A new interactive program, developed with students and teachers, could transform how schools tackle the rising tide of teen vaping, blending digital innovation with real-world classroom impact.
Study: Co-design of the ‘OurFutures Vaping’ programme: a school-based eHealth intervention to prevent e-cigarette use. Image Credit: Yta23 / Shutterstock
In a recent study published in the journal Health Promotion International, researchers developed and user-tested a school-based electronic health intervention for preventing adolescent electronic cigarette (e-cigarette) use.
Background
Globally, around 16.8% of adolescents have tried e-cigarettes, often starting as early as age 14. In Australia, one in four teenagers reports having experimented with vaping. The average age of e-cigarette initiation in Australia is 14 years. This growing trend has triggered serious concerns due to the potential harms, including nicotine addiction, lung injury, chemical exposure, and adverse mental health effects. E-cigarette use is also linked to an increased likelihood of cigarette smoking. Recent regulatory reforms have made e-cigarettes legally available only from pharmacies as a therapeutic aid to quit smoking, but illicit supply remains widespread. Schools represent a vital opportunity for early intervention, yet many programs fail to engage students or lack proven effectiveness. Further research is needed to develop credible, scalable, and relatable digital prevention tools tailored for adolescents.
About the study
The ‘OurFutures Vaping’ program was created through a four-stage co-design process led by researchers working alongside teachers and students. The development began with a systematic review and meta-analysis of existing school-based interventions targeting e-cigarette use. Although limited in long-term effectiveness, some strategies showed promise, particularly those involving social influence models and resistance skills training delivered in classroom settings.
Next, researchers conducted focus groups and surveys with 34 students aged between 14 and 16 years. These sessions explored young people's perceptions and experiences with vaping. Students contributed ideas for characters and scenarios that shaped the storyline and tone of the intervention. Their feedback helped ensure cultural relevance and realistic portrayals of vaping behavior and social pressures. Older students from Year 9 and 10 were included at this stage to ensure the development of believable and detailed character profiles and scenarios.
The third stage involved scripting and designing four digital lessons based on the findings. The interactive cartoon-based lessons were rooted in harm minimization principles and included peer-led storytelling, resistance skill modeling, and factual education. The lessons were supplemented with printable resources and optional classroom activities.
Finally, the fourth stage involved user testing with thirty-seven Year 8 students and thirteen teachers. Their feedback informed further refinement of the content, visuals, and instructional design. The finalized program offers an engaging, age-appropriate, and curriculum-aligned approach to e-cigarette prevention in schools. The program was designed for delivery to all Year 7 and 8 students, regardless of their level of risk for e-cigarette or tobacco use.
Study results
The user testing process demonstrated high levels of acceptability and relevance among both students and teachers. Students reported that the lessons were realistic, informative, and easy to understand. Between 81% and 100% rated the lessons as good or very good. They appreciated the relatable storylines, engaging visuals, and practical messages about the risks of vaping and the importance of resisting peer pressure. The interactive quizzes and reflective questions embedded in each lesson further promoted understanding and participation.
Students provided suggestions that led to meaningful revisions. These included breaking up dense text into shorter segments, adjusting character expressions to show more emotion, and including more diverse representations of gender, body types, and personal styles. Students requested that the portrayal of quitting vaping reflect real struggles rather than ideal outcomes. They also recommended incorporating social media themes, especially references to platforms like TikTok, which influence youth attitudes toward vaping. A thought bubble was added to reflect the character's curiosity about vaping, as they had never vaped before. These insights were incorporated into the revised script and visual design.
Teachers also expressed strong support for the program. On average, they had nearly seventeen years of teaching experience and represented a mix of coeducational, single-sex, government, and independent schools. Teachers found the program age-appropriate, well-structured, and aligned with the curriculum. They valued the flexibility of having optional activities and ready-to-use digital content, especially given the everyday challenges of limited class time and varying comfort levels when discussing substance use. Some teachers raised concerns about whether all content could be covered within the lesson timeframe, and also noted that device access could be a barrier for some students; however, the program delivery allows for flexibility.
As a result of the feedback, several improvements were made. The storyline endings were modified to show that quitting vaping can be difficult and not consistently immediately successful. Some factual content originally delivered by student characters was reassigned to a knowledgeable host figure to enhance realism. Additional support resources were added, including guidance on nicotine addiction and cessation services. The visuals were also adjusted to improve readability and emotional clarity, including larger font sizes, natural lip colors, and revised facial expressions.
The final version of ‘OurFutures Vaping’ includes four online lessons, each approximately forty minutes in duration. The lessons are designed to be completed on a weekly basis during regular health education classes by Year 7 and Year 8 students. Each session features an interactive cartoon narrative, optional teacher-led exercises to reinforce learning, and accompanying fact sheets. No formal training is required for teachers, and all materials are accessible online through a dedicated dashboard. This structure ensures scalability, ease of implementation, and consistency across classrooms. The program meets curriculum criteria in multiple Australian states and is underpinned by a comprehensive social influence and harm minimization approach.
Conclusions
To summarize, the ‘OurFutures Vaping’ program represents a timely and innovative response to the rising use of e-cigarettes among adolescents. Developed through an inclusive and iterative co-design process, the intervention offers a digital, engaging, and evidence-based approach that empowers students with knowledge and practical skills. By combining peer-led storytelling, resistance training, and accurate health education, the program fosters critical thinking and supports informed decision-making. It is the first digital school-based e-cigarette prevention intervention in Australia to have been developed through iterative co-design and user testing, and to undergo rigorous evaluation in a cluster-randomized controlled trial. If proven effective through ongoing trials, it holds strong potential for national rollout and international adaptation. The program can help reduce the burden of youth vaping and promote long-term health benefits across diverse school communities. However, the authors note that further work is required to address digital equity and ensure the program is accessible to all students.