Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Aug 6, 2025
Date Accepted: Feb 12, 2026
Teachers as Informal Health Educators: An Attribution Theory Approach to in‑Class Discussions on Smoking
ABSTRACT
Background:
Teachers have the potential to be influential figures in school-based health promotion as informal caregivers, yet little is known about what motivates them to initiate preventive conversations with students. Attribution theory offers a useful framework to explore how perceptions of responsibility shape communicative behavior, but it has rarely been applied in the context of teacher-student interactions around health risks such as smoking.
Objective:
This study applies the Attribution Theory to explore the motivational drivers that lead teachers to initiate discussions with adolescents about smoking.
Methods:
Data were collected from 101 middle schools in the Canton of Ticino, Switzerland, as part of a larger longitudinal study. The analysis focuses on 67 teachers who participated in the first wave. Responsibility attribution, concern, and previous classroom sanctions were examined in association with teachers’ communication.
Results:
Results from a moderated mediation model (PROCESS Model 14) showed that teachers who attributed greater responsibility to the school (internal attribution) reported higher levels of concern, which was linked to more frequent communication, particularly in classrooms where students had been previously sanctioned for smoking.
Conclusions:
These findings highlight the motivational and contextual factors that shape teachers’ communication with students on smoking behavior. By applying attribution theory in the novel context of health communication, this research contributes to understanding how perceived responsibility influences preventive communication in schools.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.