Employing the theory of planned behaviour to design an e-cigarette education resource for use in secondary schools

Abstract

Background An extended version of the theory of planned behaviour (TPB) was used to inform the design of a framework for an educational resource around e-cigarette use in young people. Methods A sequential exploratory design was employed. In Phase 1, elicited behavioural, normative and control beliefs, via 7 focus groups with 51 participants, aged 11–16 years, identified salient beliefs around e-cigarette use. These were used to construct a questionnaire administered to 1511 young people aged 11–16 years, which determined predictors of e-cigarette use and ever use. In Phase 2, sociodemographic variables, e-cigarette knowledge, access, use, marketing and purchasing of e-cigarettes and smoking behaviour were also gathered. The composite findings from Phase 1 and 2 informed the design of a post primary educational resource in Phase 3 around e-cigarette use. Results Current e-cigarette use was 4%, with almost 23% reporting ever use, suggesting current use is stable but experimentation may be increasing in this cohort. Sociodemographic variables, knowledge of e-cigarettes, smoking behaviour and TPB variables (direct and indirect measures of attitudes, subjective norm, and perceived behavioural control) accounted for 17% of the variance in current e-cigarette use, with higher intentions to use e-cigarettes within the next month, having the strongest impact on use (p < 0.001), followed by self-efficacy (p = 0.016). Sociodemographic and TPB variables accounted for 65% of the variance in intentions to use e-cigarettes in the next month; current e-cigarette use (p < 0.001), more positive attitudes (p < 0.001), stronger social influence (p < 0.001), higher self-efficacy (p < 0.001), higher control beliefs (p < 0.001) and greater motivation to use e-cigarettes (p < 0.001) were the main predictors of intentions. Phases 1 and 2 informed the mapping of key predictors of intentions and use of e-cigarettes onto the Theoretical Domains Framework, which identified appropriate intervention functions and behaviour change techniques. Conclusions This paper is the first to bridge the theoretical-practice gap in an area of significant public health importance through the development of a framework for a novel theory driven school-based educational resource aimed at reducing experimentation and uptake of e-cigarette use in young people.

Prevalence, knowledge and factors associated with e-cigarette use among parents of secondary school children

“…The TPB has been used extensively to identify factors that influence intentions and explain the underlying cognitive processes towards smoking and to look at quitting behaviour [ [16] , [17] , [18] ]. More recently, the TPB has been used to identify factors that influence e-cigarette use in adolescents and young adults [ [19] , [20] , [21] , [22] ]. Using a shorter version of the theory, Trumbo and Kim found that factors predicting students intention to use an e-cigarette were positive responses to adverts and the belief that they were less addictive [ 19 ].…”

Vaping Among Adolescents: An Overview of E-Cigarette Use in Middle and High School Students in India

“…School-based programs incorporating e-cigarette education into the school curriculum are effective interventions for preventing adolescent e-cigarette use. These programs typically provide students with information on the risks and harms associated with e-cigarette use and strategies for avoiding e-cigarette use [ 31 ].…”

“…The educational component of these programs can include information on the various chemicals found in e-cigarettes, including nicotine, which is highly addictive and can harm adolescent brain development. The programs may also provide information on the potential long-term health consequences of e-cigarette use, such as lung damage, heart disease, and cancer [ 31 , 32 ]. In addition to providing education, school-based programs may teach students specific strategies for avoiding e-cigarette use.…”

“…For instance, a school-based program may be more effective when combined with parental involvement and public policies that restrict the sale and marketing of e-cigarettes to minors. By combining multiple interventions, community-wide initiatives can have a more comprehensive approach to preventing e-cigarette use in adolescents [ 31 ].…”

Menopause as a window of opportunity: the benefits of designing more effective theory-driven behaviour change interventions to promote healthier lifestyle choices at midlife

“…Six of the nine intervention functions were able to map onto the COM-B and the TDF, these included education, training, persuasion, modelling, environmental restructuring and enablement. When considering intervention functions and how appropriate they would be to implement within an intervention, the affordability, practicality, effectiveness, acceptability, safety and equity criteria (87) was applied to each of the six intervention functions in turn, to enhance the appropriateness and suitability of the intervention components (90) .…”