Running head: MAKE VAPING HISTORY 1

Make Vaping History:

A Program to Enhance the Health of Young Adolescent

Beah Grace Flores

Brianna Herbolario

Jenny Vu Nguyen (SID: 015571502)

Marie Pascua

California State University, Long Beach

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Topic Summary

The Priority Population

Smoking is the leading cause of preventable death in the United States (Centers for

Disease Control and Prevention [CDC], 2019a). After many years of this addictive substance

affecting the health of people, cigarette smoking is finally declining (CDC, 2018), however, the

use of vaping has significantly increased from seven million in 2011 to 41 million in 2018

(Jones, 2019). Young adults ages 18 to 25 are at the highest risk of nicotine addiction directly

related to the use of e-cigarettes and vaping devices (CDC, 2019a). Among the youth, vaping has

become a rising epidemic that the United States Food and Drug Administration (FDA) is fighting

to keep vaping devices away from minorities (Henriksen et al., 2004). This population is

vulnerable to smoking and vaping because they are not aware of the dangers and harmful side

effects. According to a RAND (Research And Development) Corporation study, adolescents that

start off vaping are more likely to smoke cigarettes in the future (Targeted News Service, 2018).

This priority population is important for the program because it is the age group where most

individuals are introduced to the concept of vaping.

The Needs of the Priority Population

Due to the recent increase in the popularity of e-cigarettes, there is a higher need for

comprehensive education about its risks and dangers. According to the National Institute on

Drug Abuse (NIDA, 2017), when asked about what was in the devices, 51.8 percent of 12th

graders said it was “just flavoring.” Since vaping is relatively new, there is insufficient

information regarding the exact ingredients of the vapors and its harms. This causes a perception

within the mainstream media and adults that vaping is not harmless, which contributes to this

problem (Korbey, 2018). In order to counteract it, it is important to give teens comprehensive
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health information about e-cigarettes. In addition to learning about the dangers of vaping,

students should be taught skills such as communication, problem solving, and self-control, which

they can apply to situations where they might be pressured by their peers to engage in this

activity (Korbey, 2018). Along with health information, the students currently vaping require

support systems and the resources to quit and adapt healthier behaviors (NIDA, 2017).

Why These Needs Exist

By educating the young adults about the dangers of vaping and providing them with

statistics about known risk factors of vaping, it can deter them from using e-cigarette devices.

Some risk factors that young adults are subjected to encounter while vaping are respiratory

symptoms like coughing, shortness of breath, chest pain, nausea, vomiting, abdominal pain, and

fever (CDC, 2019b). With the e-cigarette devices, the solutions, otherwise known as e-liquids,

often include nicotine, flavoring and a humectant, such as propylene glycol. However, there is

inadequate research regarding the safety of these elements when inhaled (Truth Initiative, 2018).

In a recent report by Neel (2019), the CDC reports that the number of possible cases of severe

respiratory illness among people who vaped nicotine or cannabis-related products has more than

doubled to 450 in 33 states and a total of six people have died. Additionally, there are chemicals

found in e-liquids that may cause a condition called “popcorn lung.” According to the American

Lung Association (AHA, 2016), “popcorn lung” is the scarring of tiny air sacs in the lungs that

results in the thickening and narrowing of the airways. As a result, “popcorn lung” causes

coughing, wheezing, and shortness of breath among e-cigarette users. By informing young adults

about the risk factors and consequences they can potentially experience while vaping, it can

assist them in assessing the appropriate choices for their body and health.

Factors that Create and Determine the Needs

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There are multiple factors that contribute into identifying the needs of the priority

population. According to the United States Department of Health and Human Services

(USDHHS, 2018) 1 in 5 high school students reported using e-cigarettes. Additionally, from

2011 to 2015, a 900 percent increase in e-cigarette use was reported among high school students

(Calkins, 2018). With vaping, students have various reasons explaining why they continue with

the behavior. The overarching reasons stem from experimentation for social reasons, the flavors

tied with vaping, or using vaping as a cessation method to quit smoking (Evans-Polce et al.,

2018). While high school students are more likely to vape due to the influence by peers, research

indicates that e-cigarette advertisements in retail stores, social media, magazines, or on television

can also be a contributing factor to the increase in e-cigarette use among youth (CDC, 2017).

According to the CDC (2017), when e-cigarette ads began to increase, from 2011-2014, e-

cigarette use in the past 30 days increased from below 2 percent to 13 percent among high school

students. Another big factor associated with vaping that needs to be addressed is the easy access

that high school students have when purchasing e-flavors and e-cigarette devices. According to

the American Academy of Pediatrics (2019), although it is illegal to sell e-cigarette devices to

those under the age of 18, the youth population can still make purchases through the Internet,

where proof of age is not always required. Despite the dangers, significant gaps exist in vaping

regulations. According to Jenssen (2019), there is a lack of resources for families and schools,

which results in little to no existing knowledge on evidence-based approaches or analysis on how

to assist teens to quit vaping. As the rise of e-cigarettes and vaping continues to increase with the

upcoming generation, more education is needed within educational institutions.

