Projects: Collaborate.Health

Electronic Vapor Delivery Devices and Tobacco Use Among Youth

Recruiting peers in delivering education to reduce youth initiation of electronic nicotine delivery devices.

Agency Partner
Living TOBACCO-FREE, Massachusetts General Hospital Community Health Associates, Massachusetts General Hospital Center for Community Health Improvement
Communication Strategies for Public Health
View our schedule for upcoming opportunities


Recruiting peers in delivering formal education through both traditional school-based strategies and informal education through social diffusion to reduce youth initiation of electronic nicotine delivery devices. Included development of a curriculum, peer nomination process, and social media campaign.


Electronic Vapor Delivery Devices (EVDDs) have boomed in sales and visibility over the last few years.  The percentage of high school students who used an “e-cigarette” in the previous 30 days increased over a 3-year period, from 1.5 % in 2011 to 13.4% in 2014.  EVDDs, which may or may not contain nicotine, also contain propylene glycol, glycerin and flavorants.  Nicotine is a highly addictive substance and is the same nicotine found in combustible tobacco products. The propylene glycol, glycerin and flavorants in EVDDs can be used as food-grade additives.  As of January 2014, there were 460 brands of EVDDS and more than 7,000 unique flavors.Youth use of EVDDs raises two health concerns: 1) that youth use of EVDDs increases the likelihood youth will initiate combustible tobacco use (e.g. cigarettes, cigarillos); and 2) that inhalation of aerosolized particles, created by heating the propylene glycol, glycerin and flavorants, cause health harms.  Presently, EVDDs are currently completely unregulated by the federal government.


Reduce youth initiation of electronic nicotine delivery devices in middle school youth in communities served by the partner organization.


Two groups worked on this problem with both producing an evidence-informed solution.  One group adapted and expanded the ASSIST peer recruitment model (Audrey et al., 2006; Campbell et al., 2008; Starkey et al., 2009),  to contain the following components: 1) a series of mini-education sessions about e-cigarettes that will be delivered by a health education instructor to a health education class; 2) a nomination process for peer leaders to be selected by their peers and recruited to help develop social media messaging, manage social media groups, and educate peers informally ; and, 3) a Facebook campaign for students to interact with one other, post personal opinions concerning the issue of e-cigarettes, and display messages developed by peer leaders. The other group proposed an intervention informed by the Botvin LifeSkills® Training (Botvin LifeSkills® Training, n.d.) to be implemented at a local Boys and Girls Club. The new components of the already-implemented LifeSkills® curriculum include a facilitator workshop; the addition of an e-cigarette focused curriculum, including three new lessons and a supplemental activity to an existing lesson; the inclusion of members from the local youth group to both disseminate messages created by the sixth and seventh graders at the Boys and Girls Club and support them in their efforts to spread awareness about and against e-cigarette use; and, a mobile application component to further increase the reach of the intervention to youth in the target area and their families.


Students developed all intervention and communication components and presented them to the partner organization and stakeholders from the four communities tasked with implementation. After the semester the communities implemented pieces of the two planned interventions and the partner organization utilized aspects of the social media campaign to advance the message around the challenge. The partner organization and the course teaching team published a case study on the collaboration found here.

Project Timeline

This project took six months to complete from kick-off meeting to presentation of final deliverables. Click the button below for a detailed timeline.

View Project Timeline