# Vaping Education: A Two-Year Study Examining Health Literacy and Behaviors in a Southeastern State

## TL;DR

A two-year school-based vaping prevention program in a southeastern U.S. state improved knowledge about vaping risks but had mixed effects on youth vaping behavior.

## Contribution

The study evaluates a school-based vaping prevention program's impact on health literacy and behavior over two years.

## Key findings

- The program significantly increased youths' knowledge about vaping risks.
- In year one, higher knowledge was linked to less frequent vaping, but this effect disappeared in year two.
- Knowledge did not influence vaping frequency among youths who had already started vaping.

## Abstract

Electronic nicotine delivery systems (vapes) are the most used nicotine products among U.S. adolescents, with usage increasing significantly from 2017 to 2019. School-based prevention programs are a critical strategy for curbing youth vaping. This study utilized a retrospective pre/post survey to evaluate the effectiveness of a two-year school-based vaping prevention program utilizing a condensed version of the Stanford University Tobacco Prevention Toolkit. The program was implemented in-person and online across two years in a southeastern U.S. state. In year one, evalua-tion data were collected from 4252 youths from 20 rural counties who completed the in-person survey during the 2018–2019 program year. In year two, 1347 youths from 13 rural and urban counties completed the survey during the program year of 2019–2020. The key findings indicate significant increases in knowledge about vaping risks post-program. The findings from year one indicate that increases in knowledge about e-cigarettes were negatively related to the frequency of vaping, but this was not replicated in year two. Moreover, knowledge did not influence vaping frequency if youths had already started vaping, while pre-program knowledge did not predict the frequency of vaping in either year. These results suggest that vaping prevention education outcomes among youths are mixed.