The prevalence of e-cigarette use among youth has been a public health concern since 2015, with rates remaining high despite a decline from the peak in 2019. In 2023, 10% of high school and 4.6% of middle school students reported current e-cigarette use. This study details the implementation of the CATCH My Breath (CMB) program, a school-based e-cigarette prevention initiative, in eight central Appalachian counties known for high tobacco use rates.

Methods

From 2019 to 2023, CMB reached 6,217 students across 25 middle and high schools in West Virginia and Kentucky, with approximately one-third of these students receiving the curriculum multiple times. Program impact was assessed through registries of participating counties, schools, and teachers. Pre- and post-tests measured changes in e-cigarette-related cognitions and behaviors, including e-cigarette knowledge, current use, and susceptibility.

Results

During the study, the four-session CMB course was delivered 9,399 times. 7,088 post-tests were obtained, with approximately 84% of responses indicating decreased likelihood of e-cigarette use. Significant improvements in e-cigarette knowledge were observed, with declines in current use (5.1% to 4.4%; p=0.005) and peer influence (4.9% to 4.0%; p=0.025).

Conclusions

CMB demonstrated feasibility, effectiveness, and positive reception in central Appalachian schools. This curriculum, alongside complementary policy initiatives, holds promise for mitigating the youth e-cigarette epidemic. The success of this project prompted collaborative efforts by the West Virginia Bureau for Public Health and the West Virginia Department of Education to implement CMB in middle schools across the state from 2023 to 2026. This supports program reach and sustainability.