Blame an Adult 2.

On each side of the second die, write the following:

“Why don't you smoke cigarettes with us, your mommy won’t let you?” “Want some pot?” “Come on, no one will know if we have sex, don’t you love me?” “I have some beer in my backpack, meet me after school to drink it.” “So what if you’re grounded? We can sneak you out through your window tonight.” “Hey there’s that new kid. He’s such a dork—let’s go steal his backpack.” 3.

Students will take turns throwing the dice and then using the situation and the strategy to respond. One variation of the game may be to have pairs of students role-play the various situations and resistance strategies.

4.

Discuss with your students how it felt to use the various strategies. Would they have chosen different strategies if they were able? Which ones, and why?


Lesson 8-5

What Encourages Tobacco Use? Introduction: This is the first of three lessons that build on the concepts developed in lessons 8-1 through 8-4. Lesson 8-5 introduces how these concepts are applied to tobacco use, exploring the pressures that encourage tobacco use. In Lesson 8-6 the influences that discourage tobacco use will be considered. In Lesson 8-7 we draw these themes together to expand on issues relevant to the tobacco use decision-making process, including addiction. Each lesson may require more than one class session.

Lesson Objectives: By the end of Lesson 8-5, students should be able to: W

Identify the various ways in which tobacco is used

W

Understand patterns of tobacco use for adults and youth

W

Understand these patterns, i.e., why young people use tobacco products, in light of the influences discussed in Lessons 8-1 through 8-4

W

Recognize that factors are "weighed" in favor of or against decisions as they are made

Materials: W

Examples of packages from various types of tobacco products (or pictures) (Cigarettes; chewing tobacco; pipe; cigar; bidis; kretek; waterpipes)

W

Clothes hangers, string and index cards for creating a hanging "balance" of push/pull factors for tobacco use.

W

Tobacco product samples (pictures on CD)

W

Tobacco advertising samples (provided on CD)

W

Staff Interview Forms

Key Terms: marketing: persuasion to buy a product or accept an idea by presenting it in a favorable light that shows its advantages or attractions; advertising. perception: one's view of, or attitude toward, an idea, behavior, product or other object, that is shaped through knowledge, experience, observation, and communal and peer norms.

Page 8.5.1


Lesson 8-5:

What Encourages Tobacco Use?

Procedures: 1.

Valuable Resource:

Review with your students the various types of tobacco products (cigarettes, chewing tobacco, pipe; cigar; bidis; kretek; waterpipes). Use the following pictures from the accompanying CD of images. Emphasize the tobacco products not normally thought of as tobacco, including bidis and clove cigarettes, and the new breed of flavored cigarettes.

Many of the photographs of tobacco packaging and advertisements in this curriculum are taken from Trinkets and Trash Services, a company formed to make tobacco promotionrelated information available for antitobacco educational purposes. Their website lists thousands of images. If you are interested in obtaining more images, visit their website at: www.trinketsandtrash.org

L85_CamelPacks

Source: www.trinketsandtrash.org

s

L85_Doral

Source: www.trinketsandtrash.org

Most students will be familiar with tobacco in cigarette form, such as the familiar Marlboro and Camel cigarette brands. Note the giveaway (free racing t-shirt) provided with the Marlboro cigarettes. And most will probably have seen cigars and cigarillos. L85_Cigars

L85_MarlboroPackage

Source: www.trinketsandtrash.org

L85_Cigarillos

Students may be familiar with smokeless (or chewing) tobacco, although many may have never seen it or its packaging. It is most commonly sold as loose tobacco leaf in tins... L85_Skoal

Source: www.trinketsandtrash.org

...or in pouches such as this Red Man tobacco package. Smokeless tobacco use is particularly common among baseball players. Note how one candy manufacturer is taking advantage of this to sell bubblegum. Who will buy this product? What do your students think of this type of marketing?

L85_ChewTin

Source: www.trinketsandtrash.org

L85_RedManChew

L85_BigLeagueChew

Source: www.trinketsandtrash.org

Source: Print Ad, National Geographic Kids

Page 8.5.2


Lesson 8-5: What

Encourages Tobacco Use?

Procedures (continued) Other tobacco products include pipe tobacco... ...and even tobacco sold loose for hand-rolled cigarettes L85_HandrollTobacco

L85_PrinceAlbert

Source: www.trinketsandtrash.org

Source: www.trinketsandtrash.org

Increasingly common among young people are cigarettes that originated in India, including bidis... ...kretek... ...and clove cigarettes. L85_Bidis

Source: www.trinketsandtrash.org

Many young people smoke bidis, kretek and clove or herbal cigarettes in the mistaken belief that they are not “real” tobacco. In fact, they are made from tobacco, and are just as addictive and harmful to health as “regular” cigarettes and other tobacco products. L85_Kretek

One reason young people may believe these tobacco products are different is that they don’t really “look” like normal packaged cigarettes, nor are they marketed in the same way. Look at the colorful packaging, as well as the flavored varieties that are available: Grape! Wild Cherry! Lemon Lime! These sound like candy varieties. Who do your students think will find these colorful packages and exotic flavors appealing?

