ArticleTobacco prevention & cessation2026
School administrator perspectives on electronic nicotine delivery systems use in Montana schools: A mixed-methods study.
Article in Tobacco prevention & cessation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Schools have become central to addressing the prevention, detection, and cessation of youth's use of Electronic Nicotine Delivery Systems (ENDS). This study surveys and interviews school administrators in Montana to identify effective prevention, discipline, and cessation strategies in schools. Methods: A mixed-methods study was conducted from March through September 2025, including an online survey with 42 responses from school administrators and 11 follow-up interviews. All Montana school districts (n=400) were invited to participate in the survey, and interview participants were recruited from survey respondents. Survey questions ranged from perceptions of ENDS use to the perception and effectiveness of prevention, discipline, and cessation strategies. Interviews expanded on key survey findings and captured insights into school-level experiences related to ENDS use, prevention, discipline, and cessation strategies. Results: Of the 400 school districts sent the survey, a response rate of 10.5% (n=42) was achieved. Just over half (61%, n=25) observed student ENDS use on school grounds during the 2024-2025 school year. Certain measures, like implementing student education sessions (90%, n=36) and hallway/bathroom patrols to prevent use and notifying parents for a first offense (95%, n=38) were seen as moderately or very effective. Cessation efforts were more varied, and respondents expressed a desire for more options. The least expensive measures, such as educational sessions, installing tobacco-free signs, and putting up educational posters, were the most commonly implemented measures. In the end, interviews emphasized the need for working collaboratively with peers, parents, and school resource officers to increase prevention, cessation, and disciplinary effectiveness. Conclusions: Prevention, cessation, and disciplinary strategies to reduce ENDS use at schools vary greatly across Montana. However, respondents consistently expressed a desire for more disciplinary options and cessation resources, and noted that involving peers, parents, and school resource officers in prevention, cessation, and disciplinary strategies increased perceived effectiveness.
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