JMIR Publications

ABSTRACT

Background:

The e-cigarette usage among adolescents presents unique challenges, distinct from traditional smoking issues. The perception that e-cigarettes are less harmful and their distinctive appeal as a means of sensation-seeking among adolescents suggest that traditional smoking prevention programs may not guarantee effectiveness in preventing e-cigarette use.

Objective:

The aim of this pilot study is to assess the potential of the "Meta Nodam" program, a novel metaverse-based educational initiative, for enhancing adolescents' resistance to e-cigarette use and increasing their engagement in preventive education.

Methods:

The "Meta Nodam" program was developed on the Roblox platform, designed to promote autonomous engagement and health-related decision-making among adolescents. The study included 120 participants in a two-session intervention for two weeks, each lasting 45 minutes. Effectiveness was evaluated through pre- and post-intervention surveys measuring changes in e-cigarette usage intentions, attitudes, norms, self-efficacy, and interest development. In addition, focus group interviews with 10 participants were conducted to gain deeper insights.

Results:

The analysis of the quantitative results from this study showed a significant increase in e-cigarette-related self-efficacy (t=-3.17, p=.002), yet it revealed no effect on intentions and attitudes. Qualitative analysis indicated that the high freedom in the metaverse environment for adolescents sparked interest in e-cigarette use prevention education, particularly by enhancing social interaction and the influence of peers. Additionally, the metaverse program appeared to promote information-seeking and critical thinking among participants.

Conclusions:

Due to the short duration of the metaverse experience, limited to two sessions over two weeks, it did not alter adolescents' attitudes and intentions regarding e-cigarette use. However, it succeeded in enhancing e-cigarette-related self-efficacy and demonstrated the applicability, usefulness, and attractiveness of the metaverse program. The study highlights the potential of digital platforms like the metaverse for health education, emphasizing user engagement, interaction, and experiential learning in preventive education. Future research should consider broader participant demographics and more robust experimental designs to validate the effectiveness of such interventions.