Subgroups within the Population with Greatest Needs

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Among high school students, 11th graders use e-cigarettes more when compared to 7th and

9th graders (California Department of Education [CDE], 2017). 30.5 percent of 11th graders in

California reported to have used a vaping device in their lifetime (CDE, 2017). This percentage

is alarming considering how harmful nicotine exposure is to a teen’s still developing brain

(USDHHS, n.d.). Among the population of 11th graders, in regard to gender, male students are

two times more likely to smoke e-cigarettes than females. Perikleous et al. (2018) states that this

may be due to males’ lower harm perception, where they only avoid a risky behavior if a severe

negative risk is associated with it. In addition, students who have felt a low level of

connectedness to their school are more likely to vape than someone who is more involved in

school (CDE, 2017). The next subgroup in the California’s high school population are

Hispanic/Latino and Hawaiian/Pacific Islander students who have the highest and second highest

vaping rates accordingly (CDE, 2017). Besides general demographics of high school students,

individuals who are given a more lenient and affluent allowance are more likely to be able to

afford and engage in vaping (Perikleous et al., 2018). It is crucial that these subgroups are

addressed in terms of their need for education on the health consequences of vaping.

Geographical Location of the Subgroups

The geographical location of the subgroups would primarily be in California. According

to the California Department of Public Health (CDPH, 2019), 84.3 percent of California students

who use a tobacco product are also utilizing an electronic smoking device. The severity of this

vaping epidemic in California reveal the need for education in this specific state.

Current Solutions to the Problem

Currently, there are not many developed programs available to address the issue of

vaping among high school students. There are specific prevention programs that stop high school
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students from the use of e-cigarettes, however, the curriculum varies across school districts.

Specifically, the FDA Youth Tobacco Prevention Plan and the California Tobacco Control

Program (CTCP) are two major prevention programs that are currently being used to resolve the

identified needs. The Youth Tobacco Prevention Plan consists of a series of actions to stop the

use of tobacco products, especially e-cigarettes among youth, with a special focus on three key

areas: to prevent youth from having access to tobacco products, controlling marketing of tobacco

products geared towards youth, and informing teens about the dangers of using tobacco products,

including e-cigarettes, as well as instructing retailers about their role in protecting the youth

population (FDA, 2019a). In addition, since 1989, the California Tobacco Control Program

(CTCP) is a program by the California Department of Public Health that has led the fight to keep

tobacco away from youth, assist tobacco users to quit, and assure that all Californians can live,

work, play, and learn in a tobacco-free environment (CTCP, 2019). Although the CTCP has had

successful data in decreasing smoking among the youth, it is transitioning its focus toward

determining ways to decrease the popularity of e-cigarette usage by teens.

How Well the Needs Have Been Met in the Past

Adolescents have begun participating in the use of e-cigarettes thinking it is less harmful

than smoking actual cigarettes. Just recently, vaping has become an epidemic that seems

uncontrollable due to the easy access of the vaping products. In 2017, the National Institute on

Drug Abuse (2018) reported 27.8 percent of American high school teens using any form of

vaping. Within a year, there had been an increase of roughly 10 percent of American high school

teens who have also reported using any form of vaping (NIDA, 2018). In order to take

preventative measures, in 2016, the California Health and Safety Code section 104420, required

any school that receives public funding, to prohibit any electronic cigarette that contains nicotine
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or produces vape clouds on school grounds (Fox, n.d.). Additionally, the Education Code section

48901 prohibits smoking and tobacco products on campus and school events, where the term,

smoking, includes electronic cigarettes (Fox, n.d.). These policies show that this undesirable

habit of vaping is not tolerated. There are policies currently implemented to public schools in

California regarding e-cigarettes and vaping, however, the number of vape users continue to rise.

Research suggests that school policies banning smoking and tobacco use lowers the rate of

children using smoking products (Public Health Law Center, n.d.). Based on performance of

policies already implemented, school health educators and policy makers can create primary

interventions and programs that fill in the gaps that have not been studied before.

Goals and Objectives

Goal: To decrease the prevalence and incidence rates of e-cigarette usage among High School

students in Woodrow Wilson High School.

Process Objectives:

1. 80% of Woodrow Wilson High School participates will attend at least 3 vaping

information workshops throughout the program year.

2. 40% of Woodrow Wilson High School students will participate in at least one vaping

policy change session by the end of the program year.

3. A minimum of 50% of Woodrow Wilson High School students who vape will participate

in one vaping cessation resource workshop by the end of the program year.

Impact Objectives:

1. By the completion of the program, 80% of Woodrow Willson high school participants

will be able to identify 3 health consequences of vaping.

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2. By the completion of the program, 70% of Woodrow Wilson High School participants

will describe at least one social skill to avoid peer pressure to vape.

3. By the completion of the program, 30% of Woodrow Wilson High School students who

vape, will have an increased intention to quit by 80 percent within a year of program

completion.

Outcome Objective:

Within 5 years, vaping incidences among California High School students will be reduced by

15% within Woodrow Wilson High School.

Key Informant Interview

Our key informants are Richard Nunez, a program coordinator of the Healthy Long

Beach Youth Leadership Program for one and a half years, and Eipryl Torro, a program manager

working for around 13 years. The organization’s priority population is the entire community of

Long Beach. However, regarding vaping, their focus is on the youth within Long Beach. The

Healthy Long Beach Youth Leadership Program is part of the City of Long Beach Department of

Human and Health Services. Long Beach is one of only three city-run health departments in all

of California, providing an opportunity for better engagement for its population (Long Beach,

n.d.).

