Electronic nicotine delivery systems (ENDS), such as electronic cigarettes, electronic hookahs, and other vapor emitting devices, were introduced into the market in 2007. Although research on these products is still nascent, since entering the marketplace, sales of ENDS and in particular e-cigarettes have risen dramatically. Recent data showed from 2011 to 2012, ever-use of e-cigarettes increased from 1% to 3% among middle school students and from 5% to 10% among high school students. Further, many youth are using e-cigarettes along with other tobacco products. E-cigarettes contain candy and other flavorants that make them particularly appealing to youth. Further, e-cigarette companies are aggressively marketing to youth. Given the rapidly increasing awareness, use, marketing, flavoring, and normalization of e-cigarettes, it is clear that efforts to prevent the use of ENDS are critical. Schools have historically provided a key venue in which to implement tobacco prevention programs. However, most of the focus of the school-based tobacco prevention programs has been on preventing conventional cigarette smoking. While some schools have been informally developing preliminary e-cigarette prevention curricula for their specific schools, no formal prevention programs focusing on ENDS has been developed, tested, or widely disseminated throughout California. We received previous funding through TRDRP to develop, test, and implement a novel school-based tobacco prevention Toolkit. However, since at the time of grant funding adolescents’ use of ENDS as well as marketing of these products was uncommon, the project as originally proposed and funded was not focused on e-cigarettes. Given current use of e-cigarettes, co-use with other tobacco products, and extensive marketing, as well as our momentum and success in already collaborating with school partners to develop our novel school-based tobacco education Toolkit, it makes sense to develop and include an e-cigarette prevention curricula module into our toolkit.
The ultimate goal of this project is to identify a set of topics and strategies for delivery of anti-electronic cigarette messages that can be addressed and implemented in school-based tobacco prevention programs. The specific aims of the proposed project explicitly address the priority needs and gaps identified by our school partners and stakeholders participating in our current project, and are as follows: (1) through focus groups with middle and high school students, we will identify key misperceptions about e-cigarettes that appear to increase the likely and actual use of ENDS; and (2) using the results from the focus groups, and working with our school partners, we will develop and pilot test curricula and delivery strategies aimed at prevention of ENDS that can be incorporated into our Toolkit. The proposed project is particularly timely as the CDE and schools themselves are acutely aware of the surge in rates of e-cigarette use. However, there are no research-validated curricula on ENDS prevention from which schools can draw to guide them in fulfilling this need. It is expected that this one-year extension will result in a novel module focusing on the prevention of the use of ENDS among California’s middle and high school students. The resultant module is expected to be novel not only in content, but also in the methods used to convey anti-electronic cigarette messages to youth. The timing of this grant is extremely important as we have created outstanding momentum and established an extensive team of school partners including the CDE who are prepared to work with us on the ENDS module, and who are excited to adopt the resultant materials into the rest of the Toolkit we are developing.