Shivani Mathur Gaiha1, Abigail Duemler2, Lauren Silverwood3, Anabel Razo1, Bonnie Halpern-Felsher1, Susan C Walley4. 1. Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States. 2. Division of Hospital Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States. 3. School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States. 4. Division of Hospital Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States. Electronic address: swalley@peds.uab.edu.
Abstract
BACKGROUND AND OBJECTIVES: Educational programs are needed to combat the sharp rise in adolescent e-cigarette use. We assessed adolescent knowledge about e-cigarettes, perceptions of harmfulness and addictiveness and intent to try e-cigarettes before and after an e-cigarette educational session. METHODS: We conducted a one-group pre- and post-test study among middle and high school students in Alabama in 2019. The intervention included a 30-minute educational session based on the Stanford Tobacco Prevention Toolkit on e-cigarette types, contents, marketing and advertising, health effects and nicotine addiction. McNemar tests of paired proportions and multi-level, mixed-effects logistic regression models were used to analyze intervention effects. RESULTS: Surveys were completed by 2,889 middle and high school students. The intervention was associated with significantly increased knowledge about e-cigarettes and perceptions that e-cigarettes are harmful and addictive, and with significantly lower intent to try e-cigarettes. At pre-test, middle school students had lower knowledge, believed that e-cigarettes were not as addictive and showed higher intent to try both e-cigarettes and cigarettes compared to high school students. Groups that were associated with lower perceived harmfulness and addictiveness were: ever-users of e-cigarettes, ever-users of both e-cigarettes and cigarettes and prior users of mint/menthol flavored e-cigarettes. CONCLUSIONS: A school-based educational session was significantly associated with improved adolescent knowledge about e-cigarettes, increased the perceived harmfulness and addictiveness of e-cigarettes, and reduced intent to try e-cigarettes. E-cigarette education should be prioritized for middle school students due to lower levels of knowledge and higher intent to try tobacco compared to high school students.
BACKGROUND AND OBJECTIVES: Educational programs are needed to combat the sharp rise in adolescent e-cigarette use. We assessed adolescent knowledge about e-cigarettes, perceptions of harmfulness and addictiveness and intent to try e-cigarettes before and after an e-cigarette educational session. METHODS: We conducted a one-group pre- and post-test study among middle and high school students in Alabama in 2019. The intervention included a 30-minute educational session based on the Stanford Tobacco Prevention Toolkit on e-cigarette types, contents, marketing and advertising, health effects and nicotine addiction. McNemar tests of paired proportions and multi-level, mixed-effects logistic regression models were used to analyze intervention effects. RESULTS: Surveys were completed by 2,889 middle and high school students. The intervention was associated with significantly increased knowledge about e-cigarettes and perceptions that e-cigarettes are harmful and addictive, and with significantly lower intent to try e-cigarettes. At pre-test, middle school students had lower knowledge, believed that e-cigarettes were not as addictive and showed higher intent to try both e-cigarettes and cigarettes compared to high school students. Groups that were associated with lower perceived harmfulness and addictiveness were: ever-users of e-cigarettes, ever-users of both e-cigarettes and cigarettes and prior users of mint/menthol flavored e-cigarettes. CONCLUSIONS: A school-based educational session was significantly associated with improved adolescent knowledge about e-cigarettes, increased the perceived harmfulness and addictiveness of e-cigarettes, and reduced intent to try e-cigarettes. E-cigarette education should be prioritized for middle school students due to lower levels of knowledge and higher intent to try tobacco compared to high school students.
Authors: Francisco Cartujano-Barrera; Ruthmarie Hernández-Torres; Rafael H Orfin; Arlette Chávez-Iñiguez; Olga Alvarez Lopez; Chiamaka Azogini; Diana Bermudez; Evelyn Arana-Chicas; Xueya Cai; Scott McIntosh; Deborah J Ossip; Ana Paula Cupertino Journal: Children (Basel) Date: 2022-06-22