Both individuals were asked about their viewpoints on vaping. Richard believes that the

existence of vaping is in correlation with smoking and tobacco in the past, where people were

unaware of the risks. In earlier times, health professionals would recommend cigarette brands,

providing which types were healthier and would relieve stress. According to Richard, this was

common knowledge until the United States Surgeon General announced that smoking was linked

to cancer. As more research about the harms of vaping becomes available, he believes that
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people who vape will encounter similar health problems related to smoking. Eipryl believes that

we have the research showing vaping is harmful, but the issue with vaping is the variability of

the product. According to Eipryl, the issue with current vape pens are the different types of

adrenaline rush an individual can get from vape pens, which makes it harder to realize the degree

of harm vaping has in general. For instance, she mentions vape products like JUUL that uses

nicotine salts, a different type of nicotine that is potentially more addictive. Eipryl also states that

when looking at the death rates due to vaping, it is difficult to know the reasoning because there

are constantly new vaping products being introduced to consumers. Overall, the harms of vaping

are even more concerning than traditional cigarettes.

In terms of high-risk populations, both Richard and Eipryl revealed that the percentage of

traditional smoking among Long Beach adults is 15 percent, which is about one percent higher

than that of California. Unfortunately, there is not much statistics regarding vaping among

specific populations in Long Beach. Although, Eipryl was able to tell us that the Cambodian,

African American, and lower socioeconomic status communities have higher rates of smoking.

This organization attempts to reach the overall community of Long Beach through health fairs, a

variety of presentations and workshops with different organizations, and educational operations

with law enforcement. These methods are dependent on the specific population the program

wants to reach. Specifically, for the youth and their Healthy Long Beach Youth Leadership

Program, the organization does recruitment at schools by talking to counselors and teachers.

According to Eipryl, the primary goal of this program is to encourage youth engagement within

Long Beach and recently, have them become partners and advocates in tobacco control. To do

so, they provide activities and resources for the youth to help with tobacco control, such as

digital media and policy literacy workshops.

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Next, we asked Richard and Eipryl about how they evaluated the effectiveness of the

program. The target priority population’s feelings about the program are self-reported and are

primarily positive feelings since the youth are the ones that decide on the topics that they discuss.

The program uses a pre/posttest for the 7-week youth program. According to Richard, the pretest

is to assess knowledge, while the posttest is to evaluate the effectiveness of the program and

determine where the participants are with their understanding of tobacco and vaping products.

Additionally, Eipryl mentions that the program also evaluates how comfortable participants are

when talking to their peers about the subject of tobacco and vaping at the end of each session.

The organization also analyzes what the youth liked and disliked about the program.

Furthermore, focus groups were held at the end of the program to see if they needed any changes

for the following year.

One of the potential barriers of the program is recruitment as it is mainly comprised of

youth who voluntarily enroll in the program. Eipryl mentioned to us that some participants may

not want to attend as they had been signed up by a family member. However, for the most part,

the youth that did attend wanted to be there and are willing to participate as a result of the

program’s high retention rate. When we asked about funding, Richard stated that the

organization is funded through Prop 56 and 99, however, they do not have any funding to work

directly within the schools of Long Beach Unified.

We ended the interview by asking Richard and Eipryl about what improvements they felt

needed to be done for their target population and they both claim that the organization should be

more involved in schools and have a more comprehensive vaping campaign to further advance

their interventions. Eipryl added that she would like to see more services and programs for

people who want to quit vaping because the concept is fairly new. Although there are some new
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cessation services that have become available in the city of Long Beach, Eipryl expressed that

there are not enough services for the organization to refer people because the Long Beach

Department of Health and Human Services do not offer direct services.

Implementation Plan

Make Vaping History (MVH) is a school-based vaping prevention program that consists of

four intervention activities to address the risks of e-cigarette usage. The MVH program will hire

two certified health educators to facilitate the informational workshops, role play sessions, and

cessation resource session that will be held at Woodrow Wilson High School’s cafeteria. The

health educators will be trained to present the topics of each intervention accordingly. The

interventions will include conveying the severity associated with vaping, improving self-efficacy

to avoid peer pressure to vape, providing cessation resources, and presenting an existing policy

change about vaping. The goal of MVH is to decrease the prevalence and incidence rates of e-

cigarette usage among High School students at Woodrow Wilson High School in the Long Beach

Unified School District. The program will apply the Planned Approach to Community Health

(PATCH) model as its program planning model because PATCH stresses the importance of

community-based intervention activities toward priority health problems (Kreuter, 1992). With

the PATCH model being community-based and vaping being prevalent among the High School

community, the MVH program can apply the phases in the model to continually develop

interventions to support the current and future needs of the priority population. This model will

demonstrate the detrimental consequences vaping can attribute to the participants’ health. When

the MVH program has concluded, the participants will have the ability to determine whether or

not they will cease vaping based on the workshops, sessions, and resources that are provided. In

order to successfully implement the interventions, the program will use the Health Belief Model
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(HBM) as the behavior model. The HBM is best applied to the MVH program because the seven

constructs of the model contribute to the increased likelihood of achieving optimal behavior

change, which fully supports the program goal of decreasing the use of vaping. The seven

constructs of the HBM that will be utilized in the intervention include perceived severity,

perceived susceptibility, perceived threat, perceived benefits, perceived barriers, self-efficacy,

and cues to action.

