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!

Video Viewing Activity: "Record, Elaborate, Extend"

I'm sure that I've mentioned somewhere in an earlier post that I'm not the biggest fan of using videos extensively in my classroom. I feel that there are too many other ways to effectively teach students health education that encourage them to be active, as opposed to passive, in their education. Unfortunately, in some districts health education is thrust upon teachers who are not trained or who have no interest in teaching health; this has led to health education being stereotyped as a class where videos are shown and nothing else really goes on. This is not to say that videos should be banned from the classroom! I do use short video clips whenever I can, to bring a different element to the classroom. In the May/June 2010 issue of the American Journal of Health Education, there's an article about using video clips in a health literacy program and their implication for providing context for classroom topics. I rarely show full length videos, but find that video clips can help stimulate discussion about topics, among other things.

In the situations where I do show actual videos, I don't want the students to sit there idly and fall asleep; nor do I want them to simply write down "facts" as they watch. After all, there is a point to the video! I want them to take specific information away from their viewing, and to expand upon this information later in class or during our unit. Recently during our seventh grade ATOD unit, I showed an eighteen minute video called, "Spit Tobacco Exposed." It's a little dated, from the era when green screens and flashy graphics were popular, but the content is accurate and is presented in a way that gets the attention of students. It also reviews some other information we will have already covered regarding tobacco and nicotine, so I'm able to get some review in while also presenting new content. The rest of the lesson builds off of this video.

Prior to the video, each student received a handout with a chart on it. The chart was entitled, "Record, Elaborate, and Extend." (Please see below for an embedded version of the chart) I came upon this idea from a colleague in the social studies department, who read about it in Educational Leadership. The article, entitled "Putting Gel Pen to Paper" is written by a seventh grade history teacher. The article's premise is that students can improve their writing skills while enhancing their understanding of course content.

Because the video I showed was brief (and only part of the lesson for the day) I didn't really need to focus too much on what I wanted the students to look for. But, if you look at the handout embedded below, you'll see I did highlight specific information I wanted the students to pick up on. Some students recognized the format and knew immediately what to do because they had seen this format elsewhere with other teachers. I model what to do using the Boston Red Sox as an example.

Below is a brief summary of the chart, with some information quoted from page 65 of the article "Putting Gel Pen to Paper." After the summary of each section, I've written what I specifically was looking for for this lesson.

Record (during video). "While they view the video, students jot down key points and significant ideas in the Record section of their viewing guide. Students should keep their points brief, recording only short phrases, because the process of transcribing should interfere as little as possible with the process of watching and listening." Record brief notes and short phrases on smokeless tobacco: what it is, its effects on the body, why people do it, negative health effects, etc.

Elaborate (during break or breaks). "The teacher pauses the video to allow students to process the information they have seen and heard. Students examine their recorded notes and write a specified number of full sentences in the Elaborate section of their viewing guide that describe what they have learned. Teachers may use sentence stems to help students start writing." Re-read your recorded notes. Write full sentences, making sense of the recorded notes and linking information together. Please note that because of the short length of this video, we did not pause at all. However, the video does provide an opportunity to pause for discussion towards the end; I just choose to wait until the video is over.

Extend (after the video). "The entire class discusses the elaborated points. Students can then respond to an open-ended question in the Extend section of their viewing guides, synthesizing what they have learned from the video." Use your notes to answer the following prompts: (1) Identify three ways smokeless tobacco could alter your life. (2) Justify the need for smokeless tobacco education in schools. For the next round of classes, I am going to change these questions.

Overall, I like using this format; it also allows students to practice note taking skills. They're not sitting back passively, focusing so much on the next question that they drown other information out, and they're not just writing down random facts and tidbits information that might not have relevance to the curriculum. It also ensures one hundred percent student participation. I have not yet had to modify this for any students in my classes, but the format can be made as specific as possible and is easy to modify.

It's also important to highlight that during the video, the students should only record brief phrases, so that they don't spend a lot of time away from paying attention to the video. It's fun to see the light bulbs go off when students link information together and make connections, too!

I've embedded an example of the chart I use below. Finally, here are two student examples from one of my seventh grade classes. These examples are not perfect (I had to clarify some items when I handed them back), but they are real-life student examples from a seventh grade class. If anything, they simply provide a visual of the "Record, Elaborate, Extend" format in action.

Student Sample #1:

Student Example #1

Student Sample #2:

Student Example #2

Here is the example chart:

As always, please feel free to e-mail me with any questions, comments, or concerns.

Article Citation: Yell, M.M. (2002). Putting gel pen to paper.Educational Leadership, 60(3), 63-66.


Disclaimer: I am not affiliated with HRM Video, the creators of "Spit Tobacco Exposed" nor am I affiliated with ASCD, the publishers of Educational Leadership. However, their publication is a GREAT resource that teachers can always take something from!

Interactive Activities: ATOD Unit (Part One)

The ATOD (Alcohol, Tobacco, and Other Drugs) Unit is my favorite to teach. I could easily spend an entire course just on this, but unfortunately I am not able to do so! Today's post deals with tobacco education in my classroom.

