The Effect of E-Cigarette Educational Games to Inc Rease Knowledge and Prevent The Dangers of E-Cigarettes/Personal Vaporizers in Adolescents
Keywords:
adolescent, e-cigarette, knowledge, personal vaporizerAbstract
This study aimed to assess the impact of E-Cigarette Educational Games (ECG) on improving knowledge and promoting preventive behavior against the risks of e-cigarettes and personal vaporizers among adolescents. Conducted in Indonesia in 2024, the quasi-experimental study used a non-equivalent pretest and posttest control group design. A total of 158 senior high school students participated, divided into intervention and control groups based on the schools' locations. Participants were selected through random sampling, with stratified random sampling determining how many respondents came from each school. The intervention group received health education through ECG, while the control group was educated using leaflets. The educational session lasted three hours. Structured questionnaires collected data immediately after the intervention, measuring adolescents’ knowledge of e-cigarette risks and their preventive behaviors. Data analysis used the Wilcoxon and Mann-Whitney tests, with a significance level set at 0.05. The results showed a significant increase in knowledge about e-cigarette dangers in the ECG group (p = 0.000), with a similar outcome in the leaflet group (p = 0.000). Preventive behavior concerning e-cigarette use significantly improved in the ECG group (p = 0.000), while no significant change occurred in the leaflet group (p = 0.797). ECG proved to be an effective tool for increasing knowledge and fostering preventive behavior regarding e-cigarettes, with interactive approaches being more successful in promoting behavioral change than traditional methods.
References
Aaron, D. G. (2021). Tobacco Reborn: The Rise of E-Cigarettes and Regulatory Approaches. Lewis & Clark Law.
Abelia XA, L. R. G. H. A. R. B. MI. (n.d.). Comparison impact of cigarettes and e-cigs as lung cancer risk inductor: a narrative review.
Ahuja, N., Kedia, S. K., Jiang, Y., Xie, L., Ward, K. D., Pichon, L. C., Dillon, P. J., & Yu, X. (2022). Factors Associated With E-Cigarette Quitting Behavior Among Adolescents in the United States: A Prospective Observational Study. Journal of Adolescent Health, 71(6), 729–736. https://doi.org/10.1016/j.jadohealth.2022.07.001
Ahyar Rosidi, Maruli Taupandas, & Zulfi Jihad. (2023). Hubungan Tingkat Pengetahuan Remaja Kelas X dan XI Tentang Bahaya Rokok Dengan Intensitas Merokok Pada Siswa Di MA Hizbulwathan NW Semaya.
Astiza, D. N., Cahyono, J., Wahyuningrum, D. R., Kemenkes, P., Timur, K., & Kaltim. (2023). The Effect of Nutrition Education Using Leaflet Media on Knowledge of Meal Planning in Type II Diabetes Mellitus Outpatients at the Pasundan Health Center in Samarinda. Formosa Journal of Science and Technology, 2(7), 1901–1912. https://doi.org/10.55927/FJST.V2I7.5262
Bai, S., Hew, K. F., & Huang, B. (2020). Does gamification improve student learning outcome? Evidence from a meta-analysis and synthesis of qualitative data in educational contexts. Educational Research Review, 30, 100322. https://doi.org/10.1016/J.EDUREV.2020.100322
Beal, S. J., Crockett, L. J., & Peugh, J. (2016). Adolescents’ Changing Future Expectations Predict the Timing of Adult Role Transitions. Developmental Psychology, 52(10), 1606. https://doi.org/10.1037/DEV0000189