Informational Workshops

The first intervention strategy that MVH will utilize is informational workshops. Three

educational workshops will be presented on Woodrow Wilson High School’s campus during the

first Monday, Wednesday, and Friday from 4pm to 5pm between the months of September to

November. For each month, there will be a different topic introduced and discussed to the

students about the misconceptions and dangers of vaping. For each workshop, guest speakers

will present to the participants on the topics they are assigned. In order to recruit guest speakers,

they will be offered the incentive of exposing their business or their studies to the students. In

addition, they will be provided a $20 gift card to show appreciation.

The format of each workshop will begin with a 25-minute presentation by one guest

speaker followed by a 35-minute group discussion where students will be divided into two

groups, 9th and 10th graders and 11th and 12th graders, respectively. Additionally, each group

discussion will be facilitated by two health educators to answer any questions the participants

may have after each topic has been presented.

The first workshop will take place in the month of September where the concept of

perceived severity will be demonstrated. A guest speaker will discuss harmful effects of vaping

on the body. The second workshop in October will focus on the participant’s daily life behaviors
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that can reduce their perceived susceptibility. The guest speaker will discuss ways to surround

oneself with positive influences to reduce the likelihood of vaping. The third workshop will be in

November, which will cover long term outcomes of vaping. A different guest speaker will

discuss different ways to cope with vaping addiction and relapse.

Role Play Sessions

The second intervention of the MVH program will utilize role-playing activities found

successful in the Minnesota Smoking Prevention Program (Arkin et al., 1992). That program

designed their role-playing session to give their participants practice of saying “no” to smoking

cigarettes in front of their peers. They did this successfully by presenting their participants with a

video consisting of a variety of peer pressure scenes, followed by asking students to role play

saying "no” to smoking a cigarette. In order to help the students, they provided the students

dialogues to say in different situations such as using humor.

This session in MVH will be an hour and a half long and offered twice in a week of

March to accommodate students and give them options to promote attendance. Each session will

begin with a pre-test to assess the student’s confidence in being able to avoid a situation of peer

pressure. Then, a health educator will give an overview of what peer pressure is, how it affects

students and vaping, and some basic scripts for those scenarios in a PowerPoint presentation. The

students will then be equally separated into groups and assigned a scenario that illustrates

someone peer pressuring them, and someone being pressured to vape. The students will create a

short skit and enact the consequences of either falling for or resisting peer pressure and

incorporate the basic scripts that were introduced at the beginning of the session. By role-playing

different scenarios, the students will be able to obtain and develop social skills. As a result, this

will increase the students’ self-efficacy in being able to avoid peer pressures to vape.
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Cessation Resources

The third intervention of the MVH program will be implemented using activities

demonstrated in a tobacco cessation program by Renuka and Pushpanjali (2014). The

intervention was planned in two stages, a health education module development stage and a

leaflet and health education video development stage. As a result, the MVH program will

implement an after-school cessation program twice a month for High School vaping students at

Woodrow Wilson High School during the academic months of February and March. In order to

be available to all students, they can choose to either attend a Monday (3pm) or Friday (3pm)

session. The MVH program’s cessation intervention is planned into two stages which includes a

45-minute health education stage and a 45-minute follow-up stage. The 45-minute stage will aim

to explore the current state of vaping users and bring attention to the perceived barriers of vaping

and perceived benefits of vaping cessation. In relation to the pre-test conducted by Renuka and

Pushpanjali (2014), the health educators of the cessation intervention will also begin the first

stage by administering a questionnaire pre-test to participants. This pre-test assesses the amount

the participants vape in a day and possible barriers a student has when deciding to quit vaping.

This assessment will also serve as the attendance for this intervention. After the pre-test has been

distributed and completed, the health educators will present the participants with a 16-minute

health education video that explains the benefits of quitting vaping habits and how to overcome

and manage the barriers to quitting vaping. While watching the video, the participants will be

asked to complete a worksheet that consists of questions in relation to the video. By doing so,

this will increase the chance of the participants retaining the information provided and apply it to

their life. For the remainder of the first stage, the health educators will divide the participants

into groups to discuss what the participants obtained from the video. During this time, the health
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educators will also be available to address any concerns the participants have about vaping and

the video that was presented. The subjects were then asked to revisit after two months for follow-

up.

In the second stage, the subjects were provided with a post-test to reassess how many

times they currently vape and their willingness to quit vaping. At this point, subjects who were

willing to quit vaping habits were referred to nearby vaping cessation locations in Long Beach

by the health educators. As an incentive, the participants will be given a free lunch pass at the

end of the intervention.

Vaping Policy Change

There should be more policies implemented in California to decrease the chances of

vaping among the youth. The policies that should be addressed are an increase in cigarette excise

taxes, increased funding for CDC-recommended tobacco control programs, and the enforcement

of age restrictions on purchasing cigarettes. It is highly probable that increasing excise taxes and

funding for comprehensive tobacco control programs can lower the smoking rate among youth.

The MVH program will establish an intervention that includes a call for policy change in terms

of vaping among the youth population. The intervention would occur during the months of July

and June. During these months, sessions will be held once a week over the course of three weeks.