L85_CloveCigarette

L85_FlavoredTobacco

L85_BidiFlavors

Source: www.trinketsandtrash.org

Source: www.trinketsandtrash.org

Source: www.trinketsandtrash.org

Page 8.5.3


Lesson 8-5: What

Encourages Tobacco Use?

Procedures (continued) 2.

Teacher’s Note:

Ask your students: W

This section presents information in terms of percentages. You may need to review briefly with your students the concept of “percentages”-e.g., 50% representing 50 out of 100, or half.

How many of you know peers—people your age—who have used any of these products?

3.

Ask your students: W

What percent of people your age do you think have ever smoked cigarettes—that is, they've tried smoking at least once?

W

What percent do you think have ever used smokeless (chewing) tobacco?

Write the answers on the board or on the transparency for each group.

Teacher’s Note: 4.

Show your students the following “ever smoked” data by age. Point out to your students how their estimates are the same as (or different from) the actual statistics. By 8th Grade:

Scientists make a careful distinction between ever use and current use. Ever use will always be greater than current use because significant numbers of people who try tobacco never go on to regular or even occasional use. Ever users may also include former smokers. Current users are those who are actively using tobacco, either on an occasional or regular basis. Current use is often measured by 30-day prevalence—that is, the number of people who have used a tobacco product within the past 30 days.

L85_8thGrade

By 10th Grade:

L85_10thGrade

Page 8.5.4


Lesson 8-5: What

Encourages Tobacco Use?

Procedures (continued) By 12th Grade:

L85_12thGrade

A survey of over 200 Deaf high school students in California found that: W

45% have ever smoked

W

By college, 65% say the have smoked at least once.

Point out to your students how the rates of “ever smoked/chewed” increase as young people get older. Ask them to explain why this is the case (e.g., the older you are, the more opportunities you have to try smoking at least once.)

5.

Compare your students’ estimates with the figures given above. If their estimates were higher, explain that young people often overestimate the number of people who smoke, perhaps thinking that smoking is a more common behavior than it really is. Some people may be encouraged to try smoking if they believe that, “everyone else is doing it.” If your student's estimates were lower, explain that tobacco use and smoking are important problems for young people, especially for your students’ age group. Make sure your students understand that they are at an age of very high risk for starting tobacco use.

6.

Discuss with your class why young people smoke and use chewing tobacco. What forces encourage this decision? List these on the board. For example: W

“It makes me feel cool”

W

“To be accepted”

W

“It is something to do”

W

“It makes me look older”

W

“I need the energy boost it gives me”

Page 8.5.5


Lesson 8-5: What

Encourages Tobacco Use?

Procedures (continued)

7.

W

“It helps me relieve stress”

W

“It is an easy way to have fun with my friends”

Ask your students: W

Do you think smoking makes someone look cool, older or more mature?

W

People say they smoke to reduce stress. Do you think this works? Why or why not? People say they smoke because they are depressed. Do you think smoking makes them less depressed? Why or why not?

W

Do you think there are other ways to deal with stress or depression?

W

Where do these ideas—that smoking or using tobacco makes you look older or more cool; or that it helps you relax and have a good time; or that it gives you energy—come from? Raise the issue of the role of tobacco advertising. Make the point that tobacco marketing can be very subtle. Note the various types of appeals built into the marketing materials (acceptance/popularity, beauty, thinness, feminine/masculine, mature, etc.). What kinds of situations do these cigarette advertisements depict? When students see these ads, what kind of ideas to they start to have about smoking? Do you think these advertisements might influence young people’s expectations for smoking? Ask your students to come up with adjectives to describe these scenes: for example, fun, excitement, friendship, exotic.

L85_NewportBiking

L85_CamelCasbah

Source: www.trinketsandtrash.org

L85_CamelParty

Source: www.trinketsandtrash.org

Then ask students where the idea that “smoking is cool” comes from.

Source: www.trinketsandtrash.org

L85_NewportParty

Source: www.trinketsandtrash.org

Page 8.5.6


Lesson 8-5: What

Encourages Tobacco Use?

Procedures (continued)

What about the idea that smoking is relaxing?

L85_ParliamentHammock

Or that smoking is romantic? Notice the appeal to African Americans in this ad, and below:

Source: www.trinketsandtrash.org

L85_NewportRomance

L85_MeritYacht

Source: www.trinketsandtrash.org

Source: www.trinketsandtrash.org

L85_KoolPlayers

Source: www.trinketsandtrash.org

Virginia Slims is a cigarette brand that is marketed to women. What kind of women? What do you think from the ads below? Notice also the ethnicity of the women in these ads.

What about the notion of smoking as being “manly” and “masculine”? L85_CamelBond

L85_Marlboro01

Source: www.trinketsandtrash.org

Source: www.trinketsandtrash.org

L85_VSlimsVoice

Source: www.trinketsandtrash.org

Page 8.5.7


Lesson 8-5: What

Encourages Tobacco Use?

