Abstract
INTRODUCTION/OBJECTIVES: Since 2015, the rise in e-cigarette use among youth has concerned public health authorities. After peaking in 2019, usage rates have declined but remain high. In 2023, 10% of high school and 4.6% of middle school students reported current use. This report describes the implementation and evaluation of a school-based e-cigarette prevention program, CATCH My Breath (CMB), in 8 central Appalachian counties. These counties have some of the highest rates of tobacco use, poor health, and premature death in the United States. METHODS: A total of 6217 students across 25 middle and high schools in West Virginia and Kentucky received the CMB program from 2019 to 2023. Lists of participating counties, schools, and teachers were maintained on a rolling basis over the 4 years of the project. Program reach and impact on e-cigarette knowledge and use are reported. Thirteen-item pre- and post-tests were completed electronically by students before and after each course delivery. Questions assessed knowledge about e-cigarettes, current (past 30-day) e-cigarette use, and interest in future use. RESULTS: From 2019 to 2023, there were 9399 deliveries of the 4-session CMB course, primarily to middle school students. Approximately 84% reported being less likely to use e-cigarettes following the program. Significant improvements in e-cigarette knowledge and beliefs on 5 of 8 items were observed, including a significant increase in knowledge composite score (4.15-4.75, P < .001). From pre- to post-test, declines in current e-cigarette use (5.1% to 4.4%; P = .005) and peer influence (4.9% to 4.0%; P = .025) were also observed. CONCLUSIONS: CMB was feasible, effective, and well-received in a convenience sample of central Appalachian counties and schools. This curriculum, combined with other policy initiatives, offers hope for curbing the growing epidemic of youth e-cigarette use and nicotine dependence. The success of this project contributed to a decision by the West Virginia Bureau for Public Health and the West Virginia Department of Education to launch a joint effort to bring CMB to middle schools in all 55 counties during the next 3 school years of 2023-2026.