The first two sessions will have an estimated time of an hour and thirty minutes while the third

session will involve a three-hour field trip. Students will be required to sign on an attendance

sheet before the start of every session. In the first session, health educators will educate the

participants about policy change and the three policies that should be put into action for vaping.

The second session will entail students learning about advocacy and how to become proper

advocates towards anti-vaping policies. The policies of this intervention would include an
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increased tax on vaping products, increased funding for comprehensive vaping programs, and

higher age restrictions to 21 on purchasing vaping products. During the session, health educators

will help facilitate and assist the students in developing skills to advocate for policy change on

vaping. The second session would also involve poster making and creating various forms of

media for advocacy. The third and final session would involve students going to Long Beach city

hall and presenting their posters and interacting with government representatives. This field trip

would last around three hours so the students can properly discuss policy change with the

representatives. Health educators specialized in health policies will be able to guide the students

during the field trip and during their discussions with representatives. This intervention addresses

the Health Belief Model construct of cues to action as it allows students to call for change in

their community and government in order to decrease vaping behavior among youth.

Scope of Work

Problem Statement
Since vaping is a relatively new behavior and has become a major health concern for

many adults and High School students alike, there is a higher need for comprehensive education

about its risks and dangers. Our priority population for the Make Vaping History (MVH)

program is High School students at Woodrow Wilson High School. With a 900 percent increase

in e-cigarette use among High School students between 2011 to 2015, the usage rate is expected

to grow as these students continue to experience vaping for social reasons, as an alternative to

quit smoking, and as a stress reliever (Evans-Polce et al., 2018).

Goal of the Agreement

The goal of the program is to decrease the prevalence and incidence rates of e-cigarette

usage among Woodrow Wilson High School students in the Long Beach Unified School District.

The program’s goal will be achieved through implementing vaping educational workshops, role-
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play sessions, vaping cessation resources, and vaping policy/advocacy sessions toward Woodrow

Wilson High School students.

Objectives of the Agreement/Deliverables

Title of Program: Make Vaping History
Program Start Date: July 1, 2020 Program End Date: June 30, 2021
Title of Activity: Educational Workshop
Priority Population: Woodrow Wilson High School Students
Length of Session: 1 hour

Goal: To decrease the prevalence and incidence rates of e-cigarette usage among Woodrow Wilson
High School students in the Long Beach Unified School District.

Objective #1: By the completion of the program, 80% of Woodrow Wilson high school
participants will be able to identify 3 health consequences of vaping.

Resources Needed Tasks Teaching Method

Task #1: Health educators, guest Workshop #1: Guest speaker will go Task #1a:
speaker, classroom, PowerPoint, into detail about vaping, vaping PowerPoint
presentation, computer, projector products and its health presentation
consequences.
Task #1b: Students
will split into two
groups based on
grade level and
discuss the topic.

Task #2: Health educators, guest
speaker, classroom, PowerPoint,
presentation, computer, projector
Workshop #2: Guest speaker will Task #2a: PowerPoint
focus on the participant’s daily life presentation
behaviors that can reduce their Task #2b: Students
perceived susceptibility about will split into two
vaping. groups based on grade
level and discuss the
topic.

Task #3: Health educators, guest
speaker, classroom, PowerPoint,
presentation, computer, projector
Workshop #3: Guest speaker will Task #3a: PowerPoint
cover long term outcomes of vaping, presentation
different ways to cope with vaping, Task #3b: Students
and addiction and relapse of vaping. will split into two
groups based on grade
level and discuss the
topic.
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Deliverable: Six separate one-hour curriculum will be presented to approximately 1,500 Woodrow
Wilson High School students addressing the knowledge of vaping and its consequences, personal
life factors that influences behavioral change, and different approaches to terminate vaping
behavior.

Evaluation: Students will be given a brief multiple-choice pretest when they enter the workshop.
After each one-hour workshop, students will be given the same multiple-choice assessment from
the beginning of the workshop as a posttest to assess any changes in their level of knowledge about
perceived susceptibility and perceived severity of vaping.

Title of Program: Make Vaping History

Program Start Date: July 1, 2020 Program End Date: June 30, 2021
Title of Activity: Role Play
Priority Population: Woodrow Wilson High School Students
Length of Session: 1 hour 30 minutes

Goal: To decrease the prevalence and incidence rates of e-cigarette usage among Woodrow Wilson
High School students in the Long Beach Unified School District.

Objective #1: By the completion of the program, 70% of Woodrow Wilson High School
participants will describe at least one social skill to avoid peer pressure to vape.

Resources Needed Tasks Teaching Method

Task #1: Health educator,
PowerPoint, classroom,
projector, computer
Task #1a: The health Task #1a: PowerPoint presentation
educator will provide a 15-
minute PowerPoint
presentation on peer
pressure and vaping, the
social skills needed to avoid
peer pressure, and basic
scripts for different vaping
scenarios.

Task #1b: The health Task #1b: Role playing

educators will separate the
students into equal groups
and assign each group with
a scenario. The students
will have 25 minutes to
create a short skit enacting
the scenario and to
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incorporate social skills

needed to avoid peer
pressure.

Task #1c: Students will Task #1c: Peer learning

then take turns performing
their skit to the class.

