Anti-tobacco education in Spanish schools.
BACKGROUND
since the education reform in Spain, anti-tobacco campaigns are now fought within the context of Health Education, although the true degree of their application remains unknown. The aim of the present study is to gain insight into the degree of implementation of this type of campaign through the opinion of school principals.


METHODS
a questionnaire (answered anonymously) was sent to 8,000 school principals (43.3% of the total number of schools in Spain). Of these, 3,156 were returned, 3,050 (16.5% of the total) of them being valid for the study. The questionnaire explored whether Health Education and anti-tobacco campaigns were implemented at their schools and, if so, at what stage of the children's education and in which contexts. The statistical study was conducted using the appropriate tests as a function of the nature of the variables to be compared in each test: Student's t tests, chi2, one-way ANOVA (analysis of variance) and the Scheffé test.


RESULTS
transverse topics (topics spread across the curricular subjects -TT) are imparted in 2,718 schools (89.1%), Health Education (HE) in 2,655 (87%) --significantly more (p < 0.05) in primary than in secondary school--, and Anti-Tobacco Education (ATE) in 2,317 schools (76%), significantly more (p < 0.001) in schools imparting both primary and secondary syllabi. The stages at which ATE are imparted are mainly in primary education and during the first CSE (Compulsory Secondary Education) cycle. The mean percentage of curricular subjects in which TT are addressed is 49. 66%; HE is imparted in 42% and ATE in 27.5% of the curricular subjects. Thirteen percent of Spanish schools does not impart HE and in almost 25% no ATE are implemented.


CONCLUSIONS
teaching related to health in general and smoking in particular does not reach all children and, when it does, is sporadic and is not continued consistently through the different stages of schooling. The generalization of teaching practices designed to promote health among children continues to await full implementation in Spain.
Barrueco
M
M
Universitary Hospital, Salamanca, Spain.
Hernández-Mezquita
M
M
Jiménez
C
C
Vega
M
M
Garrido
E
E
D006266:Health Education; D006801:Humans; D012574:Schools; D012907:Smoking; D016540:Smoking Cessation; D013030:Spain; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000517:prevention & control*