Expanding the Click City Tobacco Prevention Program to Include E-cigarettes and Other Novel Tobacco Products
Condition: Tobacco Use
Study type: Interventional

Summary: 
      The goal of this study is to modify a smoking prevention program for 5th and 6th grade
      students to also target vaping e-cigarettes. Aims were to modify the program along with
      associated materials and to conduct a trial with 5th grade students in the school setting to
      see how well the updated program worked. Students either participated in the four-week
      computer based program or continued with their usual tobacco prevention curriculum.

      This study showed that students who received the computer program reduced their intentions
      and willingness to use e-cigarettes or smoke in the future more than did students who used
      their usual tobacco curriculum.
    

Detailed description: 
      Given the increase in prevalence of e-cigarette use among youth, investigators modified a
      smoking prevention program to not only target smoking but also vaping e-cigarettes.
      Investigators conducted a pragmatic randomized trial with 5th grade students in schools
      across Arizona and Oregon to evaluate the effectiveness of the updated program in a
      "real-world" setting. Forty-five schools were randomized to the intervention condition,
      wherein students used the updated version of Click City®: Tobacco, or the control condition,
      wherein students were taught their usual tobacco prevention curriculum. Students in the
      intervention schools decreased their intentions and willingness to use e-cigarettes and
      cigarettes significantly, as compared to students in control schools. The intervention also
      significantly changed all etiological mechanisms. The effects on all outcomes of the
      intervention were similar as a function of state (Arizona vs Oregon), gender, ethnicity
      (Hispanic vs not Hispanic), and historical timing (prior to school closures in 2020 vs after
      schools re-opened in 2022). The intervention was also more effective for at-risk students, as
      defined by student's previous tobacco use, current family use and/or high in sensation
      seeking. Close to 90% of the students completed the entire program, and most completed it in
      3 to 4 weeks, the expected time frame. The effectiveness of the updated Click City®: Tobacco
      was demonstrated in a "real world" setting and findings suggested that all students can
      potentially benefit from the program.
    

Intervention name(s): Click City®: Tobacco; Usual Tobacco Curriculum
Intervention type(s): Other; Other
Intervention description(s): A computer-based program assigned to students designed to prevent subsequent tobacco use. Students complete one 15 to 20 minute lesson two times a week for four weeks.; Students complete their usual curriculum designed to prevent tobacco use.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Schools were stratified by state, size of school (small, medium, large) and desired start date and randomized to intervention or control. Intervention and control schools were yoked for the timing of assessments (baseline and follow-up assessments).
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: e-cigarettes; prevention; middle school; smoking