Assessment of a Five-Session School-Based E-cigarette Prevention Curriculum on Student Knowledge,Perceptions,and Intent to Try E-cigarettes

Abstract

Adolescents’ misperceptions and lack of knowledge about health harms of e-cigarettes warrant school-based e-cigarette prevention curriculum; however, few curriculums exist and fewer have been evaluated. The purpose of this study is to assess middle and high school students’ knowledge, perceived addictiveness, and intent to try e-cigarettes before and after a five-session in-person e-cigarette prevention curriculum based on the REACH Lab’s Stanford Tobacco Prevention Toolkit. Curriculum content focused on e-cigarette health harms, ingredients, flavors, nicotine addiction, and marketing. Sessions were delivered by a tobacco educator in Birmingham, Alabama (February–March 2020) with 323 participants completing a pre-test and post-test survey. Descriptive statistics and Wilcoxon-sign rank tests for matched pairs assessed difference in knowledge, perceived addictiveness, and intent to try e-cigarettes at pre-test and post-test. Participants had an increase in correct answers for e-cigarette knowledge-related questions at post-test compared to pre-test (z = 11.15; p < .001). Perceived addictiveness of e-cigarettes increased from 37.0% at pre-test to 62.0% at post-test (z = 7.4; p < .001). Participants’ intent to try JUUL reduced from 32.6% at pre-test to 27.9% at post-test (z = −2.1; p = .037). The five-session educational curriculum improved students’ knowledge about e-cigarettes, increased perceived addictiveness, and decreased intent to try JUUL between pre-test and post-test. Further, sociodemographic factors and past 30-day use of e-cigarettes were not associated with these outcomes.