Student and Staff Knowledge of School Tobacco Policies and Student E-Cigarette Use, California 2022-2023.

Background: Since 2016, California has prohibited e-cigarette use alongside smoking in K-12 schools. School tobacco policies may reduce student e-cigarette use.

Methods: We analyzed 2022 to 2023 California Healthy Kids Survey (CHKS) and School Staff Survey data (n = 219,114). Multivariable logistic regression was used to examine associations between student and staff awareness of school tobacco policies and current e-cigarette use, adjusting for demographics.

Results: Among students, 5.2% reported current e-cigarette use; 69.6% knew of a school policy. Most staff knew the policy (91.2%), but fewer endorsed consistent enforcement (88.2%) or prevention education (61.7%). Compared to students reporting no policy, those aware of one (OR = 0.54, p < 0.0001) or unsure (OR = 0.40, p < 0.0001) had lower use. Higher staff knowledge was associated with increased use (OR = 1.2, p = 0.0199), while enforcement agreement was associated with lower use (OR = 0.81, p = 0.0019).

Conclusions: Student knowledge and staff perceptions of policy enforcement were associated with lower e-cigarette use. Findings suggest that consistent enforcement and school-wide communication, not just policy presence, are essential for impact.

Implications: Improving policy visibility and staff training on enforcement may strengthen school policies and reduce tobacco use.