Abstract
Introduction
K-12 schools are experiencing changes in the substance use landscape. In particular, oral nicotine pouches (ONP) are increasingly used by youth. Nicotine exposure during adolescence can contribute to dependence and continued tobacco use. Limited information is available on the presence of ONP-related infractions in K-12 schools or how schools are responding to student use. Understanding how emerging nicotine products are appearing in school settings may help inform more effective prevention and response strategies. This study aimed to characterize nicotine-related infractions across Virginia K-12 school settings and evaluate the school responses being used, including their perceived effectiveness.
Methods
Educational professionals were recruited across Virginia using Qualtrics with electronic gift cards provided to validated work e-mail addresses. Participants (N=202, M age=45.2, SD=9.7, 69.4% female, 60.2% White, 26.7% African American) included Vice Principals/Deans (35.4%), Guidance Counselors (24.3%), Principals/Headmasters (17.0%), and other school personnel (23.3%); experience in educational system averaged 18 (SD=9.2) years. Survey assessed school setting, substances implicated in infractions, responses to use, and perceived effectiveness of responses (rated from 0-100). Among respondents reporting school setting, 35.5% represented rural schools, 36.1% suburban schools, and 28.4% urban schools. Logistic regression and paired sample t-tests were used to compare responses.
Results
Vaped nicotine was commonly reported across all three school settings, ranging from 84.8% of suburban schools to 78.8% of urban schools. ONP infractions were less common overall, but more common in rural (20.8%) than non-rural (10.1%) settings, OR: 2.34, 95% CI: 1.06-5.18. In contrast, cigarette infractions were highest in urban schools (17.3%), followed by rural (7.7%) and suburban (6.1%) schools. The most endorsed disciplinary responses were out-of-school suspension (90.8% endorsement; M=55.9 perceived effectiveness, SD=29.9), parent conferences or notification (88.3%; M=56.7, SD=26.5), and in-school suspension (77.7% M=46.2, SD=25.3). Referral for treatment (47.6%; M = 58.5, SD=30.6) and diversion programs (29.6%; M = 59.7, SD=27.8) were less used but perceived as more effective than these disciplinary responses. Among a subsample that reported both in-school suspensions and diversion programs (n=51), diversion programs were perceived as significantly more effective, M=62.0, SD=27.9 vs. M=45.9, SD=28.2, p .001.
Conclusion
Nicotine-related infractions remain common across Virginia K-12 schools, with vaping reported most frequently. ONP infractions are less common, occurring primarily in rural settings. Cigarette-related infractions were highest in urban settings. Educational responses are primarily punitive despite perceptions that supportive responses would be more effective. These findings suggest a mismatch between current practice and perceived effectiveness, and support incorporation of treatment-oriented approaches as nicotine products evolve.