RESEARCH PAPER
Restructuring areas, reshaping norms: Denormalizing (e-)cigarette use in Swiss vocational and high schools
1
Department Consumer
Behavior and Behavior Change,
Institute of Marketing and
Management, University of Bern,
Bern, Switzerland
2
School of Health Sciences,
Institute of Public Health, Zurich
University of Applied Sciences,
Winterthur, Switzerland
3
Department of Psychology,
University of Konstanz, Konstanz,
Germany
4
The Behavior Lab Ltd.,
Oftringen, Switzerland
Submission date: 2025-11-21
Final revision date: 2026-01-18
Acceptance date: 2026-01-28
Publication date: 2026-06-18
Corresponding author
Anna Morf
Department Consumer Behavior and Behavior Change, Institute of Marketing and Management, University of Bern, Engehaldenstrasse 4, CH- 3012 Bern, Switzerland
Department Consumer Behavior and Behavior Change, Institute of Marketing and Management, University of Bern, Engehaldenstrasse 4, CH- 3012 Bern, Switzerland
Tob. Prev. Cessation 2026;12(June):29
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Adolescents often overestimate peer smoking and vaping, increasing the likelihood of initiation. School environments play a central role in shaping these perceptions. This study therefore aimed to examine whether a schoolbased environmental intervention modifying the school environment can shift adolescents’ perceived norms and reduce (e-)cigarette use.
Methods:
A quasi-experimental pre-post study was conducted in three Swiss secondary schools (March–June 2024; baseline n=664; follow-up n=884). The intervention comprised a multi-component environmental approach, including the relocation of designated smoking areas to less visible locations, accompanying signage, improvements to non-smoking areas, and informational posters. Perceived peer (e-)cigarette use, and self-reported (e-)cigarette use were reported through online surveys at baseline and at one month post-intervention.
Results:
Effects varied across schools. In School 1, perceived prevalence of (e-) cigarette use decreased (cigarettes: β= -0.44; 95% CI: -0.68 – -0.21; e-cigarettes: β= -0.53; 95% CI: -0.80 – -0.25). In School 2, reductions differed by (e-)cigarette use: never and former users reported lower perceived cigarette prevalence at follow-up, whereas occasional and regular users showed no change. Perceived e-cigarette prevalence decreased (β= -0.42; 95% CI: -0.69 – -0.15). In School 3, changes varied by (e-)cigarette use, with regular users reporting lower perceived cigarette prevalence (interaction: β= -1.60; 95% CI: -2.75 – -0.45). Perceived e-cigarette prevalence did not change. Across schools, the intervention did not affect (e-)cigarette use.
Conclusions:
A school-based environmental intervention modifying the school environment may influence adolescents’ descriptive norms, although effects appear to depend on baseline policies and implementation context.
Adolescents often overestimate peer smoking and vaping, increasing the likelihood of initiation. School environments play a central role in shaping these perceptions. This study therefore aimed to examine whether a schoolbased environmental intervention modifying the school environment can shift adolescents’ perceived norms and reduce (e-)cigarette use.
Methods:
A quasi-experimental pre-post study was conducted in three Swiss secondary schools (March–June 2024; baseline n=664; follow-up n=884). The intervention comprised a multi-component environmental approach, including the relocation of designated smoking areas to less visible locations, accompanying signage, improvements to non-smoking areas, and informational posters. Perceived peer (e-)cigarette use, and self-reported (e-)cigarette use were reported through online surveys at baseline and at one month post-intervention.
Results:
Effects varied across schools. In School 1, perceived prevalence of (e-) cigarette use decreased (cigarettes: β= -0.44; 95% CI: -0.68 – -0.21; e-cigarettes: β= -0.53; 95% CI: -0.80 – -0.25). In School 2, reductions differed by (e-)cigarette use: never and former users reported lower perceived cigarette prevalence at follow-up, whereas occasional and regular users showed no change. Perceived e-cigarette prevalence decreased (β= -0.42; 95% CI: -0.69 – -0.15). In School 3, changes varied by (e-)cigarette use, with regular users reporting lower perceived cigarette prevalence (interaction: β= -1.60; 95% CI: -2.75 – -0.45). Perceived e-cigarette prevalence did not change. Across schools, the intervention did not affect (e-)cigarette use.
Conclusions:
A school-based environmental intervention modifying the school environment may influence adolescents’ descriptive norms, although effects appear to depend on baseline policies and implementation context.
ACKNOWLEDGEMENTS
The abstract of this manuscript was presented at the 9th International Behaviour Change Conference 2025 (2–3 April 2025, Lisbon, Portugal)35.
CONFLICTS OF INTEREST
The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. All the authors report that since the initial planning of the work, all the funding for the research project was provided from the Tobacco Prevention Fund.
FUNDING
This research received financial support from the Swiss Tobacco Control
Fund (TCF). The funding source was not involved in designing the study;
in the collection, analysis, and interpretation of the data; in writing the
manuscript; or in the decision to submit the article for publication.
ETHICAL APPROVAL AND INFORMED CONSENT
Ethical approval was obtained from the Ethics Committee of the Zurich University of Applied Sciences (ZHAW) (Approval number: EA-ZHAW 2024-003-G; Date: 15 April 2024). Participants provided informed consent.
DATA AVAILABILITY
The data supporting this research is available from the following source:
https://osf.io/aebdj/?view_only=ceee00436dd44fd5a69b8d97ee5810df.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
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