Deliverable: The PowerPoint presentation can be printed to distribute among participants and share
with stakeholders. In addition, a list of all the scenarios acted out will be given to the students so
they can take notes during their peers’ performances to help remember the different strategies. The
pre/post-test will be also used as an attendance tracker.

Evaluation: The health educators will conduct a brief multiple-choice pretest for the students at the
beginning of the session. This pretest will include questions to assess the student’s self-efficacy in
avoiding peer pressure to vape in social situations and their knowledge on social skills needed in
those situations. After the hour and a half session, students will be given the same exact multiple-
choice exam from the beginning of the session as a post-test to assess any changes in their self-
efficacy and knowledge toward vaping.
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Title of Program: Make Vaping History

Program Start Date: July 1, 2020 Program End Date: June 30, 2021
Title of Activity: Vaping Cessation Resources
Priority Population: Woodrow Wilson High School Students
Length of Session: 1 hour 30 minutes

Goal: To decrease the prevalence and incidence rates of e-cigarette usage among Woodrow Wilson
High School students in Long Beach Unified School District.

Objective #1: A minimum of 50% of Woodrow Wilson High School students who vape will participate
in one vaping cessation resource workshop by the end of the program year.

Resources Needed Tasks Teaching Method

Task #1: Handouts, laptop,
projector, health education
video, pencils
Task #1a: Health educator will Task #1a: Video presentation and
use a laptop to show a 16- worksheet
minute video through the
projector that educates the High
School students on the perceived
barriers and perceived benefits
to quit vaping. While viewing
the video, the participants will
be asked to complete a handout.

Task #1b: Health educators will Task #1b: Group discussion

separate the participants into
equal discussion groups. During
this time, students can ask the
health educators any questions
or concerns they have about
vaping or the health education
video.

Deliverable: Four separate one-hour curriculum will be catered to approximately 1,500 Woodrow
Wilson High School students to address the perceived barriers and perceived benefits to quit vaping.
During these curriculum sessions, information about possible vaping cessation resources within the
Long Beach community will also be discussed.

Evaluation: At the beginning of the intervention, health educators will give the participants a ten
questions pretest that includes how many times they vape in a day and any barriers that limit them to
quit vaping. After two months of the intervention, the participants are asked to revisit for a follow-up
where they will be given the same assessment as a posttest. During the posttest, any subjects who have
expressed interest to quit their vaping habits were referred to nearby vaping cessation programs in
MAKE VAPING HISTORY 21

Long Beach by the health educators. The pre/posttest will also be used as an attendance tracker to
assess the number of participants who attend the intervention.
MAKE VAPING HISTORY 22

Title of Program: Make Vaping History

Program Start Date: July 1, 2020 Program End Date: June 30, 2021
Title of Activity: Health Policy/Advocacy
Priority Population: Woodrow Wilson High School Students
Length of Session: 1 hour 30 minutes; 3 hours (last session)

Goal: To decrease the prevalence and incidence rates of e-cigarette usage among Woodrow Wilson
High School students in Long Beach Unified School District.

Objective #1: 40% of Woodrow Wilson High School students will participate in at least one vaping
policy change session by the end of the program year.

Resources Needed Tasks Teaching Method

Task #1: Health educator, Task #1: Health educator will educate Task #1: PowerPoint
laptop, PowerPoint, students on how to become advocates and presentation
projector the current policies concerning vaping and
vaping products.

Task #2: Health educator,
video camera, laptop,
editing software, YouTube
Task #2: Health educator will teach Task #2: Lecture using
students how to create advocacy videos in YouTube, students
order to encourage policy change. Students create own advocacy
will then split into equal groups and create video
a three-minute advocacy video pertaining
to anti-vaping policies.

Task #3: Health educator,
posters, markers,
transportation (carpool,
bus, etc.), Long Beach
government representatives
Task #3: Students will be able to create Task #3: Application of
posters regarding vaping policy that will be skills and networking
displayed at Long Beach City Hall. The with government
students will take a “field trip” to rally at representatives
Long Beach City Hall and discuss policy
changes with county representatives.

Deliverable: There will be a curriculum that outlines the three sessions that occur once a week over
the course of three weeks. The curriculum will also include the PowerPoint slides that will be
taught from the first session as well as a list of Long Beach government representatives from the
field trip. There will also be contracts/permission slips that grants students the capability to go to
the field trip. Students will be required to sign on an attendance sheet before the start of each
session.

Evaluation: After completion of this intervention, students will be given an evaluation survey that
will detect the students’ attitudes towards anti-vaping policy as well as their knowledge behind
them. The survey will also ask students if they will continue to be advocates for anti-vaping
behavior and if this portion of the program influenced their decision to quit vaping.
MAKE VAPING HISTORY 23

Administration
The administration will comprise of staff who are educated and experienced in the fields

of health science, public health, and vaping. For this program to be deemed successful,

sponsorships will be made with the City of Long Beach Department of Health and Human

Services (LBDHHS). The MVH will recruit guest speaker volunteers from LBDHHS to assist at

each informational workshop. Additionally, the program will request for three student

participants to serve as volunteers to set-up and clean-up during all interventions of the program.

