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

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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.

Original languageEnglish
Article number276
Pages (from-to)1-22
Number of pages22
JournalBMC Public Health
Volume22
Early online date11 Feb 2022
DOIs
Publication statusE-pub ahead of print - 11 Feb 2022

Bibliographical note

Funding Information:
The Research Advisory Group who comprised members from the following organisations Public Health Agency Northern Ireland, Northern Ireland Chest Heart and Stroke, Institute for Public Health Ireland, HSC R&D, Cancer Research UK, for their advice and input into the design and implementation of this work. To Prof Linda Bauld University of Edinburgh who supported and advised on the research protocol. To all the schools and pupils who took part in our research.

Funding Information:
This research was funded by a grant from Chest Heart and Stroke Northern Ireland.

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • E-cigarettes
  • Vaping
  • theory of planned behaviour
  • Young People
  • School-based Intervention
  • Behavioural Change Taxonomy
  • Theoretical Domains Framework
  • Theory Of Planned Behaviour; Young People
  • E-cigarettes; Vaping
  • Theoretical domains framework
  • Theory of planned behaviour; young people
  • Behavioural change taxonomy
  • School-based intervention
  • E-cigarettes; vaping
  • young people
  • vaping
  • Theory of planned behaviour

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