Procedures (continued) 8.

Introduce the concept of “balance”—that influences can both “push” and “pull” people as they make decisions, and these forces are “weighed” in decisions that are made. Distribute index cards to the class. Ask students to write down factors that they think encourage tobacco use. Examples of such “pull” factors might include, “makes me feel cool,” “makes me look mature,” “helps me fit in with friends,” “makes me feel better,” etc.). They should use one index card per factor. Indicate to the class that in the next session we will be looking at other factors that “push” the other way—that discourage tobacco use. Save these for use in Lesson 8-6.

9.

Advise your students that in the next session they will be talking about the opposite—influences that discourage tobacco use. Ask your students to think about such forces. For example, do they think that the rules that exist at school about tobacco use have any impact on the decision of students to smoke or not to smoke? Do the rules encourage use? Discourage use? Ask your students to imagine that they have just become the Superintendent (Principal) of the school. Their first job is to help students avoid smoking. How would they do this? What rules would they create about smoking? Explain the homework assignment. Indicate that the results of the survey will be discussed in the next class session.

Homework: Have each member of the class conduct an interview with one member of the staff (faculty, dorm staff, administration, school nurse, counseling staff), completing all questions on the Staff Interview Form.

Teacher’s Note: Advise your colleagues about this assignment (via e-mail, note, etc.). Indicate that they will be asked about their own cigarette smoking practices. You may want to assign groups of students to interview a particular staff person, or you can invite a school administrator or staff person to come to class as part of an in-class interview.

Journal: What difference does it make if your perception of people smoking is different than what is actually occurring?

Page 8.5.8


Lesson 8-5 Worksheet: Staff Interview

Name __________________________________

Staff Interview Form Name of staff person interviewed __________________________________

1.

What rules does the school have about smoking? other tobacco use? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

2.

Who is allowed to smoke on campus? at social events? at sports events? at events off campus? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

3.

What happens if someone—a student, teacher, guest—who is not allowed to smoke on campus is caught doing so? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

4.

What kind of help does the school provide to people who are addicted to tobacco? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

5.

Do you think rules about tobacco use in school: are strict enough. Why? _____________________________________________________ should be stricter. Why? In what ways?_________________________________________ should be less strict. Why? In what ways?_______________________________________


Lesson 8-5 Worksheet: Staff Interview

Staff Interview Form 6.

Have you ever smoked cigarettes? Yes No

If the person answers “Yes”: How old were you when you started? _______________ What were the reasons you decided to start? ___________________________________ __________________________________________________________________________ __________________________________________________________________________

Did people pressure you to smoke? Yes No Do you smoke cigarettes now? Yes No If No: How old were you when you quit? ______________ Why did you quit?___________________________________________________ ___________________________________________________________________ ___________________________________________________________________

If the person answers “No”: What were the reasons you decided not to start? ________________________________ __________________________________________________________________________ __________________________________________________________________________


Lesson 8-5 Worksheet: Staff Interview

Staff Interview Form Did people pressure you to smoke? Yes No Was it hard to say no? Yes No


Lesson 8-6

What Discourages Tobacco Use? Introduction: This lesson examines the factors that discourage tobacco use, including knowledge of the health effects and social consequences of tobacco use, anti-tobacco efforts, and rules and regulations restricting tobacco use and smoking.

Lesson Objectives: By the end of Lesson 8-6, students should be able to: W

Identify that tobacco use has undesirable health and other consequences

W

Learn about the health effects and social consequences of tobacco use

W

Recognize the forces seeking to keep young people from using tobacco products, including anti-tobacco advertising, taxation and rules and regulations.

Materials: W

Completed Staff Interview Forms (from session 8-5)

W

Journeyworks, Inc., pamphlet: Smokeless Tobacco: Spit it Out!

W

The ABC’s of Smoking pamphlet

W

Smokeless Tobacco Worksheet

W

Cigarette package wrappers showing the Surgeon General’s warning messages

W

The Big Dipper video

Key Terms: health consequences: the physiological results, both immediate and long-term, of tobacco use smokeless tobacco: chew, chewing tobacco and other tobacco products that are consumed orally, but not smoked.

warning labels: Information that is required on all tobacco packaging and advertising, describing some of the health hazards of tobacco use.

social consequences: the results of tobacco use that pertain to relationships with others; compliance with school and community laws and regulations; economic impact; and other non-health considerations.

Page 8.6.1


Lesson 8-6: What

Discourages Tobacco Use?

Procedures: 1.

Refer to the prior lesson to remind students that there are pressures to use tobacco products. On the other hand, what are some of the factors that discourage people from using tobacco products? Have students bring out their Balance project (begun in Lesson 8-5, Activity #8). Ask them to suggest some of the forces and factors that discourage tobacco use. Examples: W

Knowledge about the health consequences of tobacco use (e.g., it causes cancer, leads to heart disease and strokes, fear of addiction, etc.)

