Click City: Tobacco Prevention Program Updates to Address E-Cigarette Concerns for Fifth and Sixth Graders

When University of Arizona College of Nursing professor Judith S. Gordon helped develop Click City: Tobacco, a landmark school-based tobacco prevention program from 2005-2012, she had no way of knowing the threat of e-cigarettes was just over the horizon. Thanks to a $225,000 National Institutes of Health Small Business Innovation Research (SBIR) grant, Gordon and Primary Investigator Dr. Judy A. Andrews of the Oregon Research Institute will update the online program to address the hazards of Electronic Nicotine Delivery Devices (ENDS), better known as e-cigarettes. In keeping with the College’s focus on harnessing technological innovation, the enhancement will also increase the program’s potential reach by expanding the types of devices on which it can be delivered.

Originally developed and tested in Oregon, the first iteration of Click City: Tobacco was based on a methodical, analytical approach to creating and testing the nicotine use prevention program. While other programs create a curriculum comprised of various components that have not necessarily been fully tested before dissemination, Gordon’s team painstakingly tested each element of the program. “We used an approach based on optimized designs where we developed each component and then tested it individually to make sure it was effective before it was included in the final program,” said Gordon.

The new and improved version of Click City: Tobacco will involve the same methodology to expand the program to include content about the risks posed by e-cigarette use. “The e-cigarette phenomenon has really exploded since we originally developed this program. Now kids are much more likely to use e-cigarettes than they are to use traditional cigarettes,” explained Gordon. “We also need to reprogram Click City: Tobacco so that it works on multiple devices that didn’t exist when we first designed it.”

The updates are designed to inform students of the risk factors around e-cigarettes, which ultimately will lead to changed perceptions of e-cigarettes. “Right now, kids think there’s no-risk in using e-cigarettes, so we want to make sure they understand the dangers involved, not only now but in the future. We want to teach them what e-cigarettes are, and change their perceptions of the device. For example, they don’t even know there’s such a thing as second-hand vapor.”

Gordon believes that the evidence-based methodology her team is using to create and evaluate the new Click City: Tobacco will lead to a scientifically sound and effective product. Also, since the program is a completely self-contained online educational tool, all a teacher has to do is set the students up with the program. “Our program is ‘plug and play,’” said Gordon. “The intervention gets delivered with complete fidelity because it’s delivered the same way every single time. It also generates reports so teachers can see how well a student is doing.”

The first version of Click City: Tobacco was a huge success with students, teachers and parents, who enjoyed it for its fun, game-based delivery but also appreciated its educational effectiveness.  The SBIR grant is meant to promote collaboration between researchers and small business developers, will enable her team to create a product that will be easily disseminated across the country. “The goal is to develop and create products that have an evidence base,” said Gordon. “So instead of businesses selling products that don’t work and academics and researchers creating effective programs that nobody ever uses, the government has created a mechanism that speeds this collaboration and creates a conduit for the commercialization of effective products.”