Smoking Sucks: For-Youth-By-Youth Trainer Training Program

Smoking Sucks: Kick Butt!
For –Youth-By-Youth Trainer Training Workshops, Nunavut, 2010
Smoking Sucks: For-Youth-By-Youth Trainer Training Program
This project was born from the principle of involving youth in educating their peers to
reduce smoking in the Nunavut Public Health Stategy while funding to put this
principle into practice came from Health Canada (Northern Regions) for 3 workshops,
one in each region of Nunavut, and follow-up support for 40 youth in 21 communities.
Initial ideas were discussed in May 2008, and in February 2009 in Rankin Inlet, the
Federal Minister of Health, Leona Aglukkaq, announced funding for the project.
Detailed planning began in the Fall of 2009, with the first workshop in Iqaluit in
January 2010. Workshops were held in Cambridge Bay during November and Rankin
Inlet during December 2010, and by March 2011 we had completed the follow-up and
reporting. Although the project is officially over, participants and trainers have kept in
touch to provide continuity to an exciting initiative for Nunavut.
The youth themselves made this project succeed beyond what we ever hoped for. The
phrase ‘But why?’ became the rallying cry for the workshops as they began to dig deeper
into the immediate – and the underlying causes – of the problems of tobacco. They
experienced first-hand how knowledge – and the ability to use it – would empower
them to help others in turn. This is the vision we aimed for in these workshops.
Our first goal was to recruit and then train youth as trainers to develop critical
awareness of the harm caused by tobacco to almost every family in Nunavut. They
would need to understand the reasons why people start smoking, how to go about
quitting, and how to help those not yet smoking, to avoid starting.
Our second goal was that the youth would do projects in their home communities to
share what they learned in the workshops. Their projects included teaching family and
friends, making presentations to their fellow students using the Smoking Sucks books
and DVDs, hosting discussions on local radio, and producing posters. Their teachers
and CHRs have confirmed that they achieved this second goal, and the youth sent
reports on their activities which we discussed with them by phone and by e-mail.
In the pages that follow you will see photos (most of which were taken by the
participants) sharing their unique experience and expressing appreciation for the
opportunity to get involved in reducing the high rate of smoking – the single biggest
preventable cause of sickness and death – in Nunavut.
1
Qikiqtaaluk Workshop: Iqaluit, January 2010
We set out to recruit two students from each of the thirteen
communities in the Qikiqtaaluk, and finally had eighteen youth
from nine communities, not a bad number. Making travel and
accommodation arrangements for workshops in the north can be
quite complicated, and we had our share of complications due to
weather, limited availability of accommodation and conference
facilities and conflicting timetables.
To publicize the project we made phonecalls and sent e-mails to
teachers and/or principals, CHRs and nurses in each community.
Making personal contact like this made for good lines of
communication and enabled us to build a relationship with people
whom we would not meet face-to-face but on whose help we
depended for the success of the project.
Once we had the names of youth who had been selected by their
teachers/CHRs, we made phone calls to all but three (some did not
have a phone) as well as most of their parents, and followed-up by
e-mail. We wanted to be sure that they were clear on what was
expected from them, and what they could expect from the
workshop, and to give the parents confidence that their children
would be in good hands. Parents – and in some cases siblings as well
– were very supportive (some wanted their kids to help them quit
too), and we found their enthusiasm very encouraging.
We started off the workshop with one trainer (Rob Collins of the
Consultancy for Alternative Education in Montreal who facilitated
the workshop on behalf of the Department of Health and Social
Services), two chaperones (Lauren Troutman and Brendan Doherty),
eighteen youth and several staff from the Department who helped
out occasionally (Ainiak Korgak, Nadia Mike and Naila Ogbuneke).
It was not long before we found that we had added four exceptional
trainers to the group: Lauren, Brendan, Nadia and Curtis
Taqqaugaq, (one of the team from Igloolik). By the end of the
second day it was quite obvious that all the participants were
becoming competent trainers too - contributing ideas, doing
presentations, organizing events and leading sessions - all of which
made the workshop flow smoothly.
2
On the first night, one of the girls quietly mentioned
that she wanted to go home as soon as possible. We
discussed the situation and she agreed to try it out for a
day at least. On the last night, she asked: “Couldn’t we
keep the workshop going for another week?”
The four-day workshop was divided between small
group sessions to study and discuss specific issues about
the problems of tobacco, and to do presentations back
in the large group. Examples include: Why do youth
start smoking? What can they do to delay or avoid
starting to smoke? How does smoking affect our health
and our lives? What can smokers do to try to quit? More
on this in the photos that follow, showing the
participants and some of the sessions in action.
