School Staff Perspectives on Tobacco Prevention: Findings From a Statewide Educator Survey

The California Department of Education (CDE) has operated the statewide, school-based, Tobacco-Use Prevention Education (TUPE) Program since 1989. Evaluating the impact of such a program is challenging in a real-world context, where multiple tobacco prevention activities have been ongoing for years and occur simultaneously. This study aimed to determine how TUPE funding was distributed geographically and whether it was associated with increased tobacco training and prevention activity in California public schools. TUPE funding levels were compared by region, and staff of randomly selected middle and high schools (n = 6,115 staff from 1,383 schools) were recruited to participate in the California Educator Tobacco Survey, administered March-June 2022. TUPE-funded and non-TUPE-funded schools were compared on respondent characteristics, health priorities, substance use prevention training, and tobacco prevention activities. Regional distribution of funding followed the same rank order as youth tobacco use rates. TUPE-funded staff were significantly more likely than non-TUPE-funded staff to perceive tobacco as a school health priority (28.0% vs. 22.6%), receive training on tobacco prevention (odds ratio [OR] = 1.4), and report that their school offered >3 tobacco prevention activities (OR = 2.1). The main conclusion was that TUPE funding was associated with increased tobacco training and prevention activity. The study also demonstrated the value of school staff surveys in assessing the implementation of tobacco prevention programming. Encouraging applications from rural, high-prevalence areas may be important in countering geographic disparities. To address the low prioritization of tobacco, future tobacco prevention efforts may aim for closer integration with other student health programs (e.g., mental health, marijuana use prevention).