The MVH program will also hire three health educators who will serve as facilitators for each of

the interventions. One specific requirement to become health educators of the program includes

having professional background in vaping. To ensure that the goals and objectives of the

program are sufficiently met, the staff and volunteers’ performance will be evaluated at the end

of each session and their time will be compensated through the form of incentives at the end of

the program year.

Timeline
Program Activities for 2020-2021
Months
Activity Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun
Hire and
train health
educators
Pilot test
program
Revise
program
based on
pilot
Promote the
program
Prepare for
program
“kickoff”
MAKE VAPING HISTORY 24

Phase in
Program
Full
implementa
tion
Evaluation

Write final
report

Budget Justification

Senior Personnel (Program Director/Health Educators)

A program director will be responsible for supervising MVH and the delivery and

success of the overall program, while simultaneously oversee other programs. The director will

be involved with MVH from the start to its completion, including determining deadlines,

processes and budgets, monitoring the performance of the program during implementation, and

determining any needs for improvements. The director will also train, hire, schedule, and

supervise all potential staff and volunteers. They will also establish connections with the schools,

school districts, politicians, and media to promote the program. An estimated $90,000 will be

used for their salary.

Two health educators will be trained under the MVH’s curriculum to effectively conduct

the sessions. They will be responsible for evaluating and implementing the components of each

intervention and creating the report of its findings. As implementers, they will keep track of

attendance, conduct pre- and post-tests, and present the curriculum to the participants. Thus,

$100,000 will be spent to cover the salaries of both health educators.

Other Personnel (Program Manager)

Other personnel include a program manager, whose job is to only oversee one program,

the MVH program. The manager will also supervise all personnel within MVH, help the director
MAKE VAPING HISTORY 25

with training, and to relay any updates about the program to the director. Moreover, they will be

the liaison for guest speakers, educators, and participants. $44,500 will be set aside for the

program manager’s salary.

Direct Costs
Equipment
The MVH program will spend a total of $2,250 for equipment funds. MVH will purchase

a High Definition Multimedia Interface (HDMI) cable ($10), projector ($300), and a portable

projector screen ($130) as a precaution if Woodrow Wilson High School (WWHS) does not

allow the program to utilize their equipment. These items will be used by guest speakers and

health educators during each intervention to display their presentations. MVH will also use the

funds to purchase four laptops ($190 each) and four camcorders ($200 each) to be used during

the policy/advocacy sessions. The program will limit any spending toward laptops for

PowerPoint presentations by utilizing a laptop that is already owned by the program’s personnel

during each intervention.

Materials/Supplies

The program plans to spend $1,000 for materials and supplies for the interventions.

Specifically, $500 will be allocated to the cessation resource intervention to print worksheets for

participants and $500 will be used to purchase crafting supplies such as markers, construction

paper, stickers, pens, paint, posters, and colored pencils to make vaping policy posters.

Incentives

As for incentives, the MVH program will set aside $400 to purchase Visa gift-cards. At

the end of the program year, the three guest speakers from the informational workshops will each

receive a $50 Visa gift-card as the program’s way of showing appreciation for their time and

dedication to the participants and the program. Furthermore, the program will allocate $250 to
MAKE VAPING HISTORY 26

print free lunch passes as an incentive for student volunteers who will help with setting up and

cleaning up during all interventions.

Advertising

An estimated $8,393 will be used on advertising the program with items and apparel to

hand out to the students and personnel. There will be a team of volunteers who will distribute

pop sockets, keychains, and pens to students around campus. About $1,000 will be used to print

flyers and posters to advertise about the program around campus. A press release will also be

conducted to reach students who may not be informed on campus. The remaining $5,607 will be

used on the development and printing of brochures and flyers that students can take home.

Transportation

$1,600 will be set aside to cover travel fees for health educators, program directors,

program managers, and program planners. Individual rates will be based on how many miles it

takes for them to get to WWHS. $400 will be set aside to rent a school bus to transport students

to and from Long Beach City Hall for the health policy intervention.

Indirect Costs

Space Fee

The space needed on campus for the program is one classroom. $8,000 will be used for 6

months of rent and $2,000 will be used for custodial fees if the school does not provide it free of

charge. $15,000 will be used for the office where the program planning will take place and it will

cover the rent and maintenance fee.

Other Expenditures (Miscellaneous)

The estimated amount for other expenditures will be around $36,000. The money will go

towards liability for the program as well as maintenance. $10,000 will be towards insurance and
MAKE VAPING HISTORY 27

liability costs for those involved in the program. Another $15,000 will be saved for necessary

utility fees such as water and electricity. $7,000 will be used for additional maintenance fees

such as custodial work. $4,000 will be saved for emergency funds for the program such as the

assistance of another health educator, more materials and equipment, transportation emergencies,

etc.

In-Kind Funding/Support

In-kind support will be offered in the form of student volunteers from WWHS who will

assist in the set-up and clean-up during each intervention. These students will also be participants

in the program intervention. Sponsorships with City of Long Beach Department of Health and

Human Services will ensure that the program will obtain guest speakers from the department in

order to educate in each of the informational workshops.

