Tobacco Education Activities: Sticky Notes, Visuals, and Straw Walk (Oh my!)

NOTE: These are some activities I use in my classroom. I am not sure who initially came up with these ideas, but I've had success with them and in no way am I trying to take credit for inventing them.

I wanted to write a post to share some of my favorite activities relating to tobacco education, after being surprised that I haven't written about these yet. Not all of these activities are "skills based" per say, but they do address the needs of different types of learners while also helping to create meaning among the students. I used these activities for an assignment in a class I am taking (not through BU, through a local education consortium) on brain based learning. We had to think about activities that would create meaning and would be considered relevant by our students. Immediately, these activities came to mind.

In order for learning to be effective, the learning must make sense to the student, and it must have meaning. My personal challenge with everything I teach this year is asking these questions: Does this make sense? Does this have meaning? Is this relevant?

I don't think boring worksheets create meaning; neither do tests or quizzes (for the most part, although they do have their place in the teacher's toolbox). Granted, as a teacher you will never be guaranteed that every single student will always be into what you are teaching, but there are ways (active learning, skills based health education, student involvement) to at least put the ball more in your court. Obviously, I think all of health education is relevant to the lives of teenagers, but part of the trouble is that so many students have heard the same messages over again: don't smoke, don't drink, don't have sex, blah blah blah. No wonder kids tune out! As teachers, we have to give them reasons to tune in instead of tune out to what we are saying.

The nature of these activities is part-lecture, part visual, part hands-on simulation. I really enjoy teaching these activities,  and it seems like most of the students enjoy them as well. The third one, as you'll see below, can be especially eye opening!

Sticky Notes. This sticky notes activity occurs during a lecture portion about tobacco's effect on the human body. I'm not the biggest fan of lectures, but let's be honest: sometimes they have to be done. I provide students with a copy of the notes with fill ins, so they know what information to look for. This was initially done for some special education students, and I decided to use it for everyone, too. As soon as I start the lesson (which includes the visuals mentioned below), I start a timer on my watch to beep every six minutes. I go about teaching the lesson normally: presenting information, checking for understanding, answering student questions, etc. As soon as the watch beeps, I place a stick note on the wall in front of the classroom. Students are initially puzzled, and I move on saying they will find out at a later time. Some students grasp this right away, others do not.

Have an idea where I am going with this? Read on!

My classes are 53 minutes each, and for this activity I'll probably get through 45 minutes of instruction time before I start to wrap things up and end with a summarizer. For the record, I don't get to utilize summarizers all the time, but for this lesson I find it essential. At this point, there's approximately seven or eight sticky notes on the wall. Here's what they mean, and here is more or less what I tell my students:

• Every 72 seconds (1 minute and 12 seconds), someone in the United States dies of smoking related causes
• The watch beeped every six minutes. During that time, five people in the United States have, theoretically, died from smoking related causes
• This adds up to approximately 443,000 people every year
• If each sticky note represents five people, how many people in the United States have passed away during this lesson?

Usually, this point tends to hit home with students, although some of them do question the merit of the data, which I obtained from the CDC and the Campaign for Tobacco Free Kids. I've thought about using one sticky note for each person, but I think that would take away from the mystique.

Visuals. There are many great visuals out there relating to tobacco use: infographics, charts and graphs, pictures of black lungs. These visuals run the gamut from educational and fact based to having a sensational shock value. If I put myself in the shoes of my students, I would probably tune out any sort of visuals I have already seen or ones that don't apply to me. Thinking outside the box and providing students with manipulative visuals is my answer to this problem. Here are two visuals I use; I do use some others, but these are slightly different.

Enter the Tar Jar. The Tar Jar was purchased by another health educator in my building, and is displayed to the right. The Tar Jar that we have contains a representation of the amount of tar that will pass through the lungs of a smoker who smokes half a pack of cigarettes every day for an entire year. It's easy to see that the amount would double if someone were to smoke one pack a day for an entire year. We discuss that tar (Total Aerosol Residue) is produced when tobacco burns, and we also take this time to discuss tobacco smoke in general. I am not sure where we purchased our Tar Jar, but if you would like to create your own Tar Jar, check out this PDF for a recipe! 

