A Commitment to Health, Communication, and Support
This family agreement is designed to encourage open communication and mutual support in maintaining a vape-free lifestyle. By signing this agreement, all family members commit to shared goals, expectations, and positive choices.
1. Our Family Commitment to Health and Wellness
As a family, we agree to:
- Prioritize health and well-being by remaining committed to a vape-free lifestyle.
- Stay informed about the health risks of vaping and educate ourselves continuously.
- Support each other in making healthy, positive choices every day.
2. Family Expectations
Each family member agrees to:
- Stay Vape-Free: Refrain from using or possessing any vaping products, including e-cigarettes and vape pens.
- Avoid High-Risk Situations: Avoid environments or social situations that encourage or normalize vaping.
- Communicate Openly: Discuss any challenges, peer pressure, or questions about vaping honestly and without judgment.
3. Family Support Strategies
To help each other stay vape-free, we will:
- Check In Regularly: Schedule regular family discussions to share experiences, challenges, and successes related to living vape-free.
- Use Healthy Alternatives: Encourage positive coping strategies for stress, like exercise, mindfulness, or hobbies.
- Create a Safe Space for Dialogue: Ensure that family members can talk about any pressures they face without fear of punishment.
4. Consequences for Vaping
If anyone in the family violates this agreement, we have agreed upon the following consequences:
- First Violation: Have a family discussion to address the situation, understand the reasons, and agree on extra support if needed.
- Second Violation: Temporary loss of privileges, such as screen time reduction or limited social outings, to reinforce our commitment to health.
- Repeated Violations: Increased support measures, such as arranging for professional counseling or joining a cessation program.
5. Positive Reinforcement and Rewards
We will celebrate our commitment to a vape-free lifestyle by:
- Setting Milestones: Celebrate specific vape-free milestones (e.g., three months, six months, one year) with small rewards or family outings.
- Offering Positive Recognition: Acknowledge each family member’s efforts in staying vape-free and supporting others.
- Rewarding Healthy Choices: Plan family activities or outings as rewards for reaching agreed-upon goals.
6. Family Signatures
By signing this agreement, each family member acknowledges their commitment to a vape-free lifestyle and agrees to uphold the expectations, support strategies, and consequences outlined above.
| Family Member | Signature | Date |
| Parent/Guardian: ___________ | __________________ | ____________ |
| Parent/Guardian: ___________ | __________________ | ____________ |
| Teen: ___________ | __________________ | ____________ |
| Sibling: ___________ | __________________ | ____________ |
Tips for a Successful Agreement
- Be Consistent: Review this agreement regularly to ensure everyone remains committed.
- Celebrate Progress: Recognize even small steps toward a healthy lifestyle.
- Stay Positive: Reinforce that this agreement is about supporting each other, not just enforcing rules.
Together, we can create a supportive, vape-free environment that prioritizes health, respect, and open communication.