INDEPTH: An Alternative to Suspension or Citation

Teen tobacco use has long been linked to lifelong dependency, with 9 out of 10 cigarette users claiming they picked up their first cigarette before the age of 18. The introduction of e-cigarettes has amplified the problem: Over the course of just one year, vaping's popularity grew from 2.1 million in 2017 to 3.6 million in 2018, prompting the U.S. Surgeon General to declare e-cigarette use among our youth an epidemic. Teens are getting hooked on tobacco and instead of getting education or support, they are getting suspended from school or other disciplinary measures. INDEPTH® is a new way to help.


Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health (INDEPTH) is a new, convenient alternative to suspension or citation that helps schools and communities address the teen vaping problem in a more supportive way. Instead of solely focusing on punitive measures, INDEPTH is an interactive program that teaches students about nicotine dependence, establishing healthy alternatives and how to kick the unhealthy addiction that got them in trouble in the first place.

Developed by the American Lung Association in partnership with the Prevention Research Center of West Virginia University, this new free education program is available for any school or community to establish to help our teens make healthier choices.

INDEPTH is an alternative to suspension program that teaches young people about the risk factors to nicotine addiction and ways to quit vaping.


Research suggests that school policies prohibiting tobacco product use, when consistently enforced, are an essential part of lowering teen tobacco use rates. It is just as important that all policies are balanced with educational programming for teens to further understand the consequences of lifelong dependence and addiction along with proven-effective strategies in supporting ultimate cessation should they want to quit. Read more:


INDEPTH is taught by any trained adult in four, 50-minutes sessions. Each session addresses a different tobacco-related issue and can be facilitated either one-on-one or in a group setting. The goal of every program is to educate students about nicotine dependence and cravings and ultimately guide them through the process of identifying their own reasons for chewing, smoking or vaping tobacco products.

Any adult can complete the online INDEPTH training, and facilitators receive a step-by-step guide that can be used to plan and implement the INDEPTH program at their school or community-based organization.

  • Session 1 Getting the Facts: Breaks down the program for participants
  • Session 2 Nicotine Dependence: Explains the harmful effects of nicotine and tobacco products
  • Session 3 Alternatives: Helps teens understand their urges and identify healthy alternatives to replace tobacco use.
  • Session 4 Past, Present, Future: Talks about next steps and how to avoid future tobacco-related problems

Download the program outline to get a better idea of what will be covered.


Although INDEPTH is not a cessation program, 60 percent of student participants reported that they were willing to quit using tobacco products after completing the program. This is why the American Lung Association equips every INDEPTH facilitator with "after INDEPTH" resources that can help your students become and remain tobacco and nicotine-free, including access to policy support and youth cessation programming.

Not on Tobacco (N-O-T) Youth Cessation Program

The American Lung Association's Not on Tobacco (N-O-T) program is a voluntary youth-centered cessation program inclusive in addressing all tobacco product use, including e-cigarettes. This program can be made available through a referral system for students who request additional support after participating in INDEPTH. It is recommended that schools and community-based organizations implementing INDEPTH also become trained as Not on Tobacco (N-O-T) facilitators to provide a youth cessation option for those students wishing to quit.

If you are interested in becoming an American Lung Association N-O-T Facilitator to establish a voluntary youth cessation program at your school or community-based organization visit Not on Tobacco (N-O-T) to learn more. The N-O-T Facilitator Training also includes the Facilitator Training for INDEPTH.

Start Your INDEPTH Program Today

Let's stop punishing students, and instead create lasting change in tobacco and nicotine usage in your school and community by starting your own INDEPTH program. Becoming an American Lung Association INDEPTH Certified Facilitator is easy:

Register for the free INDEPTH Facilitator Training Course here.

Need more information? Call 1-800-586-4872 (1-800-LUNGUSA) or email [email protected].

Proven Results for INDEPTH

In the spring of 2019, the American Lung Association recruited a total of 11 sites nationwide to participate in an INDEPTH pilot. The diverse pilot locations included middle schools, high schools, an alternative school and a court system and served urban, suburban and rural communities. The Research & Evaluation Group at Public Health Management Corporation (R&E Group), the Lung Association's external evaluator, developed online surveys to gather feedback and measure the program's effectiveness. It surveyed student participants, adults who facilitated the program and administrators from schools or sites where the program was implemented, to better understand the benefits and updates that were needed. These results guided additional edits to the curriculum, updates to training protocols and enhanced marketing and educational resources. Learn more about the pilot evaluation and results here:

Learn More

Learn more about INDEPTH and getting started as a certified facilitator by calling 1-800-586-4872 (1-800-LUNGUSA) or emailing [email protected].

Already trained as an INDEPTH Facilitator?  Please log in and register here to access the latest facilitator resources or contact [email protected] . 

E-cigarettes & School Wellness Policies: Resources for Schools

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Page last updated: June 7, 2024

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