Evaluation of the Be Vape Free Curriculum of the Tobacco Prevention Toolkit

电子烟(电子烟、烟头)是使用最广泛的烟草产品 青少年，年龄在12-18岁之间。尽管电子烟的使用、尼古丁成瘾和身体健康之间存在明显的联系 和心理健康后果，青少年继续对电子烟怀有误解，长期存在 由于暴露在营销和口味中，以及对它们的危害和令人上瘾的特性缺乏了解。 虽然学校历来为实施烟草预防计划提供了一个关键场所， 大多数以学校为基础的烟草预防项目只关注传统的吸烟，已经 结果喜忧参半，在电子烟的教育内容上有几个差距。此外，很少有研究表明 确定是否有针对电子烟预防和戒烟计划的特定群体，以及 不是，是帮忙。使用基于社区的参与式研究方法，我们开发了“无Vape” 课程，免费的5节校本教育、预防和减少(降级)计划 中学生和高中生。本课程是最有效的 烟草预防工具包，这是一个免费的在线综合烟草预防计划，数千人使用 全美各地的学校和教育工作者，已达到170多万中学和高中 学校的学生。与NIH行为干预发展阶段模型相一致，我们有 解决了充分开发、评估、改进和充分实施和 传播我们的Be-Vape课程。因此，本项目的具体目标是：(1)确定 Be-Vape-Free课程是否有效地提高了初中生的知识 电子烟和对使用电子烟的抵抗力，以及减少他们对使用电子烟的积极态度和意图- 香烟；(2)确定BE-Vape-Free课程在改变初中和高中方面是否有效 学生实际使用电子烟的情况(包括防止电子烟开始、继续、升级；鼓励 减少使用和戒烟；以及将电子烟与其他烟草和大麻产品一起使用)；以及(3) 检查干预的异质性治疗效果(HTE)，确定哪些人受益于 大多数人和那些没有从课程中受益的人。我们将采用整群随机试验，步进式- 楔形设计，加州有60所初中和60所高中(n=10,800名学生)。学校将成为 随机分为治疗组(无录像课程)或延迟治疗组(即标准健康组 第一年的教育和第二年的免Vape课程)，所有学生随后再学习12年 月份。这项研究的时机是极其重要的，因为我们有突出的势头， 建立了一支由学校和社区合作伙伴和利益相关者组成的广泛团队，拥有众多学校 已经对使用BE-Free Vape课程感兴趣，并从 加州教育局和学校。

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.