RT info:eu-repo/semantics/article
T1 Adolescents’ perceptions of tobacco and electronic cigarette prevention: six school-based cohorts (2010/11–2023/24)
A1 Sota Rodrigo, Cristina
A1 Escolar Llamazares, María del Camino
A1 Mercado Val, Elvira
K1 Adolescents
K1 Electronic cigarettes
K1 Nicotine
K1 Peer influence
K1 Prevention
K1 Program evaluation
K1 School-based intervention
K1 Adolescentes-Consumo de tabaco
K1 Teenagers-Tobacco use
AB Background: Adolescent tobacco use remains a major public health concern (World Health Organization, 2024).In recent years, electronic cigarettes have become a frequent pathway to nicotine initiation, posing new challengesfor traditional school-based tobacco prevention strategies.Methods: A repeated cross-sectional observational study was conducted with 5,658 students aged 11 to 18 yearsfrom secondary schools in Burgos (Spain), corresponding to six academic cohorts between 2010 and 2023. Thestudy was carried out within the framework of a universal school-based prevention program targeting tobaccoand electronic cigarette use, delivered during the first year of compulsory secondary education. Following theintervention, students voluntarily and anonymously completed an evaluation questionnaire. Trends in experimentationacross cohorts and associations between self-reported program participation and psychosocial andprogram evaluation variables were examined using logistic regression models and interpreted as observationalassociations without causal attribution.Results: Experimentation with conventional cigarettes showed a marked decline in the earlier cohorts and asubsequent stabilization in more recent years. Electronic cigarette use was assessed from 2021 onwards, withrelevant prevalence levels observed in the most recent cohorts. In the subsample with detailed consumption data(n = 2,206), electronic cigarettes were the most commonly used product in the past 30 days (10.4%), followed byconventional cigarettes (7.2%).Social exposure to tobacco use was high, with more than 80% of students reporting at least one smoker in theirimmediate environment. In bivariate regression analyses, self-reported participation in the program was associatedwith experimentation with electronic cigarettes (OR = 0.66; p = 0.006), although this association did notremain significant after adjustment for age, gender, school type, and social exposure. By contrast, programparticipation showed consistent associations with indicators of program evaluation, including positive appraisalof the sessions (AOR = 5.25; 95% CI: 3.85–7.16) and discussion of program content within the family (OR =1.92; p < 0.001).Conclusions: In this repeated cross-sectional series, adolescent use patterns were characterized by the increasingprominence of electronic cigarettes. Self-reported program participation was associated with indicators ofengagement and appraisal, which should be interpreted within the limits of the observational design. Overall, thefindings highlight the relevance of prevention approaches that
PB Elsevier
SN 2352-8532
YR 2026
FD 2026
LK https://hdl.handle.net/10259/12275
UL https://hdl.handle.net/10259/12275
LA eng
DS Repositorio Institucional de la Universidad de Burgos
RD 15-oct-2026