E-cigarette use among keiki is a growing epidemic. A 2019 report from the state Department of Health found 1 in 3 Hawaii teens vape on a regular basis, one of the highest youth vape rates in the nation.
To curb the situation, University of Hawaii Cancer Center researcher Scott Okamoto recently was awarded a $2.8 million grant to develop and implement a middle school prevention program targeting e-cigarette use among Big Island youths.
“It’s really a resistance-based program, where kids participate in classroom lessons that provide tools to deal with situations as they happen in their community,” Okamoto said. “A lot of the substance use prevention programs target middle schools because historically, high school substance use is already integrated into their lives.”
Nearly 18% of Hawaii middle school students reported using e-cigarette products, the highest in the nation among 14 states collecting data on the age group.
The program will be an extension of the Ho‘ouna Pono curriculum, also led by Okamoto, which focused on drug and alcohol prevention for rural Hawaii adolescents.
“Our prior work was on the development and evaluation of alcohol, tobacco and other drug use intervention for the public schools on Hawaii Island,” he said. “This project builds off of our prior work.”
Ho‘ouna Pono began in 2006 and continued through 2020, with funding from four separate grants. It provided broad prevention methods, while also analyzing their efficacy on students.
“We’re going to roll out the curriculum in the classrooms through what we’re calling a modular intervention,” Okamoto said about how the program will differ. “Whatever’s going on in their specific communities, they can customize their intervention to meet their needs.”
The focus on e-cigarettes came directly from requests by school leaders involved in the Ho‘ouna Pono program.
“The whole e-cigarette plan came about from principals and teachers that participated in the Ho’ouna Pono intervention and noticed e-cigarettes were getting out of control,” he said.
Besides the classroom lessons, prevention methods will expand to include video and social media.
“In addition to the classroom component, there’s also going to be what we’re calling a social media component, which is going to have short video clips spread across schools receiving the intervention,” he said. “It’s a multilayered approach and addresses both the home environment as well as classroom environments.”
The prevention program will span five-years, beginning with discussions and surveys where students will identify their concerns directly.
“It will be built off of the perspective of kids in our middle schools,” Okamoto said. “Our work tries to put substance use in a more realistic situation and setting for kids on the Big Island. Then have them discuss, think through, and analyze what they would do in those situations so it provides them with realistic tools to deal with the situations.”
After analyzing surveys and student responses, specific curriculum targeting Hawaii Island middle school students will be rolled out. Roughly 550 students are expected to be given the lessons, and the cohort will be followed over a two-year period to record the impact.
“For prevention in general, and certainly in this case with e-cigarettes, we’re really looking to flatten the curve,” said Okamoto. “Use is always going to go up, but you want that increase to be a lot slower. That’s what prevention intends to do.”
One of Okamoto’s goals is to address the link between e-cigarettes and students moving on to other harmful substances.
“E-cigarettes typically contain high concentrations of nicotine, which is very addictive,” he said. “High concentrations of nicotine, in turn, prime the brain for other substances, like combustible cigarettes, particularly for children and adolescents.”
Email Grant Phillips at gphillips@hawaiitribune-herald.com