Qikiqtaaluk Workshop: Iqaluit, January 2010
Iqaluit,
January
2010
Top row: Peter Derek Ottokie & Megan Ross, Cape Dorset; Nathan Kunilusie & Kayla Qappik, Qikiqtarjuaq; Joey Amaaq & Curtis Angugatsiaq Taqqaugaq, Igloolik.
Second row: Kayla Etuangat & Leevee Arlooktoo, Kimmirut; Gary Angnetsiak & James Akpaleeapik, Pond Inlet; Tim Arnadjuaq & Judah Qanatsiaq, Hall Beach.
Third row: Lily Kilabuk & Aimo Kilabuk, Pangnirtung; Bob Barnabas & Lionel Willie, Arctic Bay; Mikki Noah & Clara Natanine, Clyde River.
Bottom row: Lauren Troutman & Brendan Doherty, co-facilitators, Iqaluit; Nadia Mike, assistant & Ainiak Korgak, project manager, Iqaluit; Rob Collins, trainer, Montréal.
3
Qikiqtaaluk Workshop: Iqaluit, January 2010
Top, back: Kayla Etuangat, Leevee Arlooktoo, Aimo Kilabuk, Nathan Kunilusie Middle: Bob Barnabas, Lionel Willie, Lily Kilabuk, Kayla Qappik, Nadia Mike, Ainiak Korgak, Rob Collins, Joey Amaaq, Curtis Taqqaugaq, Tim Arnadjuaq.
Sitting: Clara Natanine, Mikki Noah, Peter Derek Ottokie, Megan Ross, Gary Angnetsiak, James Akpaleeapik and Judah Qanatsiaq.
Bottom left: A view from above; students using their Smoking Sucks books
Bottom right: Nadia Mike directs the formation of a pyramid.
4
Qikiqtaaluk Workshop: Iqaluit, January 2010
Peter Derek Ottokie, Joey Amaaq, Cutis Taqqaugaq and Megan Ross present their
session on Step 1: Get informed; get angry. Their session was all about asking “but why”
– to get people thinking: When did Inuit start smoking & why? How many Inuit smoke & how
come so many Inuit youth smoke? Why do we say “smoking sucks” – what’s the problem?
Kayla Etuangat, James Akpaleeapik, Judah Qanatsiaq and Gary Angnetsiak present their
session on Step 2: Get your mind ready which is about preparing yourself mentally for
quitting. The whole point here is that quitting isn’t easy for most smokers - we have to get
properly prepared to increase our chance to succeed.
Bob Barnabas, Lionel Willie, Clara Natanine, Mikki Noah & Tim Arnadjuaq present Step 4:
Get your body ready: 1) exercise every day, 2) eat healthy food instead of junk food,
3) drink lots of water, 4) cut down on pop, tea, & coffee, 5) avoid alcohol and other drugs,
6) get lots of sleep; 7) consider using nicotine replacements when quitting.
Aimo Kilabuk, Nathan Kunilusie, Lily Kilabuk & Kayla Qappik present Step 5: Get support:
1) assess those around you – how they might help or hinder your attempt to quit, 2) ask cool
people for help, 3) speak up for yourself, 4) cut down on stress, 5) hang out with nonsmokers, 6) act like a non-smoker, 7) avoid second-hand smoke at home & work.
5
Qikiqtaaluk Workshop: Iqaluit, January 2010
Top, left: James Akpaleeapik, Gary Angnetsiak, Judah Qanatsiaq, Kayla Etuangat & Brendan Doherty pause work for a photo. Right: Joey Amaaq adds guitar & song to the mix.
Below, left: Mikki Noah cracks up when Dr Isaac Sobol (Chief Medical Officer of Health) makes a joke. Right: Lauren Troutman adds action...
6
Qikiqtaaluk Workshop: Iqaluit, January 2010
Top, L — R: Megan Ross; Curtis Taqqaugaq; Kayla Qappik and Lily Kilabuk
Bottom L — R: Lionel Willie; Kayla Etuangat; Ainiak Korgak (Manager of Health Promotion, DHSS, and the originator of the workshop series).
7
Qikiqtaaluk Workshop: Iqaluit, January 2010
The particpants prepared a session about why youth smoke and how to avoid starting.
They practised their presentation before going ‘live’ with students at Aqsarniit Middle
School. One important lesson: it isn’t easy being a teacher, but they did very well.
Participants led by Brendan on guitar prepared a multi-media performance for the
closing ceremony. We can use different ways to get the message out about the
problems of tobacco: skits, poetry, posters, videos, quizzes & smoke-free events, etc.