W

Social consequences of smoking (e.g., gives you bad breath, smells bad, gateway to other drug use, etc.)

W

Economic consequences (e.g., expensive habit)

W

Parents’ opposition

W

Rules and regulations that restrict the purchase of tobacco, or that restrict the practice of smoking or other tobacco use.

W

Anti-tobacco information and advertising (e.g., www.tobaccofreekids.org, the Truth campaign)

2.

Write the words Health Consequences on the board. Explain to your students that knowledge about the harmful effects of tobacco on the body can help make the decision not to smoke. Distribute the pamphlet The ABC’s of Smoking. Over the past 50 years, scientists have shown that the components of tobacco—the chemicals found in tobacco and in the smoke when tobacco is burned—can harm the body in very serious ways. Ask your class if they can list some of the most important health consequences of tobacco use. Classify the responses into the following categories:

Teacher’s Note: If your students have previously completed the 7th grade unit of this curriculum, they may have already studied the health and social consequences of tobacco use. If so, you may choose to present an abbreviated version of the material presented here.

Valuable Resource: Other facts and figures regarding smoking and young people can be found at: http://tobaccofreekids.org/research/ factsheets/index.php

Check This Out!: 3.

Effects on the respiratory system: The most common way people use tobacco is to burn it and inhale the resulting smoke, either from a cigarette, cigar, pipe, bidi, kretek, or waterpipe (hookah). This smoke causes a great deal of damage to the tissues of the respiratory system: that is, the lungs and airways leading to them.

A wonderful interactive animated presentation of the effects of tobacco on different organ systems in the body can be found at: http://www.cdc.gov/tobacco/sgr/ sgr_2004/sgranimation/flash/ index.html

Page 8.6.2


Lesson 8-6:

What Discourages Tobacco Use?

Procedures (continued) When a person inhales, their lungs fill with air containing oxygen. The lungs have tiny air sacs, called alveoli, where the oxygen is absorbed into the blood and exchanged with carbon dioxide, a waste product of the body that is exhaled as the person breathes out. This process is called gas exchange, and is the primary function of the lungs. The oxygen absorbed by the blood in the lungs is then carried to the heart, and all other tissues and organs of the body. When you inhale, the inside of your lungs and airways are

L86_Alveoli

exposed to air, including any germs, dust, dirt particles and other objects

Demonstration:

floating in the air. To clean away these foreign particles, your lungs and airways secrete mucus, which traps the particles. Little hair-like structures called cilia then push this mucus, with its trapped particles, out of the lungs and airways, where it can be coughed, spit, or otherwise passed out of the body.

Purpose: To demonstrate the paralyzing effect of cigarette smoke on the bronchial cilia Materials: A tennis ball and a basketball Procedure: Have students line up in two rows facing each other, with arms outstretched in front of them, and fingertips barely touching those of the person across from them. Starting at one end, place a tennis ball in the middle of the outstretched fingertips, and ask the students to move the tennis ball down the line, by wiggling ONLY their fingertips. Repeat with a basketball. Have students repeat the exercise, but this time forbidding the students from moving or wiggling their fingers at all.

So what does smoking do? Tobacco smoke can paralyze the cilia that move this mucus out of the lungs and airways, making it more likely that germs, dirt and other contami-

Explain: This is the way cilia act to move mucus and dirt particles out of the lungs and airways. When cilia are healthy, they can move mucus and trapped contaminants out easily. When exposed to cigarette smoke, however, the cilia become paralyzed, making it much more difficult to move these contaminants out of the body.

nants (together with the mucus) will get trapped in the lungs. The more A healthy lung normally has a smooth surface. Compare the healthy lung with this diseased lung of a smoker. This lung shows lung cancer, the grayish-white bumps on the lung.

L86_HealthyLung

Image Source: The ABC’s of Smoking

L86_LungCancer

Image Source: The ABC’s of Smoking

Page 8.6.3


Lesson 8-6:

What Discourages Tobacco Use?

Procedures (continued) Demonstration: Purpose: To demonstrate what it feels like to have emphysema. Materials: Coffee stirrers (hollow) or very small straws Procedure: Have students place a coffee stirrer in their mouths. Explain that for the next two minutes, they can breathe ONLY through the coffee stirrer. After students have recovered, repeat the exercise, but this time ask students to walk around the room and try to talk with each other, again without inhaling anything except through the straw. Explain: This is the way it feels ALL THE TIME if you have emphysema. No matter how hard you breathe, your body cannot get the oxygen it needs. Have students note how much worse it felt if they had to move around. Point out that any exertion—even just walking around—becomes very difficult for a person with emphysema. Note that the disease is progressive—that is, it gets worse and worse over time—and has no cure. The disease is almost always fatal, but not before a long period of wasting and fatigue.