Beutel, M. W., Harmon, T. C., Novotny, T. E., Mock, J., Gilmore, M. E., Hart, S. C., Traina, S., Duttagupta, S., Brooks, A., Jerde, C. L., Hoh, E., Van De Werfhorst, L. C., Butsic, V., Wartenberg, A. C., & Holden, P. A. (2021). A Review of Environmental Pollution from the Use and Disposal of Cigarettes and Electronic Cigarettes: Contaminants, Sources, and Impacts. Sustainability 2021, Vol. 13, Page 12994, 13(23), 12994. https://doi.org/10.3390/SU132312994
Bintang, T., Hermansyah, & Dahrizal. (2019). Effective gastritis healthy card games in increasing adolescent understanding about gastritis. 44–47. https://doi.org/10.2991/ICIHC-18.2019.11
Bold, K. W., Krishnan-Sarin, S., & Stoney, C. M. (2018). E-cigarette use as a potential cardiovascular disease risk behavior. The American Psychologist, 73(8), 955–967. https://doi.org/10.1037/AMP0000231
Choi, H., Lin, Y., Race, E., & Macmurdo, M. G. (2021). Electronic cigarettes and alternative methods of vaping. Annals of the American Thoracic Society, 18(2), 191–199. https://doi.org/10.1513/ANNALSATS.202005-511CME/SUPPL_FILE/DISCLOSURES.PDF
Chow, C. Y., Riantiningtyas, R. R., Kanstrup, M. B., Papavasileiou, M., Liem, G. D., & Olsen, A. (2020). Can games change children’s eating behaviour? A review of gamification and serious games. Food Quality and Preference, 80, 103823. https://doi.org/10.1016/J.FOODQUAL.2019.103823
Chun, J., Yu, M., Kim, J., & Kim, A. (2020). E-Cigarette, Cigarette, and Dual Use in Korean Adolescents: A Test of Problem Behavior Theory. Journal of Psychoactive Drugs, 52(1), 27–36. https://doi.org/10.1080/02791072.2020.1712501
Coke, L. A. (2020). Vaping and Use of E-Cigarette Products in Adolescents: A New Cardiopulmonary Crisis. Journal of Cardiovascular Nursing, 35(3), 225–228. https://doi.org/10.1097/JCN.0000000000000679
de Andrade, M., Angus, K., Hastings, G., & Angelova, N. (2020). Hostage to fortune: an empirical study of the tobacco industry’s business strategies since the advent of e-cigarettes. Critical Public Health, 30(3), 280–293. https://doi.org/10.1080/09581596.2018.1552778
Emadzadeh, M., & Vakili, V. (2020). Steps toward community health promotion: Application of transtheoretical model to predict stage transition regarding smoking. Journal of Education and Health Promotion, 9(1), 177. https://doi.org/10.4103/JEHP.JEHP_719_19
Emini, E., Amalia, L., & Purnama, T. (2023). Leaflet media as an effort to increase knowledge of dental health maintenance in elementary school students. Asian Journal of Dental and Health Sciences, 3(2), 23–25. https://doi.org/10.22270/AJDHS.V3I2.44
Ernawati, I., Fandinata, S. S., & Permatasari, S. N. (2020). The Effect of Leaflet on Hypertension Knowledge in Hypertensive Patients in Community Health Center in Surabaya City. Open Access Macedonian Journal of Medical Sciences, 8(E), 558–565. https://doi.org/10.3889/OAMJMS.2020.5327
Gold, N., Durlik, C., Sanders, J. G., Thompson, K., & Chadborn, T. (2019). Applying behavioural science to increase uptake of the NHS Health Check: a randomised controlled trial of gain- and loss-framed messaging in the national patient information leaflet. BMC Public Health, 19(1). https://doi.org/10.1186/S12889-019-7754-5
Gorukanti, A., Delucchi, K., Ling, P., Fisher-Travis, R., & Halpern-Felsher, B. (2017). Adolescents’ attitudes towards e-cigarette ingredients, safety, addictive properties, social norms, and regulation. Preventive Medicine, 94, 65–71. https://doi.org/10.1016/J.YPMED.2016.10.019
Grant, J. E., Lust, K., Fridberg, D. J., King, A. C., & Chamberlain, S. R. (2019). E-Cigarette Use (Vaping) is Associated with Illicit Drug Use, Mental Health Problems, and Impulsivity in University Students. Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists, 31(1), 27. /pmc/articles/PMC6420081/
