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Risk Factors


  • Secondhand Smoke

    • Secondhand smoke is a combination of the smoke in the air from a burning cigarette, cigar or pipe and the smoke exhaled by a person who is smoking. Secondhand smoke contains at least 250 poisonous chemicals, including more than 50 that can cause cancer. It's the number one source of indoor air pollution, and it poses a health threat to the majority of Colorado residents. The 2006 Surgeon General report states that there is no safe level of exposure to secondhand smoke.

    • Secondhand smoke exposure is known to cause lung cancer, heart disease, nasal sinus cancer, respiratory disease, bronchitis, middle ear infections, asthma and pneumonia.  Nonsmokers who are exposed to secondhand smoke increase their heart disease risk by 25–30 percent and their lung cancer risk by 20–30 percent. A person standing 20 inches from a burning cigarette may inhale 10 times more cancer-causing chemicals than the smoker. An hour spent in a smoke-filled room is equivalent to smoking one cigarette. Research has shown that even brief exposure to secondhand smoke can trigger heart attacks.

    • The 2006 Surgeon General’s Report states that children are exposed to more secondhand smoke than adults. Because their bodies are still growing, the chemicals in secondhand smoke can be especially dangerous. Children who breathe secondhand smoke are more likely to develop ear infections, allergies, bronchitis, pneumonia, and more severe and frequent asthma symptoms. And, the risk of Sudden Infant Death Syndrome (SIDS) is doubled in households with a parent or guardian who smokes. Each year, approximately 10 deaths among Colorado infants are indirectly attributed to secondhand smoke exposure. Children exposed to tobacco smoke are more likely to have learning disabilities, behavioral disorders and hearing loss and are more like to become smokers themselves.

  • Colorado Clean Indoor Air Act (CCIAA) – was implemented in July 2006 and requires most indoor workplace and public places to be smoke-free, including restaurants, bars, casinos, any food service establishment, indoor sports arenas and auditoriums, health care facilities, child day-care facilities.  The law requires the entryway of any covered facility to also be smoke-free. Contact local law enforcement to report a violation or leave information about the violation at smokefreecolorado.org.

  • Mulitunit housing

  • Youth

    • Most people being using tobacco as adolescents. Interventions to prevent tobacco use initiation and encourage cessation among  need to reshape the environment so that it supports tobacco-free norms. Community programs and policies and school-based policies and interventions should be part of a comprehensive effort, implemented in coordination across the community and school environments and in conjunction with increasing the unit price of tobacco products, sustaining anti-tobacco media campaigns, making environments smoke-free, and engaging in other efforts to create tobacco-free social norms.

    • Why prevention is important

    • Second Chance


Second Chance is an on-line, interactive, and self-directed alternative to suspension program for teens who violate tobacco policy at school, or tobacco law in the community. The program may also be helpful for teens who are experimenting with tobacco, but have not violated policy or law.


Who Benefits from Second Chance?

Schools, local health agencies, and youth-serving organizations can use the program as part of a comprehensive tobacco education and prevention strategy. Administrators have the ability to:


  • Assign student usernames and passwords

  • Track student progress in the program

  • Analyze student demographics

  • Review pre- and post-test results


The Rationale Behind Second Chance

A tobacco-free policy and an alternative to suspension program are part of  comprehensive approach to tobacco use prevention and cessation. A synergy should exist between all essential components of effective tobacco prevention for schools, including policy, classroom instruction, cessation, and parent, family, and community involvement. Second Chance was developed in cooperation with the Colorado State


Tobacco Education & Prevention Partnership through Amendment 35 voter approved tobacco tax funds. Content was developed using a number of “best practice” sources and content experts in Colorado and nationwide.

    • N-O-T

    • Not On Tobacco (N-O-T) is the American Lung Association’s voluntary smoking cessation program for high school students. Over the 10-week program, participants learn to identify their reasons for smoking, healthy alternatives to tobacco use, and people who will support them in their efforts to quit.

    • The best thing about N-O-T? It really works. N-O-T is a structured approach to smoking cessation based on the social cognitive theory. Studies of 12,000 teens participating in the N-O-T program nationally found that approximately 90 percent of the teens enrolled in the N-O-Tprogram either quit smoking or cut back.