BACKGROUND-AIM:
While some studies have found no evidence for a contribution of school policies and programmes to quit behaviour of adolescent smokers, others have found that tobacco health education can reduce teenage smoking. However, information-only approaches that do not target social influences (that include both social competence and social skills development) or media literacy show less effectiveness. In this study, we examine: participation in tobacco awareness programmes by teenagers in Ireland; and associations between student participation and prevalence of current smoking and prevalence of overall nicotine use.

METHODS:
The sample comprised a nationally representative, stratified random sample of 5587 15- to 18-year-olds in Ireland, with data collected online in 2024. Current smoking was assessed using past 30-day use and current nicotine use was measured by use of any one of 6 nicotine products (cigarettes, e-cigarettes, moist snuff (snus), nicotine pouches, heated tobacco products, water/shisha pipes). Participation in Tobacco Awareness Education was measured by the question “Think about the last two years. Do you recall having participated in the following activities? Awareness events/information activities about effects and possible harms of Tobacco” (answer categories: never/once/more than once). Analysis were carried out using SPSS V29.

RESULTS:
In the previous two years, 17.2% (n=829) had participated once, and 17% (n=819) had participated more than once in any awareness events or information activities about the effects and possible harms of tobacco, while 65.8% (n=3175) of respondents had not participated in any such activities. 14.2% (n=758) of the sample were current smokers and 25.4% (n=1317) were current nicotine users. Among smokers who responded to the question on tobacco awareness education programmes, 57.4% (n=377) participated once or more than once and 42.6% (n=280) did not participate in any tobacco awareness education. Among current nicotine users who responded, 53.5% (n=630) participated once or more than once and 46.5% (n=548) did not participate in any tobacco awareness education. Participation in tobacco education awareness programmes was associated with increased odds of both current smoking (OR 3.1, 95%CI 2.6,3.6) and current nicotine composite use (OR 2.94, 95%CI 2.57,3.37).

CONCLUSIONS:
Only a third of teenagers had participated in tobacco health education in the previous two years. Those who had participated were significantly more likely to be both smokers and users of any nicotine product (OR ~3). This may point to the provision of tobacco awareness programmes for those who are already smoking and using nicotine. Otherwise, tobacco education programmes would appear to have negative effects. Although public health education campaigns are well-documented as being effective in reducing overall tobacco use, our surprising results suggest that further attention to content and outcomes of school programmes is warranted. Health literacy, providing information to empower people to resist