Overview of Smart Moves: Nicotine Module

SMART Moves is a suite of program resources that can be used to help youth develop healthy decision-making attitudes and skills. Each program resource reflects contemporary youth development best practices in a flexible format that allows Clubs to customize learning to the needs and interests of their youth and communities. These program resources are: SMART Moves: Emotional Wellness, SMART Moves: Core and topic-specific SMART Moves Modules.

The goal of the SMART Moves: Nicotine Module is to influence attitudes and teach essential skills to enable youth to make healthy decisions about nicotine and e-cigarettes/vapes. As a result of participating in this module, youth will be able to:

• Describe the health risks associated with using products that contain nicotine
• Describe the ways in which using products that contain nicotine can impact their goals
• Describe how media and peers influence a young person’s use of products that contain nicotine
• Apply decision-making and refusal skills to using products that contain nicotine

This SMART Moves module is intended to be used only after participants have completed the SMART Moves: Core targeted program. In SMART Moves: Core, youth are introduced to foundational healthy decision-making skills, such as goal setting, effective communication, a decision-making process, refusal skills and critical thinking about media messages. It is essential that youth are introduced to those foundational skills first so they can practice them in relation to the specific content of the Nicotine Module.

Youth Development Professionals’ Role in Healthy Decision-Making 

Positive youth development is an intentional approach that engages youth within their communities, schools, organizations, peer groups, and families in a manner that is productive and constructive. It recognizes, uses and enhances young people’s strengths, and promotes positive outcomes by providing opportunities, fostering positive relationships and furnishing the support needed to build on their leadership strengths.

Youth development practices that support teaching and learning are core to the quality of Health and Wellness programs. Effective Health and Wellness programs, when facilitated with high-quality youth development practices, will help youth develop the attitudes, behaviors, and skills needed to become effective and engaged learners who are on track to graduate with a plan for the future.

Youth development professionals can help all youth build resiliency skills when they:

• Establish and maintain Group Agreements at the start of any routine programmatic experience to establish a safe environment for sharing and learning
• Provide frequent opportunities for youth to reflect on their experiences
• Respond to young people’s behaviors in ways that encourage them to communicate their feelings and self-regulate
• Provide the opportunity and space for youth to check in emotionally during the Club day, and possess the ability to recognize trends in emotions and modify programming as necessary
• Programmatic and environmental adaptations to support the identities of all youth, including youth with disabilities, and youth who identify as LGBTQ
• Allow youth opportunities to independently recognize and solve problems and decisions about health
• Integrate trauma-informed approaches throughout the Club day, and especially within health programs and activities

Youth development professionals can help all youth become more effective healthy decision-makers when they:

• Model healthy decision-making among youth, including healthy eating, physical activity, healthy communication with others and emotional well-being
• Avoid the use of shaming and values-based language related to health such as “good and bad” or “right and wrong”
• Model appropriate self-disclosure about healthy behavior by refraining from sharing personal health information
• Establish themselves as health resources by addressing all questions about health-related issues with medically accurate answers or linking youth to resources
• Facilitate structured and unstructured opportunities for youth to talk with each other about health issues, peer pressure to engage in unhealthy behaviors, and resistance strategies
• Leverage opportunities to connect decision-making about health to a young person’s vision for their future self
• Create opportunities for youth to be advocates for healthy behavior among their peers at the Club and within the community
• Use opportunities to recognize youth who are making healthy choices individually and as groups

Maintaining a Safe Environment for Program Facilitation 

Although the SMART Moves suite does not introduce or cover sensitive topics like abuse or child safety, asking youth to discuss their emotions has the potential to elicit youth responses that require staff follow-up. Due to the nature of this material, BGCA strongly recommends the use of the following best practice implementation guidelines.

Prioritize Physical and Emotional Safety: Before facilitating any of the SMART Moves sessions or related modules, it will be essential to review your Club or Youth Center’s safety policies, and be prepared to respond and report, should youth disclose past or current abuse, or urgent mental health issues. For immediate safety and life-threatening mental health concerns, call 911. For concerns of past abuse or ongoing abuse, neglect or endangerment, follow your state’s mandated reporting requirements. In addition, make sure to report safety-related incidents according to your organizational policies, and use the BGCA’s Safety Helpline for additional support at 866-607-SAFE.

For more information that can support you in creating physically and emotionally safe program environments, visit the Safety page on BGCA.net for the latest resources on:

• Safety Policies and Actions
• Mandated Reporting
• Disclosures of Abuse

If you have questions about using these resources in your Club or Youth Center, or general safety questions, please reach out to the safety team at childsafety@bgca.org.

