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Development of a school program for vaping and smoking prevention and protocol for a cluster randomized controlled trial in fifth grade students

Marina Hinssen, Julia Kohn, Josef Mohammad, Valentin Vecera, Gertraud Stadler

Scientific Reports, 2026

92 participants

Abstract

This article presents the intervention development study and protocol for a longitudinal cluster-randomized controlled trial of a school-based vaping and smoking prevention program based in Germany. E-cigarette use is rapidly increasing among adolescents who have never smoked, yet well-evaluated prevention interventions are lacking. Although school-based prevention programs are moderately effective, they are often difficult to implement in schools facing high structural burden. Using Intervention Mapping, we developed a vaping and smoking prevention program intended for a broad range of schools, including lower-SES settings. Development drew on qualitative interviews with students (N = 62) and experts (N = 54), followed by feasibility testing in 13 classrooms with pre- and post-intervention surveys (N = 92). The resulting intervention comprises three classroom sessions delivered by trained facilitators. Interview and feasibility data supported: (i) lowering the prevention target age to Grade 5; (ii) emphasizing e-cigarettes, resistance skills, social norms, and stress management; (iii) adapting materials to improve fit with schools serving lower-SES student populations; and (iv) the intervention’s high acceptability and feasibility, suggesting readiness for full-scale evaluation. The intervention will next be tested in a cluster-randomized controlled trial with at least 1500 students across 26 Berlin schools, randomized (1:1) to intervention or active control group.…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 92 participants or records.

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