A lot of Jordan Bolyard's classmates at Shortridge Middle School think smoking is cool.

"It's romanticized by TV," the eighth-grader said. "The hero characters always smoke, and people associate it with being tough." But Jordan and his friend Emilie Vanderstel don't believe the hype. They remember a class trip to the Ruth Lilly Health Education Center, where they met a man whose smoking caused esophageal cancer. The man now breathes through a hole in his throat. A mechanical device makes it possible for him to speak, but the sound is electronic and strange. "It was really scary to see," Emilie said. Educational field trips like the one that had such an effect on Jordan and Emilie are just one element of Marion County's Tobacco Free Youth Initiative. The project, designed to prevent middle-schoolers from becoming smokers, is slated to receive the Partnership for Healthy Children Award from the American Public Health Association next month. The World Health Organization reports that 700,000 American children are regularly exposed to tobacco, either through smoking themselves or through spending time in smoky environments. Indiana children are at particularly high risk, said Dr. Stephen J. Jay, chairman of the Department of Public Health at the Indiana University School of Medicine. Indiana ranks eighth among the 16 tobacco-producing states, which have a higher percentage of smokers and a greater cultural acceptance of smoking than other parts of the country. With a $300,000 grant from the Robert Wood Johnson Foundation and matching grants from local hospitals and foundations, the Marion County Health Department launched the initiative in 1997. Officials were concerned after a survey they conducted showed that about 30 percent of Indianapolis teen-agers were smoking. Since then, the Health Department, Indianapolis Public Schools, hospitals, nonprofit groups and community groups have worked on the project, said Sandy Cummings, chronic disease program coordinator at the County Health Department. "I think it's effective because it takes a very comprehensive approach to tobacco control," Cummings said. At school, students learn about the dangers of smoking through a curriculum called Lifeskills Training. They are told, for example, that there are 4,800 chemicals and gases in cigarette smoke, 43 of which are known to cause cancer. Each year, a small group of students attends a two-day leadership camp. They study both the negative effects of smoking and the best ways to discourage their friends from doing it. The anti-smoking influences continue in the children's communities. The Health Department works with neighborhood associations to make sure the message gets out at health fairs, Easter egg hunts and other events. "We want to saturate their whole environment with similar messages," Cummings said. Data collected last December showed that 18 percent of IPS middle-schoolers who didn't participate in the initiative were smokers, compared with 10 percent for students who had participated. Students in the program also are less likely to spend time with people who smoke. Reducing children's exposure to secondhand smoke is as important as discouraging them from using tobacco themselves, Jay said. "Passive smoking is remarkably toxic," said the doctor. Within seven minutes of exposure to secondhand smoke, scientists can measure changes in a person's blood. Over time, nonsmokers who spend a lot of time with smokers can develop asthma, lower respiratory infections, ear infections and even heart disease or cancer. The peer pressure that results from spending time with friends who smoke isn't the only factor that can cause teens to become addicted. Inhaling a lot of secondhand smoke can make kids more tolerant to the effects of nicotine poisoning, such as nausea and coughing. As a result, the first time a child tries smoking, he or she may not suffer negative effects. "It's very worrisome," Jay said. The Tobacco Free Youth Initiative is just one positive step Indiana has taken in reducing the problem, officials say. Another was the formation earlier this year of the Indiana Tobacco Prevention and Cessation Agency, which has an annual budget of about $25 million. The agency is working to increase the number of smoke-free workplaces, to encourage smoke-free college environments and to decrease the number of children exposed to secondhand smoke. Jordan and Emilie say the efforts have been successful so far. "Some kids are starting to think for themselves," Jordan said.

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