and the longer you smoke, the greater the damage done to these cells until they lose almost all of their ability to clean the lungs. The result is often "smoker's cough," the hacking, mucus-laden cough that long-time smokers often experience, especially on awakening in the morning. If the lungs and airways become inflamed and clogged with mucus, this can lead to chronic bronchitis, making it difficult to breathe. When a person smokes, the tobacco smoke is inhaled into the lungs, where the smoke leaves behind a sticky residue called tar. Contact with this residue can damage the lungs, and over time may result in diseases such as lung cancer and emphysema. The smoke also damages the alveoli, the little air sacs where gas exchange in the lungs takes place. This damage means that your lungs become much less able to perform the gas exchange that brings oxygen into your body. In some people, this damage

Demonstration: Purpose: To demonstrate the effects of atherosclerosis (narrowing of the body’s arteries). Materials: Coffee stirrers (hollow) and wide drinking straws; styrofoam cups and bottled water. Procedure: Fill cups with equal amounts of water. Have students pair off, distributing a coffee stirrer to one half of each pair, and a wide drinking straw to the other half. On the word “Go,” the students will drink their cups of water as quickly as possible, as if taking part in a race. Explain: The chemicals in tobacco smoke cause the blood vessels in your body to narrow, going from wide-open tubes like the wide straws, and becoming narrowed like the coffee stirrers. Students can see how much harder they had to work to move water through the coffee stirrers. This work puts additional stress on the heart, which pumps blood through the body.

progresses to become a disease called emphysema, where the alveoli (air sacs) have been damaged to the point where oxygen can no longer be absorbed into the bloodstream.

Page 8.6.4


Lesson 8-6:

What Discourages Tobacco Use?

Procedures (continued) Smoking also causes the airways (the lungs and the tubes leading to them) to overreact to harmful substances, causing them to tighten up ("constrict"), and leading to wheezing and shortness of breath. This can be especially serious for those people who already suffer from asthma.

4.

Effects on the circulatory system: The chemicals found in tobacco have many effects on the body's circulatory system. Smoking encourages a process call atherosclerosis, or narrowing of the arteries and blood vessels. This reduces the flow of blood and oxygen to important organs, including the brain and heart. Over time, this narrowing can lead to a heart attack (if the heart tissue is deprived of the oxygen it needs to keep beating), or a stroke (caused by a blockage of a blood vessel in the brain or neck, leading to tissue damage

L86_Atherosclerosis

or destruction in the brain.)

5.

Mouth and throat tissues: The chemicals that cause damage to lung tissues can also damage tissue in the mouth, leading to gum disease, mouth sores and tooth loss. These chemicals can also lead to cancer of the mouth and throat.

6.

Other organ systems: Over the long term, smoking has also been linked to cancer of the bladder, kidney, pancreas and other important organs in the body.

s

L86_GumDisease

Tobacco use can lead to gum ulcers as in this picture here. Eventually, this tissue damage can lead to oral cancer, such as that featured in the anti-tobacco advertisement at right: L86_OralCancer

Page 8.6.5


Lesson 8-6:

What Discourages Tobacco Use?

Procedures (continued) 7.

What about smokeless (chewing) tobacco products? Since these aren’t burned and smoked, doesn’t that make them safer? Explain to your students that these

Teacher’s Note: One compelling story of a young victim of chewing tobacco can be found at:

products also contain harmful chemicals that can

http://whyquit.com/whyquit/ SeanMarsee.html

cause diseases such as oral cancer. Many young people believe that these types of tobacco are safe because they are not smoked, but this is an incorrect belief.

8.

The story can also be found on the accompanying CD (in the “WebPages” folder, titled “Sean Marsee’s Message”). You might want to consider reviewing this story as a class exercise, or having students read it as part of a homework or journal exercise.

Social consequences of smoking: Ask your students if anyone can think of any reasons—other

Optional Activity:

than harmful health impacts—that would discourage people from smoking. Possible prompts include:

Show the video The Big Dipper.

Personal appearance/grooming: e.g., bad breath,

This is a 1980’s video that is old, but it has excellent information and is captioned.

yellow teeth, discolored fingers, holes in clothing. Relationships with others: e.g., upsetting parents, disappointing teachers, putting off friends.

Rules and regulations: e.g., getting punished for breaking school rules, being asked to step outside restaurants, getting cited or ticketed in public places for violating no-smoking regulations. Financial considerations: e.g., the economic costs of smoking. Also, as the health consequences of tobacco use have become better known, more and more people in our society and elsewhere have come to recognize these dangers and have decided to actively fight against smoking. There are increasing numbers of rules about where one can and cannot use tobacco products. Smoking is now prohibited in many workplaces—including schools, hospitals, airplanes, and public buildings.

9.

Explain that one of the difficult things about educating young people about tobacco is that many of the health impacts seem to be so far off into the future that they don't seem to matter. However, there are some immediate health impacts, even for youths. What are these? W

Cigarette smoking during adolescence appears to reduce the rate of lung growth, and hence the maximum level of lung function that can be achieved.

Page 8.6.6


Lesson 8-6:

What Discourages Tobacco Use?

