The Head Start Tobacco Cessation Initiative: Using Systems Change to Support Staff Identification and Intervention for Tobacco Use in Low-Income Families

Abstract

Tobacco use continues to be the leading cause of preventable illness and death in the United States. Remarkably, more than nine million preschool-aged children are exposed to secondhand smoke, resulting in increased rates of morbidity and mortality. Even more disturbing is that tobacco use is highest among people with the lowest levels of income and education. Thus, reaching these populations is a challenge facing tobacco control programs. This report describes an innovative pilot project implementing a systems change model that involves multiple stakeholders in integrating evidence-based cessation strategies into federal Head Start programs, which serve low-income adults and their children. The Tobacco Cessation Initiative was developed through a partnership between the American Legacy Foundation, the Mailman School of Public Health at Columbia University, and the Louisiana State University Health Sciences Center School of Public Health. The partnership developed guidelines to fit into the overall mission of Head Start by enabling participating sites to incorporate tobacco cessation identification and referral protocols into their existing infrastructures. This program allowed Head Start sites to incorporate, into their existing family services, protocols for user identification and referral; build partnerships with groups supporting tobacco cessation; link families to cessation services; and educate families about risks associated with exposure to secondhand smoke. Applying system strategies in non-clinical settings such as Head Start offers a way to improve the health and quality of life of preschool children at the highest risk for exposure to secondhand smoke.

Falling Through the Cracks of Early Intervention and Prevention: Missed Smoking Cessation Referrals for Mothers in Early Head Start

“…Aligned with these findings, and given the extent to which SHS is detrimental to children and families, Head Start (HS) recently underwent a substantial initiative to revise their smoking cessation programming. With stakeholder involvement, HS integrated cessation strategies into already existing infrastructure (the Head Start Tobacco Cessation Initiative; Moody-Thomas et al, 2014) via additional focus on smoking cessation and SHS exposure during needs assessments. This initiative also included training workshops for HS staff centering around psychoeducation about nicotine addiction, cessation resources, and evidence-based counseling interventions (Moody-Thomas et al, 2014).…”