Motivational Drivers for Teachers as Informal Health Educators to Initiate In-Class Discussions With Adolescents About Smoking: Moderated Mediation Study Using Attribution Theory

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 showed that teachers who attributed greater responsibility to the school (internal attribution) reported higher levels of concern (β=–0.41; P=.002) and engaged in more frequent in-class discussions on smoking (β=–0.26; P=.02). Although concern alone was not directly related to communication (β=–0.14; P=.22), its effect was significantly moderated by contextual sanctions (β=1.01; P<.001). 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.