Procedures (continued) W

Young smokers are much more likely to experience shortness of breath, coughing spells, phlegm production, wheezing, and overall diminished physical health. Often young smokers have more difficulty exercising because they have a hard time getting enough oxygen when they breathe hard.

W

Young smokers are less physically fit than their non-smoking peers.

W

Smoking can contribute to the onset of asthma, or can severely aggravate an existing asthma condition.

W

Chewing tobacco can lead to mouth sores and gum disease, even at a young age.

W

Both smoking and chewing tobacco can lead to bad breath, yellowed teeth, stained fingers, dulled taste buds, and a dulled sense of smell.

W

One unseen impact-young people who start smoking at a younger age are more likely than later starters to develop a long-term addiction to tobacco. If you start smoking at a younger age, chances are you will have a much more difficult time quitting tobacco use later on, than someone who begins smoking at a later age.

Teacher’s Note: 10.

Have the wrappers from four packs of cigarettes on a table. W

Ask students to look carefully at the packs to find something exactly the same on each pack—the Surgeon General’s Warning.

W

Explain that the government requires a warning on all packs of cigarettes because of the danger involved with smoking. Ask students if they think these warnings are useful? Do they think people read them? Do they think these warnings are effective for young people

Your students may have looked at the Surgeon General’s warnings in the 7th grade curriculum here. Extend the exercise by asking students to design warning labels that they think would be effective for other young people their age, especially the Deaf. For additional information about warning labels, see the file L86_WarningLabelFacts.pdf on the accompanying CD.

their age? Why or why not? What messages do they think would work better? Are there any messages they can think of that could be aimed specifically at Deaf people? Should they warn about other diseases or consequences of smoking?

L86_SGLabels

Page 8.6.7


Lesson 8-6:

What Discourages Tobacco Use?

Procedures (continued) 11.

Have students take out the index cards from Lesson 8-5, on which they wrote the "pull" factors making smoking or other tobacco use seem attractive. Distribute additional index cards, and have students begin to write down “push” factors that would keep someone from wanting to smoke cigarettes, using the discussions above as a guide. Using string and clothes hangers, suspend the “pull” factors from one side of the hanger, and the “push” factors on the other side. Explain that many different factors enter into the decision to smoke, some favoring smoking and others discouraging smoking. But if they analyze the issues carefully, there are always many more reasons against smoking than there are for smoking.

12.

Explain to students that despite all of the factors that should discourage tobacco use, many young people still take up the practice of smoking cigarettes or chewing tobacco. Once they’ve started, however, they begin to experience a powerful new feeling that keeps them smoking—sometimes after just a few days. Many young people, more than 7 out of every 10 who have started to smoke, want to stop. But when they try to quit they run into a characteristic problem— addiction. Ask your students what they think is meant by the term addiction. List their responses on the board or a piece of paper to be retained for the next class session when the addictive nature of tobacco use is discussed.

Homework: Distribute the Smokeless Tobacco Worksheet. Ask students to review the pamphlet Smokeless Tobacco: Spit It Out!, and complete the worksheet.

Journal: Several years ago, smokeless (“chewing”) tobacco was used by many baseball players. In 1993, players, coaches, and managers were banned from using smokeless tobacco during games. Why do you think smokeless tobacco was banned? Do you think it was a good decision? Why? Why not? What are the benefits of a ballplayer complying with this rule? to the ballplayer? to spectators? to the team and others?

Page 8.6.8


Lesson 8-6 Worksheet: Smokeless Tobacco

Name __________________________________

Smokeless Tobacco 1.

How is smokeless tobacco used? ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________

L86_CopenhagenCowboy L86WS_ChewTin

2.

Source: www.trinketsandtrash.org

What are the different names for smokeless tobacco? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

3.

What is the drug that is in smokeless tobacco? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

4.

Is smokeless tobacco addictive? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

5.

Name five ways that smokeless tobacco harms your body. _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________


Lesson 8-6 Worksheet: Smokeless Tobacco

Smokeless Tobacco 6.

Why do companies want you to get hooked on smokeless tobacco? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

7.

What can you do if someone pressures you to use smokeless tobacco? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________


Lesson 8-7

Tobacco: You Decide! Introduction: You can present this lesson or invite a guest speaker to take part. IF you wish a guest speaker to participate, make arrangements in advance with the local Health Department or voluntary agency. Review with the speaker the sections of the lesson (e.g., the addiction cycle, etc.) for which he or she will be responsible.

Lesson Objectives: By the end of Lesson 8-7, students should be able to: W

Distinguish between the stages of tobacco use (experimentation, initiation, regular use)

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Recognize the key characteristics of “addiction�

W

Understand the addiction cycle as it relates to tobacco use

Materials: W

D.A.R.E. Decision-Making Process Handout

W

Mechanical Smoker

W

Graphic: the Addiction Cycle

Key Terms: nicotine: The active ingredient in tobacco products that is the chief cause of physical addiction through its effects on brain chemistry. addiction: Extreme physiological and psychological dependence on a substance such as tobacco, alcohol or other drug, that has progressed beyond voluntary control. People who are addicted often feel sick when they stop using this substance.

addiction cycle: The sequence of steps that spiral into addiction, involving the gradual development of physical dependence, along with the growing importance of withdrawal symptoms, in encouraging and reinforcing continued tobacco use.

