PEC Innovation · 4 authors, 2 centres
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College health providers in New York State report high confidence and knowledge about vaping, yet less than half have received formal training, and 64% do not know whether students primarily vape nicotine or cannabis. This disconnect suggests that perceived knowledge may not align with actual understanding, highlighting a need for targeted education and training. The findings underscore opportunities to improve provider-patient communication about vaping on college campuses.
**Background:** Electronic cigarette (e-cigarette) use is highest among young adults, including college students, with 45% of college students reporting ever use. Despite the critical role college health providers play in addressing substance use, little is known about their knowledge, confidence, and training needs regarding vaping (both nicotine and cannabis). This mixed-methods pilot study aimed to assess these factors among providers in the State University of New York (SUNY) system.
**Methods:** A sequential-explanatory mixed-methods design was used. First, a cross-sectional online survey was administered to 50 college health providers from 26 SUNY campuses between July and November 2019. Participants included nurses (54%), health educators (10%), doctors (8%), and other staff (22%); 80% were female, mean age 49.2 years, and 80% non-Hispanic White. Second, targeted semi-structured telephone interviews were conducted with 11 providers who completed the survey (March–July 2020). Survey items assessed knowledge, confidence, professional practices, past training, and future training needs using 5-point Likert scales. Qualitative data were analyzed using thematic content analysis.
**Key Results:** Despite high self-reported knowledge (76% agreed they feel knowledgeable talking about e-cigarettes) and confidence (86% agreed they feel confident), only 44% had participated in any vaping-related training or educational activity. Notably, 64% of providers reported they did not know whether students on their campus primarily vape nicotine or cannabis. Misinformation was evident; for example, one interview participant incorrectly stated e-cigarettes are “unregulated,” despite FDA regulation since 2016. Most providers (85%) believed e-cigarettes are “just as harmful as cigarettes and should not be recommended as a safer alternative for smokers,” and only 6% considered them much less harmful. A significant difference (p < 0.01) emerged between providers wanting to learn more about harms (n=43) versus benefits (n=33) of e-cigarettes. The majority (82%) indicated they have time to learn more about e-cigarettes, and 74% felt it is a priority. Preferred training formats included webinars and materials (e.g., posters, social media content) that could be shared with students. Qualitative findings revealed that providers recognized the importance of distinguishing between nicotine and cannabis vaping and understanding product type, source, and nicotine content, but many felt they lacked this information.
**Clinical Implications:** This pilot study reveals a critical gap between college health providers’ perceived and actual knowledge about vaping. The high confidence but low training participation and lack of awareness about what students are vaping (nicotine vs. cannabis) suggest that educational interventions are urgently needed. Providers should be trained to ask specific questions about product type, source, delivery system, and frequency of use. Given the EVALI outbreak and the co-use of nicotine and cannabis, accurate risk communication is essential. The study also highlights the need for harm reduction–informed messaging, as many providers hold a unidimensional view that e-cigarettes are as harmful as combustible cigarettes. Future research should assess the sources of providers’ knowledge and develop tailored training programs (e.g., webinars, social media campaigns) to improve provider–student communication about vaping.