In collaboration with the University of the South and community partners, we propose to continue our work with Grundy County High School looking at perceptions of tobacco use among youth to understand and develop a high-school based tobacco prevention and cessation program. The proposed project will provide crucial evidence about use of tobacco products in a vulnerable population, and means of reducing these rates, which is well within the goals of the Foundation.

In March 2015, as a collaborative effort between the University of the South in Sewanee, Tennessee and the Grundy County Health Council, we conducted five focus groups in Grundy County schools to identify perceptions and tobacco use behaviors among middle school and high school students to aid development of a successful school-based tobacco cessation program. The qualitative results of the Grundy County focus groups have been informative and will help us in developing the quantitative component of this research to further inform our future school-based prevention/cessation program. To summarize the focus group findings, youth reported that tobacco use was widespread throughout the community and that the majority of their family members and friends use tobacco. Males indicated using tobacco to alleviate withdrawal symptoms whereas females were more likely to report stress and peer pressure as a reason to smoke. Harm to one’s health was a major consequence from using tobacco products, as well as financial expenses, detriments to athletic performance, and losing teeth from the use of smokeless tobacco.

Barriers to quitting included easy access to tobacco products, peer pressure, seeing others smoke, as well as a lack of resources to quit, while successful strategies to aid in quitting included going to the gym, social support, having alternative activities available, as well as receiving incentives for quitting, such as gym membership, money, gift cards, and prizes. Furthermore, students thought that a tobacco cessation program conducted during or after school with some form of counseling and the use of technology may be helpful. Since peer pressure is a barrier to quitting, a program designed to have students quit with their friends was suggested and a peer mediated prevention program might be helpful in deterring students from starting to use tobacco products. HS students also mentioned the desire to have college students involved in the counseling component. Finally, educating family members on tobacco use and addiction and teaching ways in which they can support their child in not using tobacco products, regardless of their own tobacco use, might be another component of a prevention or cessation program.