As you prepare to facilitate the SMART Moves Modules, you’ll see facilitator notes titled “Important Note About Emotional Safety” that serve as a reminder to listen closely to youth responses and follow-up with reporting or additional support as needed.
 

Seek Training to Support Implementation: Since this subject matter is related to identifying emotions and building effective coping strategies when youth feel a strong emotion, it may be beneficial to consider the ways in which trauma might impact young people’s understanding of emotion, and their emotional reactions to various situations. To develop an increased understanding of the varying backgrounds of youth, consider training in the following topics prior to facilitating the emotional wellness targeted program: Adverse Childhood Experiences (ACEs) and Trauma-Informed Care (TIC). For more information and free online TIC Trainings and Resources, visit the National Child Traumatic Stress Network at nctsn.org/resources/training. For more information on ACEs visit: CDC.gov.

Make Referrals, When Needed: The programs in the SMART Moves suite, especially SMART Moves: Emotional Wellness, are skill-building programs, not a therapy or counseling tool and should not be used in this way. Understanding your role and professional ability as a youth development staff is critical.

Some sessions may cause youth to become emotional, share personal stories about past trauma, or even open up about their mental health. It is important to keep in mind that you are not expected to take on the role of a therapist or counselor, nor would it be ethical for you to do so. You should, however, be able to recognize when youth are disclosing abuse or another traumatic event, and to report and refer as appropriate. You are not alone in supporting Club youth. There are many caring adults and professionals available and able to provide support when necessary. If you have a social worker or therapist on staff, ask them to be available to step in if needed during or after the program. If you do not have a social worker or therapist on staff, consider familiarizing yourself with the local agencies in your area to make referrals when needed.
 

Use the following resources when making a referral:

• BGCA Incident Response Guide: Visit BGCA.net and search for "Incident Response Guide."
• Visit 211.org for more information on local resources.
• For non-life-threatening mental health concerns, consider utilizing the free Crisis Text Line by texting CLUB to 741741 to communicate with a trained crisis counselor 24/7. This resource should be used in collaboration with parent support.

Please refer to your state laws and organizational policies on how to discuss your mandated reporting obligations with young people. We encourage you to continue to build trusting and supportive relationships using high-quality youth development practices outlined in the Blueprint: To access, visit BGCA.net and search for "Program Basics BLUEprint."

Create a Safe Space: Create a welcoming and comfortable environment by:

• Providing a variety of comfortable seating options, soft lighting, calming music and optional fidgets/manipulatives. Examples of manipulatives include: puzzles, pipe cleaners, putty, paper and crayons.
• Establishing Group Agreements and norms prior to beginning the program.
• Utilizing emotional check-ins as a way for youth to pause and reflect on how they are feeling.
• Being an active listener throughout the program and following up with any youth afterwards who appear to need additional support by stepping aside to discuss how they are feeling and determining how you can help.

Before each session try saying something like, “This is a safe space where you are safe to feel and talk about your emotions and ask for help. All feelings are normal and healthy and there is no wrong way to feel. You are always welcome to pass if you are not comfortable sharing in front of the group. I am here to help if you want to talk about anything during or after program. Does anyone have any questions before we start?”

Grow In and Model Your Own Social-Emotional Development: Take time to reflect on your own social-emotional skills and identify your strengths and areas for growth by using the Personal Assessment and Reflection – SEL Competencies for School Leaders, Staff and Adults developed by CASEL. Create a plan for addressing your areas for growth and commit to working on it. Youth will look to you as a role model for how to talk about and process emotions, as well as how to cope with stressful situations. Be a leader in not only teaching the emotional wellness targeted program but modeling it in your everyday interactions.

A Note About Language

The following terms are intentionally used throughout the SMART Moves: Nicotine Module sessions for the reasons outlined here:

• Nicotine – Since both traditional tobacco products and e-cigarettes/vapes contain the drug nicotine, we have used nicotine as the umbrella term that includes all tobacco products, including e-cigarettes.
• E-Cigarettes/Vapes – The tobacco prevention field uses the term e-cigarettes consistently, but youth may be more familiar with the word vape. We want youth to recognize and make the association that vapes are a form of electronic cigarette.

Family and Caregiver Resources

Boys & Girls Clubs of America has created supplementary resources for use with families and caregivers. These resources are designed to create additional communication opportunities for families to talk together about the content in the SMART Moves: Nicotine Module and invite them to share their values on health and wellness. In this module, you will find a sample family night agenda and an extension activity for families and youth to do together to continue learning.

