AI Insight
This study evaluated ReFresh, a 3-hour web-based program designed as an alternative to school suspension for adolescent e-cigarette use. Among 173 middle and high school students caught using e-cigarettes, participants showed significant increases in motivation to quit, perceived importance of quitting, and recognition of e-cigarette harms and risks after completing the program. Most students also reported increased confidence in seeking help for e-cigarette use or mental health concerns.
Why it matters
The findings suggest schools can respond to student e-cigarette use without resorting to suspension, which removes students from educational settings and fails to address nicotine dependence. This approach offers a practical alternative that keeps students in school while providing cessation-focused intervention, though actual behavior change still needs confirmation through controlled studies.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Electronic cigarettes are the most commonly used tobacco product among U.S. adolescents. Schools most often respond to student e-cigarette use with exclusionary discipline such as suspension, which removes students from school and does not address potential underlying nicotine dependence. Web-based alternatives to suspension offer a way to keep students in school while providing cessation-focused support, but evidence on their effects is limited. This study examined changes in e-cigarette-related attitudes and motivation among adolescents who completed ReFresh, a self-paced, web-based alternative-to-suspension program completed in approximately 3 hours. Using a single-group pre-post design, we analyzed data from 173 middle and high school students (grades 6 to 12; mean age 15.0) referred after being caught using e-cigarettes on school grounds across 24 delivery sites (e.g., schools, afterschool programs, and health centers). The program comprises five interactive online lessons grounded in the 5 A’s clinical framework (Ask, Advise, Assess, Assist, Arrange), motivational interviewing, and cognitive and behavioral skills training. Changes were analyzed with non-parametric tests. After completing ReFresh, participants reported greater motivation to quit ({chi}2 (6) = 22.79,OR = 3.80, 95% CI [2.2,8.8], p < .001) and rated quitting as more important (V = 3037.50,95% CI [1.00, 2.00], p < .001, r = 0.2). They also viewed e-cigarette use as more harmful and more risky (V = 8137.00, 95% CI [0.50, 0.63, p < .001, r = 0.62; V = 7734.50, 95% CI [0.50,0.80), p < .001, r = 0.65)), with the largest shifts in perceived harm relative to cigarettes and perceived risk of mental health problems. Most students reported comfort and confidence seeking help for e-cigarette use or mental health concerns, ranging from 71.10% of students agreeing they felt "More confident asking a trusted adult for help at school" to 80.50% of students agreeing they felt "More confident encouraging a peer to seek help". This study suggests that a brief, web-based alternative to suspension may shift the attitudes and motivation that precede quitting while keeping students in school, offering schools a non-exclusionary way to respond to e-cigarette use. Controlled studies measuring actual e-cigarette behavior are needed to confirm whether these programs reduce use.
Source: Evaluating ReFresh, a Web-Based Alternative to Suspension for Adolescent E-cigarette Use