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.

中文翻译：

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阿拉巴马州的学校电子烟教育：对电子烟知识，感知和尝试意图的影响。

背景和目标

需要制定教育计划来应对青少年使用电子烟的急剧增加。我们评估了青少年对电子烟的了解，对有害性和成瘾性的认识以及在进行电子烟教育之前和之后尝试使用电子烟的意愿。

方法

我们于2019年在阿拉巴马州的初中和高中学生进行了一项单组测试，该测试包括基于斯坦福烟草预防工具包的30分钟教育课程，内容涉及电子烟的类型，内容，营销和广告，健康影响和尼古丁成瘾。配对比例的McNemar检验和多层次，混合效应逻辑回归模型用于分析干预效果。

结果

调查由2889名中学生和高中生完成。该干预措施与对电子烟的知识和对电子烟有害且容易上瘾的认识显着增加，以及尝试使用电子烟的意愿明显降低有关。在预测试中，中学生的知识水平较低，他们认为电子烟没有上瘾的能力，与高中生相比，他们更倾向于尝试电子烟和香烟。与较低的感知的有害性和成瘾性相关的人群是：电子烟的经常使用者，电子烟和香烟的经常使用者以及薄荷/薄荷醇味电子烟的先前使用者。

结论

以学校为基础的教育课程与青少年对电子烟的了解程度提高，电子烟的危害性和成瘾性增加以及尝试使用电子烟的意愿明显降低有关。与中学生相比，中学生应优先考虑电子烟教育，因为其知识水平较低，而且尝试吸烟的意愿更高。