Another visual I use is bubble wrap. That's right, basic bubble wrap. Once, I ran out and had to find online bubble wrap to use! I use bubble wrap when we talk about the alveoli in the lungs, which are tiny air filled sacs. Their main job is to exchange oxygen. Alveoli are very stretchy, like tiny balloons. Smoking damages the alveoli by making them less elastic; this damage is permanent and cannot be repaired. Ultimately, this makes it harder to breathe and can lead to COPD. I use the bubble wrap in a demonstration, popping a few of the bubbles and asking students to re-inflate the bubbles I popped. This is impossible, and it emphasizes the point that damage done to the alveoli cannot be repaired. I do point out that the alveoli do not "pop" like the bubble wrap, and that the takeaway point is that the damage cannot be repaired.

Straw Walk. This is one of my favorites; an entire lesson in itself. I am able to tie in information relating to heart rate my students have learned in physical education class. I being by setting the following ground rules: "Students must behave respectfully and responsibly during all activities in class today. While we are in the hallways, there will be no talking, no fooling around, and no immature activity. Any violations of the above or specific rules mentioned by Mr. Bartlett before the activity will result in an immediate detention. No excuses, no exceptions! If at any point you feel dizzy, short of breath, or lightheaded, STOP. Your grade will NOT be negatively affected. Listen to your body!"

Initially, students take their resting heart rate on a thirty second count, and multiply that by two. I the describe a route we are going to take walking through the middle school, finishing with a stair climb from the first floor up to the third floor. When we get to the top, the students take their heart rates again. They also make a note on their worksheets of how they felt in comparison to taking their rest heart in the classroom.


Upon our return to the classroom, each student receives a drinking straw. Now, we complete the same walk as before, but with a twist: students have to place the straw in their mouth and breathe only through the straw. Sometimes, I give students the option of pinching their nose shut, too. We complete the same walk, and for most students it gets tough once we start going up the stairs. We use the same process: take the heart rate again, but I also focus more on how the students feel after this portion of the activity. Sometimes, the heart rate doesn't always increase, depending on a variety of factors (fitness, error in taking heart rate, etc.; in my experience, however, students almost always identify that breathing through the straw simply felt harder.


Once we get back to the classroom the second time, we go through a discussion and the students engage in a reflection about the activity. Some questions I may ask: Which activity felt the hardest for you to complete? How did it feel breathing through the straw? What would your life be like if this was the only way you could breathe? We only walked for this activity, what would it feel like to run, dance, swim, etc. breathing like this? How would regular lifestyle activities be affected?

Sometimes, I offer students the opportunity to go through their normal school day only breathing through the straw, but no one has taken me up on it! When I was student teaching, my cooperating practitioner had the students run laps around the gym. I have thought about doing this, but because not all of my students are athletes, I like this activity as conducted because it focuses on lifestyle activities: we all walk and walk up and down stairs.


Wrap Up. Listen, I'm not saying that these are magical activities that would completely hold the attention of your students for the entire class period. Depending on the population you are working with, they might not even be effective. As a health educator, that is your decision to make. All I know is that I tend to luck out when I use approaches like this. If these types of activities are able to create meaning with the brains of my students, there's a greater likelihood that they will remember the information. So, when the time comes for one of my students to determine whether or not to engage in risky behavior, this information could be recalled and may prevent any negative consequences associated with risky behaviors. Granted, this is only the knowledge side; providing students with skills in health education is the other piece of the puzzle.


Later this week, I'll finally be reposting the HIV Transmission Simulation that I have taken from an excellent online source. I'll be posting the original lesson as well as the one with my own additions. I have to catch up on some work for my class before I head to Vermont for the weekend, so I will try to get it up before I leave, but I can't promise anything. Stay tuned!