Curtis Taqqaugaq answers questions from the class at Aqsarniit Middle School about nicotine as a “gateway drug” or bridge, explaining that many more smokers than nonsmokers move on to experiment with — and get hooked on — alcohol and other drugs.
8
Qikiqtaaluk Workshop: Iqaluit, January 2010
To conclude
As the photos show, the workshop was mainly structured around small
groups doing assignments using the book Smoking Sucks: Kick Butt! then
making presentations to the rest of the group, and giving each other
feedback. Other learning activities included discussion sessions, role
plays, tobacco game shows and videos that we watched and discussed.
For the closing evening, we invited twelve guests from the
Department of Health and Social Services to dinner who discovered
that it wasn’t just a free lunch - they had to work for their keep. First
they had to complete a quiz about the hazards of smoking, tobaccorelated morbidity and mortality rates, and the issues facing smokers
who are trying to quit. All got through the quiz under the critical
eye of the youth trainers only to find out that they also had to hand
out certificates to their ‘trainers’ for the evening.
Before the workshop closed, participants completed an evaluation and
gave the following scores (extracted from the analysis sheet):
•
•
•
•
organization and timing of sessions (based on 3 criteria):
attitudes and skills of trainers (10 criteria)
training materials (5 criteria)
advantages to participants (3 criteria)
87%
92%
95%
92%
On the last day of the workshop one of the participants said that she
had quit smoking shortly after the workshop started. We have been in
touch with her since then, and she is still firmly smoke-free. Several
others became ex-smokers too, though some have since relapsed.
The non-smokers in the group are even clearer in their determination
to remain smoke-free, and to keep trying to help others to quit.
9
Kitikmeot Workshop: Cambridge Bay, November 2010
We began recruiting in the Kitikmeot by asking principals,
CHRs and nurses in each community to select two youth to
take part who would meet the criteria for the project. Once
we had the names, we contacted the youth and their parents
directly to make sure that we all had the same understanding
of the workshop, and to start building relationships. We
made the usual travel arrangements, knowing that there might
be changes in store – and so there were. Blizzards in the
region cancelled all flights but we finally got everyone into
Cambridge Bay on the third day. We couldn’t simply extend
the workshop by the same number of days on the other side,
because flights don’t go to all five communities every day, and
we wanted to avoid unsupervised stop-overs in another
community for a night or two on the way home. So we
adapted the timetable and extended the hours worked each
day, and because of the small size of the Kitikmeot group,
were able to complete the workshop nicely.
Nora Evaglok (CHR and co-trainer), had all the books and
materials ready that were mailed in advance so setup was easy,
and we began the workshop within a few hours of arriving in
Cambridge Bay. After introductions and supper together we
clarified the rules, approved the compressed timetable and
then watched the video “Smoking: Truth or Dare”, followed by
discussions.
On day two we started with a discussion about how tobacco
had affected the life of each person in the group. We then
divided into smaller groups to study and discuss sections of
Smoking Sucks: Kick Butt! Each group presented their sections
to the large group, and we explored potential issues that could
come up when the teams would present their projects back
home, and practised how to deal with them.
We had our meals together in the co-op hotel restaurant so
that we could use all the time available for working on the
10
timetable. We ended day two watching the video Smoking
Sucks: Kick Butt! (in Inuktitut with English subtitles) that
follows the sequence of chapters in their books.
On day three we began with a review of the proceedings up
till then, and prepared presentations that the teams would do
in their communities and for the closing dinner. Nora Evaglok
with Brent Evetalegak and Kalene Epilon from Cambridge
Bay, arranged the guest list for the closing evening and we
were pleased to invite Keith Peterson, Minister of Justice for
Nunavut who was in Cambridge Bay at the time, to address
the group and hand out the certificates.
The closing dinner began
with a skit by the group,
which coincidentally was
about how big tobacco
exploits and deceives
smokers. We then heard
from Keith Peterson how
Nunavut was taking on
big tobacco in an attempt
to recover the costs of
health care from damage
to the population caused
by tobacco. The co-op
donated two prizes to
show their support for the youth – much appreciated.
On the last day we evaluated the workshop, debriefed about
upcoming projects and distributed books to take home.
Evaluation results were:
• organization and timing of sessions (3 criteria):
• attitudes and skills of trainers (10 criteria)
• training materials (5 criteria)
• advantages to participants (3 criteria)
98%
99%
100%
100%
Kitikmeot workshop: Ikaluktutiak/Cambridge Bay, November 2010
Ikaluktutiak/
Cambridge Bay,
November 2010
Top row: Brent Evetalegak & Kalene Epilon, Cambridge Bay; Caroline Anavilok & Robert Hunter, Gjoa Haven.
