Effectiveness of a peer-led behavioral intervention program on tobacco use-related knowledge, attitude, normative beliefs, and intention to smoke among adolescents at Iranian Public High Schools

Abstract

Background: Theory-based tobacco use prevention programs in schools were implemented to evaluate the effectiveness of this peer-led intervention on tobacco use-related knowledge, attitude, normative beliefs, and intention to tobacco use of school children aged 14–17 years old. Methods: A school-based cluster randomized controlled intervention study was conducted among 1 st , 2 nd , and 3 rd grade high school children in Sanandaj City, Iran. 4-h integrated tobacco use prevention program comprising of four structured modules was developed and delivered to the intervention group by trained peer educator. Outcome measures comprised changes in students’ smoking-related knowledge, attitude, normative beliefs, and intention to tobacco use from baseline to 6-month follow-up through validated anonymous questionnaire. Results: The present study showed an intervention effect on tobacco use-related knowledge, normative beliefs, and intention to tobacco use but not attitude. The results indicated that there was significant decrease in intention to tobacco use ( P ≤ 0.013) observed after 6-month postintervention. The intervention module was also effective in improving smoking knowledge ( P ≤ 0.001), normative beliefs with regard to perceived prevalence of cigarette smoking and water-pipe use among adults and adolescents ( P ≤ 0.001) in intervention group 6-month postintervention. Conclusions: Participation in the peer-led education program to tobacco use prevention may have improvement in knowledge, normative beliefs, and intention to tobacco use. An implementation of the peer-led behavioral intervention components in the school setting may have a beneficial effect on public health by decreasing intention to tobacco use among nonsmoker adolescents.

Validation of the European Drug Addiction Prevention Trial Questionnaire (EU-Dap) for substance use screening and to assess risk and protective factors among early adolescents in Chile

“…This finding is supported by other studies [ 50 , 51 ] and emphasizes that students may be more influenced by their beliefs or the interpretation of reality than by the actual prevalence of drug use among friends [ 52 , 53 ]. Interventions aiming to increase critical thinking and fact-checking skills may help to reduce the impacts of these normative beliefs [ 19 , 54 ].…”

The Role of Knowledge, Attitude, Gender, and School Grades in Preventing Drugs Use: Findings on Students’ Intentions to Participate in Peer Education Program

“…The research at Iranian public high schools showed similar result between the groups of students who were given the peer education method and the groups of students who were not given peer education according to gender. 26 Meanwhile, research on high school students in Surabaya, Indonesia shows that gender has a significant relationship with intention to participate in peer education programs in efforts to prevent drug abuse, where women have higher intentions than men. 27 …”

Peer‐led interventions to reduce alcohol consumption in college students: A scoping review

“…Peers are defined as people who share similar characteristics, circumstances or experiences. Several studies have demonstrated their effectiveness in changing tobacco use behaviours among young people (Bilgiç & Günay, 2018;Ford et al, 2013;Mohammadi et al, 2019;Orsal & Ergun, 2021). To date, the evidence of the use of peer-led interventions to prevent alcohol consumption is weak and scarce, as was evidenced in a recent meta-analysis of peer-led programmes for alcohol use among youth ages 11 to 21 (Georgie et al, 2016).…”