Guo, J. L., Hsu, H. P., Lin, M. H., Lin, C. Y., & Huang, C. M. (2020). Testing the Usability of Digital Educational Games for Encouraging Smoking Cessation. International Journal of Environmental Research and Public Health, 17(8), 2695. https://doi.org/10.3390/IJERPH17082695
Hartati, I., & Putri, S. T. (2021). Influence Of Health Education On Knowledge And Attitude About The Hazards Of Smoking. https://doi.org/10.51601/IJERSC.V2I4.138
Hsieh, H. W., Wu, C. S., Tsai, C. C., Liao, Y. C., Chen, P. Y., Tseng, H. L., Huang, M. Z., & Chen, M. F. (2023). Comparing the effectiveness of board game-based and drill-based education programs in improving Taiwanese nurses’ fire safety knowledge, attitudes, and behavior: A quasi-experimental study. Nurse Education Today, 129, 105919. https://doi.org/10.1016/J.NEDT.2023.105919
Kamriana, K., Dewiyanti, D., Arafah, S., & Alwi, A. (2024). The Effectiveness Of Leaflet Education Media On Knowledge And Attitudes Regarding Health Protocol During The Covid 19 Pandemic In Canrego Village, South Polongbangkeng District, Takalar District. Journal of Midwifery and Nursing, 6(2), 564–571. https://doi.org/10.35335/JMN.V6I2.4711
Katonai, Z., Gupta, R., Heuss, S., Fehr, T., Ebneter, M., Maier, T., Meier, T., Bux, D., Thackaberry, J., & Schneeberger, A. R. (2023). Serious Games and Gamification: Health Care Workers’ Experience, Attitudes, and Knowledge. Academic Psychiatry : The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 47(2), 169–173. https://doi.org/10.1007/S40596-023-01747-Z
Kregting, L. M., van Ravesteyn, N. T., Spijker, W., Dierks, T., Aitken, C. A., Geuzinge, H. A., & Korfage, I. J. (2020). Effects of a leaflet on breast cancer screening knowledge, explicit attitudes, and implicit associations. Patient Education and Counseling, 103(12), 2499–2507. https://doi.org/10.1016/J.PEC.2020.06.032
Maciej Serda, Becker, F. G., Cleary, M., Team, R. M., Holtermann, H., The, D., Agenda, N., Science, P., Sk, S. K., Hinnebusch, R., Hinnebusch A, R., Rabinovich, I., Olmert, Y., Uld, D. Q. G. L. Q., Ri, W. K. H. U., Lq, V., Frxqwu, W. K. H., Zklfk, E., Edvhg, L. V, … فاطمی, ح. (2021). Hubungan Terpaan Informasi Rokok Elektrik Lebih Aman 95% dari Rokok Konvensional dan Tingkat Pengetahuan Tentang Rokok Elektrik dengan Minat Menggunakan Rokok Elektrik. Interaksi Online, 9(4), 189–202. https://doi.org/10.2/JQUERY.MIN.JS
Manninen, M., Magrum, E., Campbell, S., & Belton, S. (2024). The effect of game-based approaches on decision-making, knowledge, and motor skill: A systematic review and a multilevel meta-analysis. European Physical Education Review. https://doi.org/10.1177/1356336X241245305/ASSET/IMAGES/LARGE/10.1177_1356336X241245305-FIG1.JPEG
Merecz-Sadowska, A., Sitarek, P., Zielinska-Blizniewska, H., Malinowska, K., Zajdel, K., Zakonnik, L., & Zajdel, R. (2020). A Summary of In Vitro and In Vivo Studies Evaluating the Impact of E-Cigarette Exposure on Living Organisms and the Environment. International Journal of Molecular Sciences, 21(2). https://doi.org/10.3390/IJMS21020652
National Academies of Sciences, E. and M. (2019a). The Promise of Adolescence: Realizing Opportunity for All Youth. The Promise of Adolescence. https://doi.org/10.17226/25388
National Academies of Sciences, E. and M. (2019b). The Promise of Adolescence: Realizing Opportunity for All Youth. The Promise of Adolescence. https://doi.org/10.17226/25388
Neila Sulung, & Abdi Iswahyudi Yasril. (2022). Metode besar sampel dan teknik pengambilan sampling untuk penelitian kesehatan / penulis, Neila Sulung, Abdi Iswahyudi Yasril | Dinas Perpustakaan dan Arsip Daerah DIY. Sleman : Deepublish.