Tobacco education may be the first thing (besides sex ed) that comes to mind when someone hears the term, "health class." There are many substance-abuse programs out there. Perhaps the most famous, D.A.R.E. (Drug Abuse Resistance Education), is surrounded by controversy. A meta-analysis by Ennett et al. generally found that the short term effectiveness of DARE was less than other, interactive prevention programs. However, I only skimmed the well-known article and they do find some positives for the program as well.

Our school district uses a curriculum component from The Michigan Model for Health entitled, "The Power is Your to Be Tobacco Free" in seventh grade. The curriculum focuses on teaching students the skills they need to stay away from tobacco, make decisions to protect themselves and others from tobacco, and how tobacco can harm their bodies. It doesn't come with a lot of the "facts," so we supplement.

Below I've outlined two sample activities that I've used in my classroom during parts of our tobacco unit. I'll have another post later this week with a second set. I adapted a lot of these from other sources. After all, the best teachers are sometimes the best stealers! As an aside, I make sure that I never say smoking is "stupid" or anything along those lines in order to remain sensitive to students who have family members who smoke. One main objective of my job is to give the students the tools they need to make healthy, positive decisions. Ideally, it helps promote behavior change too. If adults want to smoke, then that is their educated choice (presumably).

During my lesson on smoking's effect on the body, each student has a worksheet with fill ins, charts, and blank sections. They write in information I have on a PowerPoint as I go through each effect.

Is Your Money Up in Smoke? (Homework Activity) Click here for a PDF of the assignment.

The cost of a smoking habit is expensive. As a homework assignment, I have the students research the local price of one pack of cigarettes. Students may ask an adult, use the internet, or look for prices at local stores/gas stations. After they find the price, they do some math to determine how much a person who smokes one pack a day spends on cigarettes for a year and ten years.

Students then "go shopping." They find out what they could spend all that money on. Some students make the argument that all of the money spent on cigarettes could be spend on issues such as education or world hunger. A post-homework reflection could be added, but I choose to use a discussion instead. Some students will mention that for people who smoke more than one pack a day, the cost would be far more expensive.

Extension: Compare the cost of a pack of cigarettes in different regions of the country, such as in New York City where tobacco taxes are very high. We could then discuss that in NYC's situation, smoking has decreased dramatically (a blog entry on this last link will be forthcoming if I can find more up-to-date data, especially after their controversial ad from last year; I used that in class last year). You could also have students graph differences based on location, which ties in cross-curricula activities with geography and math. However, in my opinion this is spending too much time on a very small aspect of the tobacco curriculum. The Michigan Model has this as an in-class, teacher-led activity. I choose to do it differently.

Cilia "Volleyball!"

Adapted from "Cilia Volleyball" in Activities That Teach by Tom Jackson

Cigarette smoke greatly affects the cilia in a smoker's lungs. Cilia are tiny, hair-like structures who have the job of sweeping foreign material such as mucus, dirt, and other harmful material out of the lungs. Cigarette smoke damages the cilia, and as a result there's often a buildup of mucus in the lungs. This results in the body's next method of removing gunk from the lungs of a smoker: smoker's hack.

This activity involves blowing up balloons before class. Because of my classroom setup, I blow up about eight. I label each one "Mucus" with Sharpie beforehand. After I talk about what I just mentioned and smoker's hack, I take out my balloons. I divide my class into thirds (I have three sections of two columns, with a space between sections), and have them demonstrate being cilia. I usually do this first by waving my arms and hands like in the "wave" seen at numerous sporting events. I get into it; it's more fun that way!

After the students get the hang of this, I have one third of the room do the wave. The front of the room acts as deep in the lungs, and I have a student stand behind the last row to represent the mouth (complete with hacking sound effect). Then, I drop the balloons, and as a result of the wave motion, the balloons find their way through the rows and out the mouth. I explain that this is a normal, healthy lung; when there is mucus and other gunk the cilia are able to expel it.

Next, I go to the middle of the room. I do the same thing this time around, but now I select a small number (maybe three out of nine or ten in the section) to sit on their hands. They're not allowed to touch the balloons in any way. This group tries to expel all the "mucus" and is usually pretty successful, but not fully. Then, I go to the last group. This time, I make sure that all the students except one in the front and one in the back sit on their hands. Usually, none of the "mucus" goes anywhere.

After this demonstration I explain that the last group represents the lungs of a habitual smoker. After they were able to experience being cilia in the lungs, having a discussion about the activity is very important. Some students don't make the connection right away, so I use images of cilia in the lungs to further explain their role in the body.

NOTE: Tom Jackson, who created this activity, has the balloons represent particles of smoke/tar that pass into the lungs. His activity is slightly different; mine was adapted to fit the space of my small classroom.

I was planning on documenting some more activities in this post, but I feel that I have rambled on long enough! As always, please feel free to comment or e-mail with questions, comments, or concerns.