2nd row: Jamie Ihakkaq (left) & Fabien Qirngnuq (right), Kugaaruk; 3rd row: Kristine Mannilaq (left), Taloyoak; Nora Evaglok, co-trainer (right), Cambridge Bay.
Bottom row: Katelyn Atatahak & Carla Algona, Kugluktuk; Rob Collins, co-trainer, Montréal.
11
Kitikmeot workshop: Ikaluktutiak/Cambridge Bay, November 2010
Top L—R: Jamie Ihakkaq, Fabien Qirngnuq, Robert Hunter, Rob Collins, Carla Algona, Katelyn Atatahak, Brent Evetalegak, Kalene Epilon, Nora Evaglok, Caroline Anavilok, Kristine Mannilaq.
Bottom: Small groups at work. During the worksops, participants split their time between large group sessions and working in smaller groups or pairs.
12
Kitikmeot workshop: Ikaluktutiak/Cambridge Bay, November 2010
Top L & R: Trainers at work: studying Smoking Sucks books
Bottom: an exercise break and working in pairs to plan projects to do in home communities.
13
Kitikmeot workshop: Ikaluktutiak/Cambridge Bay, November 2010
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Top left & right: Groups work on presentations that they adapt from their Smoking Sucks books, e.g. “What steps can smokers take to improve their chances of quitting?”, and “How does
second-hand smoke harm non-smokers (and smokers too)?” Bottom: Keith Peterson, Minister of Justice for Nunavut, explains to the group during the closing ceremony that Nunavut is working with
other provinces to sue tobacco companies to recover health care costs from the harm caused by tobacco.
Kitikmeot workshop: Ikaluktutiak/Cambridge Bay, November 2010
Left, top and middle: Participants pose
questions about the problems of smoking in
Nunavut, e.g. “What % of kids who
smoke before age 16 will stay smokers
for the rest of their lives?” and “Is
smoking part of Inuit culture?”. (They
were totally understanding about putting
their guests on the spot, so allowed them
do an “open book” quiz, with page
references to help. Nice.)
Top, right: “What’s in a cigarette?” John
Evaglok draws a slip of paper from the
model of a cigarette to read the result to
the gathering.
By the way, the answer to the first
question above is 80% - which is why it is
so important to keep younger youth from
starting in the first place. The second
answer (determined by the group) is that
smoking was never part of Inuit culture
before - but sadly it has become so now.
Above, left: The conference room, Arctic Islands Lodge, where we held the
workshop - with some animation for the photo.
Above, right: Katelyn Atatahak receives her Smoking Sucks
Workshop certificate from Keith Peterson, Minister of Justice.
15
Kivalliq Workshop: Rankin Inlet, December 2010
By the time we held the third workshop in
the For-Youth-By-Youth Trainer Training
Program, things fell into place more easily.
We had gained more confidence - in the
capacity of the youth we would be working
with, and in our training as we made and
tested improvements in our approach during
the previous workshops.
Thirteen youth, representing all communities
in the Kivalliq, took part in the workshop
from 3rd to 8th December 2010 with Yvonne
Aggark-Tautu (CHR) from Rankin Inlet as
the co-trainer. We had solid co-operation
from teachers, principals and CHRs in
recruiting a wonderful group of youth.
Dimarees Shimout (Coral Harbour) and
Joanne Killulark (Baker Lake), both CHRs,
strongly supported their students before and
after the workshop.
Our workshop was held at the co-op’s
Turaarvik Hotel where we had a block of
rooms in one wing as well as the conference
room. In each hotel where we had our
workshops, it seemed at the start that the
hotel staff were anxious about a group of
youth being accommodated together. But by
the end of our stay, the participants showed
that any fears about them were for nothing.
Having said that, the energy and enthusiasm
of the groups was contagious, while also
consuming lots of the same.
16
Above: The whole group together, names are on the opposite page.
Kivalliq Workshop: Rankin Inlet, December 2010
Nuatii (Andrea) Kablutsiak & Mary Ulimaumi,
Arviat
Putuaq Kreelak,
Baker Lake
Veronica Tuktudjuk & Megan Ipkarnerk,
Chesterfield Inlet
Jupie Angootealuk & Mavis Ell,
Coral Harbour
Yvonne Aggark-Tautu,
co-trainer, Rankin Inlet
Maina (Cassandra) Gordon & Gail Wallace,
Rankin Inlet
Blanche Tegumiar & Robin Katokra,
Repulse Bay
Rob Collins, trainer,
Montréal
Aqpa Kasaluak & Megan Angootealuk,
Whale Cove
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Kivalliq Workshop: Rankin Inlet, December 2010
Top: Cassandra Gordon presents a different view of her book • Group presentation by Jupie and Robin • The group decided to produce a poster.
