The Journal of School Nursing

Few published studies have explored the impact of smoking prevention programs among elementary-school children. This study describes a qualitative, cross-sectional evaluation of the Tar Wars tobacco prevention program among 5th-grade students (n = 888), along with impressions from classroom teachers and program presenters. Results from this evaluation reveal that all constituencies involved with the Tar Wars program—5th-grade students, classroom teachers, and program presenters—indicated high satisfaction with this youth tobacco education program. Students enjoyed the program and indicated understanding of key themes, classroom teachers stated that the program was worthwhile in presenting unique information, and presenters were enthusiastic about the ease of presentation and opportunities for future presentations.

Research has shown that tobacco use usually begins in early adolescence, results in an increase in future health problems, and ultimately affects national health care costs. Despite the messages about the dangers of smoking, young people continue to smoke. A school-based tobacco education program designed to produce a more favorable attitude about the positive effects of not smoking and increase knowledge of the hazards of smoking was implemented for 6th graders in a parochial middle school. After the intervention, there was a significant increase in knowledge about tobacco but no change in attitudes regarding the use of tobacco. The results have implications for school nurses who design and teach programs to prevent tobacco use.

There is evidence of a substantial increase in teen use of both cigars and marijuana over the last decade. The theoretical concept of sensation seeking suggests a conceptual relationship between teen use of the substances. The hypothesis was that a relationship existed between the use of cigars and marijuana. Data for this study were gathered during the evaluation in a local school district of a teen tobacco-use reduction program. Questionnaire data and focus group results supported the study hypothesis and provided the direction for peer tobacco education to include an emphasis on this significant relationship. Identified associations between use of different substances supplies cues for the school nurse and other health providers to pursue specific areas of substance use practices when assessing students.

Many smoking cessation programs for adult smokers are described in the medical and nursing literature. Programs designed to prevent smoking among adolescents and children also are prevalent in the literature. Despite these prevention programs, many adolescents choose to start smoking. Once adolescents begin smoking, it is difficult to find ways to help them quit. Few programs exist that are targeted to help this population with smoking cessation. This article provides an in-depth review of 5 smoking cessation programs designed for adolescents. Each of the programs presents unique strategies for helping teenage smokers quit. Techniques used in these programs include peer leadership, nicotine patch therapy, peer support, computer instruction, and one-on-one counseling with a nurse practitioner. Each program was studied for efficacy with adolescents. Although none of the programs reviewed showed remarkable success, they serve as guides for future program development. Additional programs need to be developed and studied with larger, more diverse populations. Nurses must identify or develop smoking cessation programs that meet the needs of all types of adolescents and are effective in helping them to quit. Once designed, these smoking cessation programs should be made accessible to adolescents in a variety of settings.

School nurses have the experience, insight, and passion to speak in pubic forums on issues regarding the health and education of children. They are seeking opportunities to inform district decision makers and the general public about student needs and about the importance of having adequate resources to meet these needs. Nurses may be called upon to speak both formally and informally to parent and community groups, the school board, and to their peers. To be credible and to communicate their messages effectively, nurses must hone their presentation and speaking skills, which may include the use of up-to-date technology.

The National Association of School Nurses proposed the concept of certification for school nurses in the 1970s. The development and evolution of the school nurse certification process, from concept to reality, is described in this article. It is the first of a 2-part series on national certification for school nurses. Part 2 will examine issues and answer questions about the certification, give information from past and current presidents and certified school nurses about their experiences, and present a forecast about the future of school nurse certification.

In 1999, the U.S. Supreme Court ruled that “school health services” include nursing services that are required for students needing one-on-one (“private-duty”) nursing care to attend school. This ruling settled opposing federal court interpretations of the Individuals with Disabilities Education Act, clarifying the rights of students with complex medical needs and the responsibility of school districts to provide them with an appropriate educational program. In responding to the challenges and opportunities raised by this decision, school nurses must understand the implications for school nursing practice and for school districts, educate their school leaders and communities, and provide leadership for creative and collaborative problem solving.