HHD's Youth Tobacco Control Initiative in Latin America

HHD’s innovative youth tobacco control intervention, developed on behalf of the World Health Organization and successfully pilot tested in India, Ghana, and Mexico, is now being adapted and pilot tested in Montevideo, Uruguay. Uruguay is a key country in this initiative, not only because tobacco use is high among its youth, but because Uruguay has been emerging as a leader in tobacco control efforts in Latin America. In addition, the strength and institutional capacity of the Uruguayan schools and the country’s small size facilitate monitoring and validating interventions.

In 2004, Uruguay was one of the first Latin American countries to ratify the Framework Convention on Tobacco Control (FCTC), an international treaty that promotes strategies to prevent and decrease tobacco use. In addition, Montevideo is the first municipality in South America to be implementing active policies against tobacco. The funders of the Uruguay project are the New York Community Trust, U.S. Embassy/Uruguay, Anna Whitcomb, and the Municipality of Montevideo.

An important aspect of this project is the extensive involvement of different stakeholders, including Uruguayan NGO, Iniciativa Latinoamericana (IL), headed by sociologist Dr. Juan Mere. IL’s aim is to foster the healthy development and growth of young people through volunteerism and social participation using interactive strategies. The intervention development team, which includes trainers from IL, is working with an advisory committee comprised of individuals representing the Ministry of Education, National Drug Council, School of Medicine, city of Montevideo, Tobacco Control Alliance, U.S. Embassy, Ministry of Public Health, and Pan-American Health Organization. The team has also engaged the support of local educators.

The project goes well beyond a no-use tobacco message for youth ages 10-13. “The intervention encourages students, teachers, families, health and education officials, and community leaders to understand the determinants of their own health and create a health-promoting school environment,” says Sergio Meresman, an HHD consultant in Uruguay. In health-promoting schools each young person is viewed as a whole individual within a dynamic environment that shapes his or her behavior and as someone who has the potential to alter that environment.

Youth will develop advocacy and media literacy skills, understand the manipulative practices of the tobacco industry, gain tools to influence their environment, and support the Framework Convention on Tobacco Control. They will participate in interactive games and debates on tobacco control issues and track tobacco billboards in their neighborhoods. Both students and teachers will be involved in making changes in their environment by developing policy changes to support a smoke-free school environment, putting up “No smoking signs,” and enforcing no smoking among both students and teachers.

“What makes this project in Uruguay especially exciting and significant are the creative ways the evidence-based intervention is being adapted and implemented, says Wendy Santis, HHD curriculum developer and senior research development associate. “While we are maintaining the core components of the curriculum, with the help of educational consultant Magdalena Paladino, we are also adding participatory methods and activities, involving students in a leadership process, customizing the language and activities to the Uruguayan settings, and establishing a formal network of trainers and technical assistance.”

One teacher, commenting about the curriculum, said “I like the lessons because we work with important themes in a way that excites the students and engages them in active participation.” According to Dr. Antonio Pascale, project field coordinator in Uruguay, “Youth are the center of this initiative, involving themselves in health promotion and prevention and integrating this work into the community.”

Currently, trainers Pablo Fernandez, Claudia Reynoso, Natalia Maidana, and Serrana Vilaro from IL are pilot testing the intervention in six schools in Montevideo and Canelones while other teachers observe them. In 2006, the teachers who are now observing will teach the curriculum with changes incorporated from the pilot testing. In this way, a network of trainers is being developed. “We see this tobacco control initiative as just a first step in our work in Uruguay,” says Tania Garcia, Director of HHD’s Northeast Center for the Application of Prevention Technologies “one that will enable us to build networks to address other public health issues, such as life skills and nutrition.”