Middle: Mary, Nuatii, Cassandra and Gayle do their group presentation • Mary, Veron, Megan, Jupie, Gayle, Nuatii (Andrea), & Cassandra (Mina).
Bottom: Blanche, Veron, Putuaq & Megan present to the group • Jupie, Putuaq, Megan, Mavis, Blanche, Mary & Veron around the table in the big group.
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Kivalliq Workshop: Rankin Inlet, December 2010
Top: The whole gang looking formidable in uniform • Blanche, Veron, Putuaq, & Megan
Bottom: Megan finishes assembling the model cigarette for their presentation • Putuaq lays out the wording for the poster
19
Kivalliq Workshop: Rankin Inlet, December 2010
Top: Megan offers Barb Stevens, Director, Health & Social Programs for Kivalliq, a ‘draw’ from the many diseases and toxic chemicals that you get in a cigarette.
All the rest: Various scenes from the workshop.
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Kivalliq Workshop: Rankin Inlet, December 2010
Each workshop has a defining
characteristic, and for the Kivalliq
one, it was that of the 9 who
came as smokers, 7 had quit by
the end. Two have since told us
that they relapsed, but that they
had specific plans to make
another quit attempt for an
upcoming event.
“I was homesick on the first night and I even cried
when I talked to my dad on the phone. Now I don’t
want to go back. I never thought about quitting before
and my folks didn’t know I was smoking, so now that I
quit, I can’t tell them, so I have to keep it quiet” (name
withheld). In other examples, parents encouraged their
children who smoked to use the workshop to learn
about quitting and then help their families. This idea
came up several times in our conversations with
parents – that the youth could make a breakthrough
and then help their families in turn, as well as their
peers and younger students at school. Getting support
from family and friends to quit and stay quit is a
crucial part of the process.
On the last day, we found that we no longer had the
use of the conference room so we had to wrap up in
the restaurant instead, and did not do a formal
evaluation although it was clear that it was at least as
successful as the other two workshops which had
scores of 92% and 99% respectively as we have seen.
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Smoking Sucks: For-Youth-By-Youth Trainer Training Program
Conclusion
The youth selected for the workshops gave of their
best during training and in implementing projects in
their communities. Their teachers and CHRs have
described how they hosted radio shows and
facilitated sessions in school using the books and
DVDs they took home with them from the
workshop, and parents have told us how proud they
are of the ideas and initiatives of their children. The
support network among the youth continued after
the workshops, as they shared news and encouraged
each other to act on their new critical awareness
about the problems of tobacco.
This critical awareness they developed on the
workshops, combined with the direct action that the
youth took in their home communities, is crucial to
help tackle the epidemic of smoking in the north.
Too often, we see scarce resources being allocated to
doing “head-counting” research that merely
documents that there is still a problem with tobacco
use, while little or nothing is done to actively support
smokers who want to quit, or to motivate young
people who have not yet started smoking. It certainly
has not helped either to have new policies or
frameworks introduced and then fade away as
another health problem becomes the priority for
funding just as progress is starting to be made on the
previous priority.
Hands-on, critical practice that empowers people to
change – and sustains support for them as they try to
change – might just be what is needed to bring the
programs for tobacco control within reach of those
who are more ready to quit than we think. (During
the past twenty years, we have been fortunate to take
part in workshops such as these, and in communitybased participatory research projects, in distance
education courses for frontline health workers, and
other projects involving action–and–learning for
tobacco reduction. From these experiences we have
come to believe that people in Nunavut – and other
Inuit regions – are more ready to quit than others
might think.)
It was a tremendous privilege to be allowed into the
lives of the youth taking part in the Smoking Sucks
workshops, and to see the change they experienced
and effected. We saw them learn to dig deeper into
issues, asking “but why?” again and again until they
got to the root causes of the problems of tobacco,
and then acted on what they learned with their
families, friends and other youth in their
communities. Well done to all, and thank you.
___________________________________________________________
Rob Collins and Merryl Hammond, Ph.D.,
Consultancy for Alternative Education, Montréal
[email protected] • [email protected]
31st March 2011
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A photo album from the Smoking Sucks
workshops held in Iqaluit, Cambridge Bay and
Rankin Inlet, from January to December 2010.