E-cigarette policies at schools may be insufficient without staff training

A new analysis supports implementation of school policies to boost staff awareness of and intervention in e-cigarette use among students, but suggests that training on such policies is necessary to boost their effectiveness. Minal Patel of Schroeder Institute at Truth Initiative in Washington, D.C., and colleagues present these findings in the open-access journal PLOS ONE on March 16, 2022.

In 2018, the U.S. Surgeon General declared adolescent e-cigarette use an epidemic, citing a sharp increase in use in recent years. Federal policies ban cigarette use at schools that are recipients of federal funding, but states, local municipalities, and individual schools create their own policies regarding e-cigarette use at school. Thus far, few studies have explored the impact of such policies.

To help clarify, Dr. Patel and colleagues analyzed survey responses from 1,480 teachers and administrators who worked in U.S. middle schools and high schools in November and December of 2018. The survey asked staff to report their schools' e-cigarette policies and related training, as well as their experiences with implementing such efforts.

Most staff reported that their schools had implemented e-cigarette policies, but fewer than half reported having been trained on such policies. Fewer than half were able to identify an image of a JUUL device—the most popular e-cigarette at the time of the survey. However, staff who reported e-cigarette policies at their schools had higher odds of recognizing a JUUL device than those from schools without policies, and those who reported receiving training on the policy had further increased odds of recognizing a JUUL device compared to those who had not received policy training.

Additionally, staff from schools with e-cigarette policies were more likely than staff from schools without policies to report intervention on e-cigarette use by students, whether in the form of communicating with students on avoiding such devices or reporting that students had been detected using such devices on school property. Again, staff who had been trained on e-cigarette policies were still more likely to report intervention.

In line with prior studies, this study suggests that school e-cigarette policies alone may be insufficient without accompanying efforts to train staff on implementing such policies, including fostering continued awareness of the evolving landscape of e-cigarette products.

The authors add: According to these data, although less than half of surveyed middle- and high-school teachers and administrators were able to identify an image of JUUL as an e-cigarette at the height of its popularity, those who worked in schools with e-cigarette policies, and had received training on those policies, were more likely to recognize e-cigarettes and intervene on student e-cigarette use. Only 30% of those with policies in place received training on their school's e-cigarette policy, presenting a critical gap in preventing youth from using e-cigarettes. For this reason, we've developed resources like a curriculum and text message quit program, as well as suggestions on how to address in-school tobacco use among students. More information and resources can be found here."