Welcome back, Project ALERT All-Stars!  We hope the summer was just the respite you needed before your deep dive into the new school year.  A special welcome to our newest program partners salmon fishing in Kennewick, WA, backpacking in Jackson, WY, and kitesurfing in Kaneohe, HI. Aloha!

As we reported earlier this year, vaping hit a new milestone in 2018, with use among teens surpassing all annual use increases for any drug since 1975, when Monitoring the Future began tracking the most widely-used substances among youth.  Riding vaping’s coattails were traditional cigarettes, with use increasing in teens for the first time in since 2010.  This confirms the co-use trend that researchers have been eyeing closely for years, and findings indicate that the use of combustible cigarettes is strongly associated with use of e-cigarettes among teens.  So, rather than being a ‘safer alternative to conventional tobacco’ as they have been described, e-cigs have smoke-screened their way into the sinister ranks of potential ‘gateway drug’. Research by our RAND colleagues has been featured on CNN to support this notion.[1] As a result, communities are on high alert, revisiting both traditional and e-cigarette use laws and point-of-sales policies at state and local levels as a way to keep their kids safe.  Read about how San Francisco became the first major US city that wants to see the practice of JUULing dissipate faster than a Blurpleberry-scented vape cloud.  In a twist of irony, the landmark prohibition has occurred in the city JUUL Labs calls home.

SF bans the sale of e-cigarettes

Many states and hundreds of municipalities have already raised the smoking age to 21, and members of Congress have been working together (imagine that!) to introduce several bipartisan bills to make the age increase federal law.  Retailers nationwide would face stiff penalties if caught selling tobacco and vaping products to anyone under age.  Let’s hope our legislators make right and swift decisions for our nation’s youth!

Feedback from our program partners has always been a key component in the success of Project ALERT.  Now we’re teaming up with an innovative implementation tool called Getting To Outcomes (GTO).  GTO is a toolkit organized around a 10-step process to help communities plan, implement, and evaluate the impact of programs that attempt to prevent negative behaviors in teens.  RAND has used GTO to help communities run programming for drug prevention, teen pregnancy prevention, positive youth development, and underage drinking prevention.  The ALERT and GTO teams at RAND would like to make GTO into an online platform and this survey asks about your interest in such a product. This is a unique opportunity to bring GTO into the Project ALERT classroom to provide educators with an additional layer of implementation support!  Feel free to forward the 4-question survey link to your colleagues.

For more information about how GTO works (and a close-up of the really cool graphic!), visit our web page.

Take the brief 4-question GTO survey here.

Non-combustibles?  Heat-not-burn??  Fresh menthol heatsticks?? The ‘IQOS’??  The name sounds a bit like one of those prehistoric birds from the last Jurassic Park movie, but since it’s the brain child of Philip Morris, it’s more tiger crouched in a field of gazelles than primeval pterodactyl.  IQOS is actually a clever acronym for ‘I Quit Ordinary Smoking’ and – wait for it – claims to be less toxic than traditional cigarettes. So, as with e-cigarettes, we’re compelled to question another ‘safer’ technology from Big Tobacco.  Healthy sales of the IQOS has increased its advertising budget from $300 million in 2018 to $400 million this year.  These are undoubtedly exciting times for the maker of Marlboro. They’ve redefined what it means to smoke by inventing futuristic devices that our kids want, show off, share, and ‘like’ on Facebook.  They’re using slick social media campaigns and cool YouTube videos to recruit young smokers.  Our only response can be vigilance, knowledge, and education - now more than ever.

How can we stay on top of the glut of nicotine delivery devices being dispatched to our kids? Keep up with the corporate vernacular by checking out this brief primer from the FDA on the similarities and differences among the most popular types of cigarettes.  Continue your lesson with the Truth Initiative’s page on the latest heat-not-burn tobacco products.  Then wrap things up with an incident overview from the FDA about the recent rash of severe respiratory illnesses potentially linked to e-cigarette use with Lung Illnesses Associated with Use of Vaping Products. 

Remember that about 300 youth become regular smokers each day, and cigarette manufacturers want to see increases, so we must do what we can.  We want to encourage our program partners to stay current about these products and issues.  Reading up on these emerging trends and their potential harms will give you the knowledge base to help your students navigate the ever-changing, increasingly-confusing tobacco landscape.

What questions about emerging tobacco products have come up in your teaching setting?  Email us at projectalert@rand.org.

Our Spanish curriculum has been updated to reflect the most recent 2018 prevalence of use data published by Monitoring the Future.  The full manual is available for download, as are the individual lessons.  Want to save a few trees?  The core lessons that have been updated are 1, 2, 3, 4, 8, and 11; all other core lessons plus the booster lessons and the overview are still current in the 2018 version. Be sure to use these updated materials to deliver the most up-to-date prevalence of use information to your students! 

Our pre-/post-assessment survey has been updated to include mentions of vaping and e-cigarettes.  We’ve also added a few items on prescription painkillers.  At over 60 questions, this is indeed a long survey, but it’s one of several tools you can use to measure changes in perception of peer use, in current use, and in intentions to use.  We encourage you to have students fill it out in its entirety; however, if time is a factor we suggest choosing a few questions that will fit best with your student population.

Though results of the pre- and post-test surveys can provide valuable information, the responses alone will not indicate the level of effectiveness of Project ALERT or any specific drug prevention program. The reason for this is that no matter where you live or what programs you are using, drug use rates increase as youth get older. The rates will be higher in eighth grade than in seventh and in seventh than in sixth. Therefore, if you look only at survey responses from youth that have participated in a specific program over time, you may be tempted to conclude that the program is ineffective, due to increasing drug use rates.

In actuality, the program may be very effective, in that it may have substantially slowed down the rate of increase compared to what would have happened without the program. To determine this, you will need to be able to compare drug use rates in schools or communities that are using a specific drug prevention program versus similar schools or communities that are not.

Access the updated Pre- and Post-Test

Feel free to share your results with us.  We’re always interested in how your kids are responding to Project ALERT!  Email us at projectalert@rand.org.

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