Total Cost
Expenditures Estimated Amount Spent
Salary for senior and other personnel $234,500
Health Educators (2) $50,000 x 2 (100,000)
Program Director $90,000
Program Manager $44,500
Materials/Supplies $1,000
Equipment $2,250
Volunteer Incentives $1,750
Space Fee $7,500
Advertising $15,000
Transportation $2,000
Miscellaneous $36,000
TOTAL COST: $300,000
MAKE VAPING HISTORY 28

Marketing Strategies
MAKE VAPING HISTORY 29
MAKE VAPING HISTORY 30
MAKE VAPING HISTORY 31

Evaluation Plan

Engaging Stakeholders

The stakeholders of the Make Vaping History (MVH) program include Long Beach

Unified School District (LBUSD), Woodrow Wilson High School’s (WWHS) administration and

Parent Teacher Student Association, Long Beach Department of Health and Human Services,

and WWHS’ students. Information such as reasons behind evaluation, designs, and concepts

implemented, and how it will be used will be disclosed to the stakeholders. Any other concerns

or questions about the program will be communicated to establish trust and equal involvement.

All detailed records will be reported to ensure efficiency and confidence of the program to the

stakeholders.

Describing the Program

The goal of MVH is to decrease the prevalence and incidence rates of e-cigarette usage

among students at Woodrow Wilson High School. MVH plans to achieve its goal through a

variety of educational workshops and activities to create awareness towards vaping and its

harmful effects. At the end of the program year, WWHS students will have increased knowledge

about vaping consequences, be able to avoid peer pressure, and have an increased intention to

quit vaping.

Focusing the Evaluation Design

Before implementation, MVH will conduct a formative evaluation to seek feedback from

experts and members of the WWHS community to assess the feasibility and efficiency of the

program. Expert feedback will be received through phone or in-person interviews with key

informants and stakeholders. Focus groups consisting of WWHS teachers, students, and staff

will assess if the program’s components are capable of high inclusion, recruitment, reach,
MAKE VAPING HISTORY 32

response, and satisfaction among participants. Gift cards will be given to individuals for their

contributions to the program.

For process evaluation, MVH will aim to monitor and document the progress. To

measure the extent to which MVH is reaching the target population, sign in sheets will be used to

keep track of recruitment and retention. Debriefing meetings will be held with the health

educators to ensure the delivery of the program is consistent with the curriculum. These will be

done after the first offering of an intervention in its scheduled week. Lastly, MVH will use a

non-experimental design for an impact evaluation, with the WWHS participants being the

control group. The long-term effectiveness of the program will be looked at through the pre and

post tests given during each intervention. Due to the program being only for one school year and

on a budget restriction, this design seemed fit for its convenience with MVH’s limited resources.

In order to assess the need for changes, MVH will have different measurement indicators.

The indicators for each intervention include multiple-choice tests, attendance sheets, and surveys

respectively. The program will also apply quantitative data as evidence. These forms of evidence

can assess whether the program’s process, impact, and outcome objectives have been met.

Gathering Credible Evidence

In order to measure MVH’s process objectives, attendance sheets will be used for each

intervention. The participants will be required to sign-in at the beginning of each intervention

and an Excel sheet will be used to keep track of each participant’s attendance. When a

participant misses two sessions, a follow-up email and letter to their homeroom will be sent.

After two follow-ups and continued absence, that participant will be excluded from the study.

To evaluate the impact objectives, MVH will utilize different pre-posttests in all four

interventions. The first pre-posttest will have multiple-choice questions based on the topic of the

educational session to test the participant’s knowledge. The second test will use multiple choice
MAKE VAPING HISTORY 33

questions and the Likert scale to analyze the participant’s self-efficacy on avoiding the peer

pressures to vape. The third test will use a Likert scale to measure the participant’s intent to quit

vaping and usage. The fourth intervention will include a survey with multiple-choice questions

and the Likert scale to detect the students’ attitudes and knowledge toward anti-vaping policy.

These pre-posttests are essential in depicting the success of the program to the stakeholders.

Five years after the program’s conclusion, MVH will conduct a school-wide survey on

the usage of vaping among WWHS students. This will measure the program’s outcome objective

and assess if MVH influenced the target population. It will also portray the success or failure of

the program to the stakeholders.

Justifying Conclusions

In order to justify the program’s conclusions, we will compare the posttest data to the

2018 National Youth Tobacco Survey (NYTS). In 2018, the NYTS reported 20.8 percent of

High School students vaping in the United States (FDA, 2019b). To consider MVH a success,

posttest data about vaping incidences by WWHS’ students must fall below 20.8 percent. If the

vaping usage percentage is greater than NYTS’ data, we will provide extra vaping educational

resources to WWHS to assist them in lowering the vaping rates among their students after

program completion. By comparing our data to the NYTS, we can determine whether our goals

and objectives reached our population and if our program was well executed.

Ensuring Use and Sharing Lessons Learned

MVH will work directly with WWHS’ staff to see which interventions worked best for

the students to implement the skills and knowledge into the school’s curriculum. Successful

interventions are encouraged to be taught to future WWHS students. After the completion of the

program, the findings will be distributed to the local newspaper of Long Beach, Press-Telegram.
MAKE VAPING HISTORY 34

Findings will also be featured in other publications in Los Angeles County to inform the

community about MVH’s accomplishments and inquire about sponsorships and support. The

literacy level and language usage will be simple for parents, students, and educators of the

community to easily understand the program’s components. By making this program available to

the community, it can lower vaping usage among youth and benefit future generations.

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 MAKE VAPING HISTORY 35

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