• Deliver tobacco prevention programs, in person or virtually, to students enrolled in Cleveland County Schools.
• Deliver a range of early intervention/diversion programs either in person or virtually to students enrolled in Cleveland County Schools who have violated tobacco-free policies established by the school system.
• Develop, implement and maintain a comprehensive tobacco messaging program director to youth using a vairety of media including evidence-based options specifically developed for the younger population.
• Work with school nurses to refer students to age-appropriate tobacco cessation programming offered by physician practices and/or public health providers to reduce nicotine dependence.
• Develop, implement and maintain episodic programming to targeted youth populations including educational materials, health fairs and special events.

• Cleveland County Public Health Center staff, especially health education and school health
• Cleveland County Schools-faculty, staff, and admininstration
• Cleveland County Schools-students, parents, guardians
• Substance Abuse Prevention Coalition
• Public Health Board of Cleveland County
• North Carolina Tobacco Prevention Control Branch
• Partners Behavioral Health MCO/SYNAR
• Drug Free Communities Grant Program-SAMHSA
• Atrium Health

The Cleveland County Health Department has provided substance abuse prevention/early intervention programming to the public since 2001 when an independent agency CODAP (Community Organization for Drug Abuse Prevention) became part of the Health Education/Health Promotion unit.  Since then, the delivery of substance abuse prevention services has been provided by health educators who deliver both classroom instruction and individual interventions.  Development and implementation of substance abuse prevention programming is data-driven, drawn from information collected in Community Health Assessments and PRIDE Student Drug Use Surveys.  CCHD is fortunate to have a supportive partner in Cleveland County Schools administrators and staff in developing, delivering and evaluating substance abuse programming to youth in the county.  The Substance Abuse Prevention Coalition has led community efforts to address substance abuse prevention since 2008 and has supported numerous grant applications for funding which have enabled expanded programming options.  The Drug Free Community federal grant was first awarded to CCHD in 2015 and was renewed in 2020, focusing on annual targets affecting youth, ranging from underage drinking, misuse of prescription medications and tobacco products use, including electronic cigarettes.  The PRIDE Student Drug Use Survey is conducted through this grant every two years and is an excellent measure of progress in addressing alcohol, tobacco and other drug use by youth in the county.  CCHD is the recipient of the Substance Abuse Prevention and Treatment Block Grant awarded through the Partners Behavioral Health LME and focuses on classroom-based interventions using evidence-based programming.

CCHD has endeavored to create a continuum of substance abuse prevention programming addressing youth in the county to encourage positive decision-making and goal setting and to promote healthy lifestyle choices. 

• 467 7^th grade students at Shelby Middle, Crest Middle and Burns Middle Schools completed the ten-session evidence-based program Too Good for Drugs which focuses on building positive communication and refusal skills as well as educating students on the signs and symptoms of addiction to substances.
• The Too Good for Drugs program was extended to 59 elementary school students at three sites in the county using the curriculum specifically designed for elementary students.
• 55 individuals were trained in the CATCH MY BREATH evidence-based curriculum addressing use of e-cigarettes by youth.
• CCHD staff provided SYNAR tobacco education to 80 tobacco retailers in the county, including vape shops; included in the program were paid advertisements, merchant education and environmental scans. 
• The SOAR (Student Options and Redirection) diversion program received 44 referrals during the 21-22 academic year; this program is designed to reduce out-of-school suspensions for violation of Cleveland County Schools substance abuse policies and provides a targeted education/intervention to student participants. Each student is assessed for chemical dependency using the SASSI (Substance Abuse Subtle Screening Inventory) and participates in four sessions with a certified health educator. Successful completion of the program reduces the out-of-school suspension from ten days to five and provides the student with education designed to meet each individual’s needs.
• A new tobacco cessation program designed specifically for adolescents was introduced in 2022 and facilitated through the school-based health centers in the middle and high schools in the county.  The program, called HALT (Helping Adolescents Leave Tobacco) is offered to students who are referred by school administrators, staff or school nurses.  Based on the results of an assessment for nicotine and dependence as well as readiness to quit, and with parental permission, students may participate in two levels of support.  The first level includes individual and/or group educational/behavioral counseling with four to six sessions to help teens quit smoking or vaping, reduce the number of tobacco products used and increase healthy lifestyle behaviors.  The second level of support involves Nicotine Replacement Therapy following guidance and recommendations from the American Academy of Pediatrics.  The school-based health center nurse practitioner may prescribe patches, lozenges and gum to assist students with nicotine cravings.