||5R01CA263121-02 Interpret this number
||Evaluation of the Be Vape Free Curriculum of the Tobacco Prevention Toolkit
Electronic cigarettes (e-cigarettes, e-cigs, vapes, ENDS) are the most widely used tobacco product among
adolescents, aged 12-18. Despite clear connections between e-cigarette use, nicotine addiction, and physical
and mental health outcomes, adolescents continue to harbor misperceptions about e-cigarettes, perpetuated
by exposure to marketing and flavors, and a lack of understanding about their harms and addictive properties.
While schools have historically provided a key venue in which to implement tobacco prevention programs,
most school-based tobacco prevention programs focus on conventional cigarette smoking only, have had
mixed results, and have several gaps in their educational content on e-cigarettes. Further, studies have rarely
determined if there are specific groups for whom e-cigarette prevention and cessation programs are, and are
not, helping. Using a community-based participatory research approach, we developed the “Be Vape-Free”
Curriculum, a free 5-session school-based education, prevention, and reduction (de-escalation) program for
middle and high school students. This curriculum is part of and includes the most effective components of the
Tobacco Prevention Toolkit, a free online comprehensive tobacco prevention program used by thousands of
schools and educators across the United States, having reached more than 1.7 million middle and high
schools students. Aligning with the NIH Stage Model for Behavioral Intervention Development, we have
addressed 3 of the 6 stages needed to adequately develop, evaluate, refine, and fully implement and
disseminate our Be Vape-Free Curriculum. Thus, the Specific Aims of this project are to: (1) Determine
whether the Be Vape-Free Curriculum is effective in increasing middle and high school students’ knowledge of
e-cigarettes and resistance to using, and decreasing their positive attitudes towards and intentions to use e-
cigarettes; (2) Determine whether the Be Vape-Free Curriculum is effective in changing middle and high school
students’ actual use of e-cigarettes (including preventing initiation, continuation, escalation; encouraging
decreased use and cessation; and use of e-cigarettes with other tobacco and marijuana products); and (3)
Examine the heterogenous treatment effects (HTE) of the intervention, identifying both those who benefit the
most and those who do not benefit from the curriculum. We will employ a cluster-randomized trial, stepped-
wedge design, with 60 middle and 60 high schools in California (n=10,800 students). Schools will be
randomized to either the treatment (Be Vape-Free Curriculum) or delay-in-treatment arm (i.e., standard health
education first year and Be Vape-Free curriculum in second year), with all students followed for another 12
months. The timing of this proposed research is extremely important as we have outstanding momentum, have
established an extensive team of school and community partners and stakeholders, have numerous schools
already interested in using the Be Vape-Free Curriculum, and have garnered tremendous support from the
California Department of Education and schools.
School-based programs to prevent adolescent e-cigarette use: A report card.
, Gaiha S.M.
, Halpern-Felsher B.
Current problems in pediatric and adolescent health care, 2022 Jun; 52(6), p. 101204.