Page 8.7.1


Lesson 8-7: Tobacco:

You Decide!

Procedures: 1.

Show the transparency of the D.A.R.E. Decision Making process steps. Review the components of the process with your students. Emphasize the importance of clarifying decisions and identifying consequences; be sure students have considered the varying consequences involved in a decision to smoke, including both health and social consequences.

2.

Discuss tobacco use as an example of a behavioral choice that has multiple consequences. Ask your students to suggest possible outcomes

L87_DARE

of a decision to use tobacco. For example: W

disappointing or offending friends and other peers

W

disappointing or angering parents and other adults

W

breaking school rules or the law

W

adding to tobacco companies' revenues

W

influencing others to try and use tobacco products

W

preventing the purchase of other products because of the cost of tobacco products.

W

3.

health consequences

Go back to the list of reasons for why young people use tobacco products that the class developed in Lesson 8-5. For example: W

“It makes me feel cool”

W

“To be accepted”

W

“It is something to do”

W

“It makes me look older”

W

“I need the energy boost it gives me”

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“It helps me relieve stress”

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“It is an easy way to have fun with my friends.

Ask your students to brainstorm alternative activities or choices through which to address these issues without resorting to tobacco use.

Page 8.7.2


Lesson 8-7: Tobacco:

You Decide!

Procedures (continued) 4.

Ask your students to consider an additional reason why tobacco users continue to use these products—even after they have made the decision to stop. Add the words “I’m addicted—I can’t quit” to the list of reasons (above) on the board. Students may be able to pose alternatives to the reasons given in Activity 3 above. However, what is the logical alternative to “I’m addicted—I can’t quit.”? Don't start.

Teacher’s Note: Make sure students understand that, while people offer several reasons for why they began smoking, very quickly "addiction" takes over as a primary reason for continuing to smoke. Even though they may come to decide that smoking in fact does not make them look cool, or feel more accepted, or give them an energy boost, physical addiction to tobacco makes it very difficult for them to stop smoking.

L87_Cartoon

Page 8.7.3


Lesson 8-7: Tobacco:

You Decide!

Procedures (continued) 5.

Ask your students if, when smokers make the decision to quit, can they do so? Can this be easily done? Why? Why not? Discuss with students why it is often difficult to stop. Several factors contribute to smoking when a person is starting to smoke, including peer pressure, stress reduction, boredom, the desire to rebel, and others. However, as one begins to smoke more regularly, the main reason for smoking quickly emerges: the person feels unpleasant or bad if he is NOT smoking, and to feel better, he needs to smoke another cigarette. This is addiction. Review the characteristics of addiction that your students listed in 8-6. Most students will likely refer to the cravings associated with addiction; some may be aware of the notion of withdrawal. Add to the discussion using the following information about nicotine and the addiction cycle.

6.

Ask the class what happens when someone smokes. Use the Mechanical Smoker to demonstrate the residue that is left behind in the lungs from smoking a cigarette. Explain that when a person uses tobacco, either by burning it and inhaling the resulting smoke, or by placing it in the mouth and sucking on it, chemicals in the tobacco smoke (or juice in the case of smokeless tobacco) are absorbed by the body. In fact, cigarette smoke contains over 4,000 chemicals, including ammonia (used as a floor/toilet cleaner), arsenic (used in making rat poison), formaldehyde (used to preserve dead body tissues), and hydrogen cyanide (one of the components of gas chamber poison). More than 50 of these chemicals are known human carcinogens—that is, they have been proven to cause cancer—and dozens more are thought by scientists to be possible human carcinogens. One of the most important chemicals in tobacco smoke is nicotine. Nicotine by itself does not cause cancer. It is, however, highly addictive. It is nicotine that produces the mild pleasant sensations when a person smokes, but that also compels smokers and chewers to continue using tobacco even when they want to quit.

7.

Show your students the addiction cycle graphic. Review the key elements of the addiction cycle with your students. When tobacco is used, nicotine is rapidly absorbed into the bloodstream, either through the lungs (smoking) or through the mucous membranes in the mouth (chew). It is quickly transported in the blood to the brain.

Page 8.7.4


Lesson 8-7: Tobacco:

You Decide!

Procedures (continued)

6 So you smoke another cigarette. And the cycle starts over again.

1

Within seconds of inhaling, nicotine speeds its way to your brain.

5

Over time, your brain becomes accustomed to nicotine stimulation. Once this happens, you experience unpleasant withdrawal symptoms if your nicotine craving is not satisfied.

4

Your brain starts to crave another “hit” of nicotine— telling you to smoke another cigarette.

W

2

In your brain, nicotine causes the release of a chemical called dopamine which stimulates feelings of pleasure and relaxes you.

