The impact of school smoking control interventions on adolescents′ knowledge, attitudes, and behaviors regarding e-cigarettes

ObjectiveTo analyze the effectiveness of school-based tobacco control interventions by comparing students′ knowledge, attitudes, and use of e-cigarettes before and after the implementation of interventions, and to provide a basis for further development of school-based tobacco control measures. MethodsFrom October 2022 to May 2023, a six-month tobacco control intervention was conducted among all students in a vocational high school in Qingpu district, Shanghai. Anonymous questionnaires were administered before and after the intervention. Propensity score matching was performed using gender, grade, and smoking/vaping status of family members and friends as matching variables. Data were compared using the χ2 test. ResultsA total of 981 and 819 valid questionnaires were collected at baseline and post-intervention, respectively. After propensity score matching, baseline and follow-up data from 770 students were obtained. At the end of the intervention, 79.5% of the students expressed their hope that the school would continue to promote the construction of a smoke-free environment. After the school-based tobacco control intervention, students′ awareness of the harms of e-cigarettes improved. The proportion of students who agreed that "e-cigarettes pose safety hazards" increased significantly from 81.8% to 85.8% (χ2 = 4.604, P = 0.032). Support for e-cigarette control measures increased among adolescents, especially support for banning e-cigarettes in indoor public places, which increased by 4.4% after the intervention. The proportion of students who had ever tried e-cigarettes increased from 4.4% to 5.5%, while the proportions of current e-cigarette users and those intending to use e-cigarettes decreased. ConclusionsSchool-based tobacco control interventions are effective in improving students′ knowledge, attitudes, and intentions regarding e-cigarettes, but further efforts are needed to enhance the effectiveness of these interventions.