Abstract

Significance: Over the past few decades, an intensive amount of research has been conducted on the consequences of adolescent cigarette smoking, leading public health to implement a variety of anti-smoking campaigns throughout society.  As a result, cigarette smoking has seen a decline amongst students in the United States. There is limited evidence for perceptions of what has contributed to this decline. The objective of this study is to identify educator perceptions of why cigarette smoking has decreased among California students.

Methods: Open-ended responses (n=4185) to the question “What do you think is the MOST important reason that cigarette smoking among students has decreased” were coded from the 2019-2020 California Educator Tobacco Survey (CETS). A sample of 150 responses were independently coded by 2 individuals to create an initial codebook and establish inter-rater reliability. A single individual coded the remaining responses using Dedoose software and identified themes.

Results: Three prominent themes were identified to explain why cigarette smoking has decreased among students: the existence of alternative products, the availability of information on health risks due to cigarette smoking, and the increased difficulty to access cigarettes.

Conclusion: Overall, educators within California observed a decrease in the number of students smoking cigarettes. However, educators noted many students have substituted cigarettes with other products such as e-cigarettes and marijuana. Results of this study support previous research indicating the positive effect of cigarette prevention education, programming and policies that limit accessibility to these products. The implementation of prevention education for novel tobacco products such as e-cigarettes may help reduce the risk of use of novel products among students.