3

But as soon as you stop smoking, this stimulation wears off as the nicotine level in your body falls.

In the brain, the nicotine excites the pleasure/excitement/relaxation centers, creating a pleasurable sensation.

W

However, this stimulation rapidly dissipates, prompting the desire - the craving - for another “hit” of nicotine. Without this “hit” most tobacco users begin to experience unpleasant symptoms, known as “withdrawal symptoms.” These can be: i

Feeling irritable, moody or tense

i

Headache or dizziness

i

Feeling restless or nervous

i

Insomnia

i

Upset stomach or constipation

i

Coughing

i

Drowsiness or fatigue

i

Difficulty concentrating

i

Increased appetite

i

Dry mouth, sore throat, gums and tongue

Page 8.7.5


Lesson 8-7: Tobacco:

You Decide!

Procedures (continued) W

To relieve these feelings most tobacco users will again use the tobacco product. This restarts the addiction cycle.

W

For many tobacco users, over time the body builds up a gradual tolerance to nicotine. This means that the tobacco user needs even more doses to create that same sense of well-being.

W

Many people who try to stop using tobacco products experience “withdrawal symptoms.” While this is not likely to last for a very long time, these symptoms can be unpleasant and many people who try to quit therefore relapse to tobacco use to relieve these feelings.

8.

Remind your students that most young people who smoke have many incorrect beliefs about tobacco use. W

They think that smoking won't affect their health until they are older. Even though many of the most dramatic health effects of smoking, such as lung cancer, emphysema, heart disease or stroke usually occur later in adulthood, emphasize that the damage starts as soon as one starts smoking. Review the immediate health consequences of smoking that were outlined in Lesson 8-6.

W

They don't realize how quickly tobacco users become addicted. They say, “I only smoke a little. That won't hurt me.” Or “I'm only going to smoke for a few years, then I'll quit.” Again, point out that there is no “safe” amount of smoking. Tobacco smoke--even just a little bit--can harm the body. And while people may say they'll smoke “just a little,” most people cannot do that for long. Tobacco is powerfully addicting, and if your body has “just a little” tobacco, it will quickly L87_Boasting

develop the need for greater and greater amounts just to feel normal. And no one can assume that “just smoking a little” doesn't do any damage to the body. Smoking for just a short time can cause permanent damage to the lungs, heart, eyes, throat, urinary tract, digestive organs, bones and joints, and skin.

Page 8.7.6


Lesson 8-7: Tobacco:

You Decide!

Procedures (continued) W

They think they can stop whenever they want to. i

“I'll never get addicted”

i “This is something I just like to do. It doesn't mean that I HAVE to do it.” i

“I'm young. I have plenty of time to quit when I want to.”

i

“I can quit whenever I want.”

Instead, what they find is that once they try to quit smoking, they find that they cannot. They experience withdrawal symptoms just like adult smokers; they find that they are addicted. Remind your students that all tobacco products are addictive—including chewing tobacco—not just cigarettes.

9.

Discuss with your students the relationship between the two characteristics of tobacco products: (1) that they are addictive (because of nicotine, one component of tobacco), and (2) that they have serious health consequences (because of the tar and other chemicals in tobacco products). Explain that because young people get “hooked” on cigarettes, despite what they expect, these health and other consequences can result.

10.

Discuss the cycle of tobacco use with your students. Remind your students that most experimentation and initiation begins in childhood or adolescence but rapidly becomes regular use for most tobacco users. Many people—including many young people—try to quit but find they relapse (i.e., go back to smoking), and regular use continues. This is why quitting is so difficult. And this is why the best way to avoid addiction is not to start using tobacco—at all—in the first place.

Journal: Some people who smoke cigarettes cough, are short of breath, and know they increase the chance of having a heart attack or getting diseases such as cancer. Why do you think these people keep smoking cigarettes? What would you tell them if you could chat with them?

Page 8.7.7


Lesson 8-7: The D.A.R.E. Decision-Making Process

Name __________________________________

Decisions, Decisions! The D.A.R.E. Decision-Making Process

D

Define the decision to be made.

A

Assess the options. What are the options? What are the consequences of each option?

R

Respond by choosing the option that will have the most desirable impact.

E

Evaluate the final choice. How good was the decision that was made?


Lesson 8-7 Graphic: The Addiction Cycle

The Addiction Cycle

6 So you smoke another

cigarette. And the cycle starts over again.

1

Within seconds of inhaling, nicotine speeds its way to your brain.

5

2

Over time, your brain becomes accustomed to nicotine stimulation. Once this happens, you experience unpleasant withdrawal symptoms if your nicotine craving is not satisfied.

In your brain, nicotine causes the release of a chemical called dopamine which stimulates feelings of pleasure and relaxes you.

3

4 Your brain starts to crave

But as soon as you stop smoking, this stimulation wears off as the nicotine level in your body falls.

another “hit” of nicotine— telling you to smoke another cigarette. L87_AddictionCycle


Lesson_08th