Osibogun, O., Bursac, Z., & Maziak, W. (2020). E-Cigarette Use and Regular Cigarette Smoking Among Youth: Population Assessment of Tobacco and Health Study (2013–2016). American Journal of Preventive Medicine, 58(5), 657–665. https://doi.org/10.1016/J.AMEPRE.2020.01.003
Sánchez-Sánchez, E., García-Ferrer, L., Ramirez-Vargas, G., Díaz-Jimenez, J., Rosety-Rodriguez, M., Díaz, A. J., Ordonez, F. J., Rosety, M. Á., Rosety, I., & Poza-Méndez, M. (2023). Knowledge, Attitudes and Behaviours of Adolescents and Young Adult Population on the Use of E-Cigarettes or Personal Vaporizer. Healthcare 2023, Vol. 11, Page 382, 11(3), 382. https://doi.org/10.3390/HEALTHCARE11030382
Sapru, S., Vardhan, M., Li, Q., Guo, Y., Li, X., & Saxena, D. (2020). E-cigarettes use in the United States: Reasons for use, perceptions, and effects on health. BMC Public Health, 20(1), 1–10. https://doi.org/10.1186/S12889-020-09572-X/FIGURES/5
Saragih, F., Rochadi, R. K., & Keloko, A. B. (2020). The Effectiveness of The Media Leaflets and Film on Knowledge of The Attitude snd Skills of Cadres in Ovitrap Making. International Archives of Medical Sciences and Public Health, 1(2), 107–116. https://pcijournal.org/index.php/iamsph/article/view/38
Scalise, N. R., Daubert, E. N., & Ramani, G. B. (2020). Benefits of Playing Numerical Card Games on Head Start Children’s Mathematical Skills. The Journal of Experimental Education, 88(2), 200–220. https://doi.org/10.1080/00220973.2019.1581721
Seitz, C. M., Staley, M. E., Kearley, J., Wright, L., Bowman, R., Phillips, C., & Orsini, M. M. (2022). E-cigarette sharing behavior among college students: An exploratory study. Journal of American College Health, 70(5), 1297–1300. https://doi.org/10.1080/07448481.2020.1800710
Short, M., & Cole, A. G. (2021). Factors Associated with E-Cigarette Escalation among High School Students: A Review of the Literature. International Journal of Environmental Research and Public Health, 18(19). https://doi.org/10.3390/IJERPH181910067
Singh, P., Hoon, T. S., Md Nasir, A., Md Ramly, A., Md Rasid, S., & Meng, C. C. (2021). Card game as a pedagogical tool for numeracy skills development. International Journal of Evaluation and Research in Education (IJERE), 10(2), 693–705. https://doi.org/10.11591/IJERE.V10I2.20722
Singh, R., Burke, M., Towns, S., Rahman, M. A., Bittoun, R., Shah, S., Liu, A., & Bhurawala, H. (2024). Exploring General Practitioners’ Knowledge, Attitudes, and Practices towards E-Cigarette Use/Vaping in Children and Adolescents: A Pilot Cross-Sectional Study in Sydney. International Journal of Environmental Research and Public Health, 21(9). https://doi.org/10.3390/IJERPH21091215
Sugiyono. (2019). Metode penelitian kuantitatif kualitatif dan R dan D / Sugiyono | Perpustakaan Universitas Islam Negeri Sultan Syarif Kasim Riau. Bandung : Alfabeta.
Surapaneni, K. M. (2024). “CARBGAME” (CARd & Board GAmes in Medical Education): a gamification innovation to foster active learning in biochemistry for medical students. Advances in Physiology Education, 48(1), 97–101. https://doi.org/10.1152/ADVAN.00214.2023/ASSET/IMAGES/LARGE/ADVAN.00214.2023_F003.JPEG
Wakefield, M., Haynes, A., Tabbakh, T., Scollo, M., & Durkin, S. (2018). Current vaping and current smoking in the Australian population aged 14+ years.
Wardoyo, C., Satrio, Y. D., & Ma’ruf, D. (2020). Effectiveness of Game-Based Learning – Learning in Modern Education. KnE Social Sciences, 4(7), 81-87–81–87. https://doi.org/10.18502/KSS.V4I7.6844
Wilandika, A., Fatmawati, A., Farida, G., & Yusof, S. (2022). The Kasaba Quartet: The Impact of Card Games on Knowledge and Self-Efficacy HIV/AIDS Prevention. Open Access Macedonian Journal of Medical Sciences, 10(E), 341–348. https://doi.org/10.3889/OAMJMS.2022.8681
Zusanty, M., Masitoh, S., & Setyowati, S. (2022). The Positive Effect of Educative Game Tools (Puzzle) On Cognitive Levels of Pre-School Children (4-5 Years). Journal of Education and Instruction (JOEAI), 5(1), 52–64. https://doi.org/10.31539/JOEAI.V5I1.3307.




