Grades 5 & 6

Keeping Healthy

This section includes a survey to determine students' perceptions about tobacco, their understanding of its effects, and their experience with it. In addition, it includes activities to educate students about the health consequences of tobacco use.

Activity 1: Take a Tobacco Survey

  • Skills: Assessing Risks and Consequences
  • Suggested Time Consideration: 25 minutes

This student survey is designed to help you launch your tobacco prevention unit and generate class discussion about tobacco. But first, be sure to read the Overview Booklet for Grades 5–9. It provides all the information you need to know to successfully implement this material.

Survey, Parts One and Two

Part One of the activity asks students about their experiences with tobacco. It consists of questions taken from the CDC’s National Youth Tobacco Survey (NYTS) 2004 Questionnaire — a survey that can be used to estimate current use of tobacco products and selected indicators related to tobacco use among U.S. middle school and high school students. These surveys are periodically done by the government to assess tobacco use. The complete survey and reports are available online here.

Part Two of the Survey includes open-ended questions that ask students what they think or know about the prevalence and health consequences of tobacco use, quitting, and why young people use tobacco.

Once you have completed all activities, please delete or dispose of all student tobacco surveys.

  • Rationale

    Collectively, the two-part survey will give you insight into your students’ perceptions about tobacco use and their prior knowledge of the facts, which can help you more effectively implement the unit and address their questions and concerns. Once students complete the survey, use the facts listed in the answer key to help dispel misperceptions students may have about tobacco use, and to reinforce the message that most young people are tobacco free. Since the survey asks students about their personal experience with tobacco, it should be done independently and anonymously. Tell students to input your email when asked. The anonymous results will be sent directly to you. The topics presented in the survey will be addressed throughout the program materials. For example, students will be provided with facts related to the health consequences of tobacco use. In addition, they will be given information about why some adolescents use tobacco, and why most choose to remain tobacco free. They will also be provided with refusal skill techniques that they can use if they are ever pressured to use tobacco.

  • Getting Started

    Before starting the activity, explain to your class that they are going to take a survey that asks them questions about tobacco to help you understand what they know or think about it. To begin, ask students:

    • Do you think it is legal for young people to purchase tobacco products? (Explain that it is illegal to sell tobacco products to minors in every state.)
    • Do you think there are health consequences related to using tobacco? (Explain that students will learn more about health issues in this unit.)

    Direct students to the online survey by clicking the thumbnail below. We recommend emailing the link to your students, posting it on a class webpage, projecting it on an interactive whiteboard, and/or writing it on a chalkboard. Tell students the survey will be entirely anonymous. Explain that no personally identifying information will be included in emails sent to you. Encourage students to answer the questions as honestly as they can.

    Launch Activity

  • Talking About It

    Once they are done, let students know that you are going to share some information with them. They can listen and should feel free to volunteer answers if they feel comfortable. Once you have completed all activities, please delete or dispose of all student tobacco surveys.

  • Wrapping Up

    Answers, part one

    1–4. Answers will vary. Review the answers students provided for these questions. This will give you a sense of your students’ experience with tobacco, but should not be shared with the students.

    5. Explain to students that some young people try tobacco because of a “lack of self-efficacy in the ability to refuse offers to use tobacco,”3 or they don’t know how to tell their friends they don’t want to try it. Explain to students that people their age are sometimes pressured to use tobacco, and that pressure can be difficult to handle. Let them know that in this unit, they are going to learn some ways to say “no” and cope with peer pressure.

    6. Explain to students that according to the Surgeon General, symptoms such as coughing, shortness of breath, nausea, and phlegm production can start to develop in young people who smoke.3 Moreover, students may have heard that quitting tobacco is difficult, but they may not know why. Read to your students the following passage from the Surgeon General’s Report “Preventing Tobacco Use Among Young People”:

    Most young people who smoke regularly are already addicted to nicotine, and they experience this addiction in a manner and severity similar to what adult smokers experience. Most adolescent smokers report that they would like to quit smoking and that they have made numerous, usually unsuccessful attempts to quit. Many adolescents say that they intend to quit in the future and yet prove unable to do so. Those who try to quit smoking report withdrawal symptoms similar to those reported by adults.3

    Answers, part two

    Answers will vary, but share the following with your students.

    1. Most middle schoolers do not smoke: 2% are current cigarette smokers, which means 98% are not.1 (Current is defined as having used tobacco on at least one day in the 30 days preceding the survey.)

    2. Ask students to volunteer answers about why they think young people use tobacco. Explain to your students that some of the reasons young people try tobacco are:3, 4

    • They don’t feel good about themselves (low self-esteem and self-image).
    • They aren’t doing well in school (low achievement in school).
    • They don’t know about the health consequences of smokeless tobacco.
    • They think lots of people smoke (overestimating the number of people who smoke).
    • They don’t realize that they can become addicted (underestimating addictive potential of nicotine).

    Ask students: Why do you think most young people do not use tobacco? Explain that most people choose to be tobacco free. Some reasons include:3, 4, 5

    • Their friends don’t use tobacco.
    • They know about the health consequences.
    • They want to be tobacco free.

    3. If students volunteer stories, remind them not to use names. Listen to their concerns and explain to students that feeling pressure from friends happens, but that they will learn some ways to deal with the pressure.

    4. Again, answers will vary. Write students’ answers on the board, and explain to them that they are going to learn more about health consequences in Activity Two.

    5. See answer 6 in Part One. Additional information on addiction is included in the Support Lessons. You can also see the booklet for grade 7.

    6. Answers will vary. However, explain to your students that according to a poll, most kids strongly dislike being around smokers.6

  • Survey Data Collector

    To assist you with evaluating your students’ anonymous responses to this tobacco survey, we have created a data collection spreadsheet that will allow you to input and view quantitative and qualitative measures. Click here to access the downloadable survey-response spreadsheet. You’ll also find it in the “Materials” section below.

  • What Do You Think?

    Let students know that you don’t expect them to know the answer to this question and they should just take a guess. Afterward, ask volunteers to share their answers. Reinforce that only 6 out of 100 middle schoolers are current cigarette smokers. To end the lesson, display the “Tobacco: Myth or Reality?” poster and review the content with your students. The poster will reinforce the message that most young people are tobacco free.

  • Sources

    1 CDC. Smoking & Tobacco Use. Fact Sheet Youth and Tobacco Use: Current Estimates of Youth Tobacco Use. Referenced 2012.
    2 CDC. Smoking & Tobacco Use. Fact Sheet Youth and Tobacco Use: Estimates of Current Tobacco Use Among Youth. Referenced 2017.
    3 U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; Washington, D.C., 2012. Referenced 2017.
    4 CDC. Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. MMWR 1994; Vol. 43, No. RR-2; 1-18. Referenced 2017.
    5 Milton, M.H., Maule, C. O., Yee, S. L., Backinger, C., Malarcher, A. M., & Husten, C. G. Youth Tobacco Cessation: A Guide for Making Informed Decisions. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2004. Referenced 2017.
    6 The American Council on Science and Health (ACSH). The Scoop on Smoking from ACSH: What every teen should know about tobacco. Referenced 2009.
  • Materials

    For additional information on factors that influence young people to either abstain from or experiment with tobacco, review the Overview Booklet.

Grade 5-6 Overview Booklet


Overview Booklet


Survey Data Collector


Wall Poster: Myth or Reality?