Each family and caregiver resource supports a particular SMART Moves: Nicotine Module session.

BGCA’s Vaping Prevention Resource Guide

The Vaping Prevention Resource Guide contains current information for Club professionals about e-cigarettes/vapes and vaping among youth, including strategies for talking to youth about this behavior. (Find the full URL under Links to Resources in each of the sessions.) Use this resource as a starting point to build your own knowledge before facilitating the Nicotine Module sessions.

Utilize the Program Evaluation Resources to Measure Local Impact

This program includes a suite of evaluation resources to help you measure the impact of the SMART Moves: Nicotine Module among youth in your Club or Youth Center. The survey tools measure attitudes and skills that can lead to the intended outcomes of the program. The resources include pre/post-evaluation surveys, a follow-up survey and a reflection survey. Similarly to the National Youth Outcomes Initiative Member Survey, these evaluation tools are intended to be used only for youth in Grades 3 and above.

Commonly Asked Questions for Group Discussion

This section is adapted from BGCA’s Vaping Prevention Resource Guide. The rapid rise of e-cigarettes/vapes and their wide number of products in this category has led to confusion and misinformation. Many young people think that vaping is harmless,ⁱ but the use of e-cigarettes/vapes can damage health and has been recently linked to lung illness and death. Below are some commonly asked questions from youth about vaping, along with facts to help you answer if they arise while you’re facilitating this SMART Moves module. When answering youth questions, remember to reply in ways that use the GUIDE approach:

• GU – Give recognition and thank them for asking
• I – Identify the facts
• D – Describe how a behavior might impact a youth’s future goals
• E – Explore referrals to trusted adults to provide guidance

QUESTION: Isn’t vaping healthier than smoking cigarettes?
RESPONSE: Thanks for asking that. It’s something a lot of you might be wondering! The amount of nicotine in one JUUL pod is equal to 20 cigarettes (an entire pack!). That’s a lot of potential impact to a developing brain.ⁱⁱⁱ Some believe vaping is a safer alternative to traditional cigarettes since it may be used as a smoking cessation tactic, but e-cigarette/vape users commonly use other nicotine products as well.^iv In fact, youth who vape are four times more likely to eventually start smoking traditional cigarettes.^v And vaping has now been linked to serious lung illness and death in both teens and adults.^vi Who is someone you can talk with about your questions related to vaping and your health?

QUESTION: Are e-cigarettes/vapes addictive?
RESPONSE: Thanks for asking. Many people are probably wondering the same thing. Yes, e-cigarettes/vapes contain nicotine and nicotine is addictive. Since your brain is still developing until you’re 25 years old, it’s even easier for you to become addicted to nicotine.^vii Nicotine exposure during adolescence can also lead to higher risks of learning or attention difficulties later in life.^viii How might that affect all the goals you’re working towards in school?

QUESTION: I’m only vaping the flavoring, what’s the big deal?^ix
RESPONSE: Great question. That’s an important thing to know! You may not realize it, but in addition to flavoring, the vast majority of devices contain nicotine, including all products from the most popular brand, JUUL. Additionally, the aerosol itself may contain harmful ingredients, including particles, chemicals and heavy metals such as tin and lead. Think about the ways that being addicted to nicotine might impact many of the goals you’ve shared here.

QUESTION: Everyone is doing it, so it’s not that big of a deal, right?
RESPONSE: I appreciate you asking something that many of us may be thinking, so let’s talk about it! While vaping among youth has increased significantly in recent years, the majority of youth actually do not vape. This is true across all age groups.^xi Youth with friends or family members who use e-cigarettes/vapes, or those who have been exposed to targeted marketing may be more inclined to think that most people vape. This misconception could normalize vaping, so it is important to make sure you know the real numbers. It’s important to talk with a trusted adult about your thoughts about vaping, or even share with an adult some of the things you’ve learned in this program.

QUESTION: Why is vaping a problem if it’s legal?
RESPONSE: I’m impressed that you know that vaping is not against the law! But, vaping is against the law for those under the age of 18 (and under 21 in some states). The FDA and several large stores in certain states are already taking steps to restrict sales to people under 18 and improve age verification methods.xⁱⁱⁱ Although it may seem confusing, not all products that are legal are safe to use. Nicotine and alcohol are both drugs that are legal and have known health risks. In 2019, there was an outbreak of vaping-related lung illnesses and deaths across the United States.^vi A family member you trust can be a great person to talk with if you have more questions about vaping.