Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

The impact of education programs on smoking prevention: a randomized controlled trial among 11 to 14 year olds in Aceh, Indonesia

Authors: Teuku Tahlil, Richard J Woodman, John Coveney, Paul R Ward

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

School-based smoking prevention programs have been shown to increase knowledge of the negative effects of smoking and prevent tobacco smoking. The majority of evidence on effectiveness comes from Western countries. This study investigated the impact of school-based smoking prevention programs on adolescents’ smoking knowledge, attitude, intentions and behaviors (KAIB) in Aceh, Indonesia.

Methods

We conducted a 2 × 2 factorial randomized controlled trial among 7th and 8th grade students aged 11 to 14 years. Eight schools were randomly assigned to a control group or one of three school-based programs: health-based, Islamic-based, or a combined program. Students in the intervention groups received eight classroom sessions on smoking prevention education over two months. The KAIB impact of the program was measured by questionnaires administered one week before and one week after the intervention.

Results

A total of 477 students participated (58% female, 51% eighth graders). Following the intervention, there was a significant main effect of the Health based intervention for health knowledge scores (β = 3.9 ± 0.6, p < 0.001). There were significant main effects of the Islamic-based intervention in both health knowledge (β = 3.8 ± 0.6, p < 0.001) and Islamic knowledge (β = 3.5 ± 0.5, p < 0.001); an improvement in smoking attitude (β = −7.1 ± 1.5, p < 0.001). The effects of Health and Islam were less than additive for the health and Islamic factors for health knowledge (β = −3.5 ± 0.9, p < 0.01 for interaction) and Islamic knowledge (β = −2.0 ± 0.8, p = 0.02 for interaction). There were no significant effects on the odds of intention to smoke or smoking behaviors.

Conclusions

Both Health and Islamic school-based smoking prevention programs provided positive effects on health and Islamic related knowledge respectively among adolescents in Indonesia. Tailoring program interventions with participants’ religion background information may provide additional benefits to health only focused interventions.

Trial registration

Australia and New Zealand Clinical Trials Register, ACTRN12612001070​820
Appendix
Available only for authorised users
Literature
1.
Ng N, Weinehall L, Ohman A: ‘If I don’t smoke, I’m not a real man’–Indonesian teenage boys’ views about smoking. Health Educ Res. 2007, 22 (6): 794-804.CrossRefPubMed
2.
World Health Organization [WHO]: The MPOWER package. WHO report on the global tobacco epidemic, 2008. 2008, Geneva: World Health Organization
3.
Centers for Disease Control and Prevention [CDC]: Global youth tobacco survey (GYTS) Data (Ages 13 to 15). Indonesia-National 2006. 2009, Atlanta: Centers for Disease Control and Prevention [CDC]
4.
Thaib T: Hasil Riskesdas Depkes RI: Aceh perokok berat dan paling jorok. 2009, Banda Aceh: Serambi Indonesia
5.
Centers for Disease Control and Prevention: Best Practices for Comprehensive Tobacco Control Programs—2007. 2007, Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health
6.
Aditama T: Philip Morris comes to Indonesia: What does a company get for $5 billion?. Multinational Monitor. 2005, 26: 26-28.
7.
Gingiss PM, Roberts-Gray C, Boerm M: Bridge-It: a system for predicting implementation fidelity for school-based tobacco prevention programs. Prev Sci. 2006, 7 (2): 197-207. 10.1007/s11121-006-0038-1.CrossRefPubMed
8.
Park E: School-based smoking prevention programs for adolescents in South Korea: a systematic review. Health Educ Res. 2006, 21 (3): 407-415. 10.1093/her/cyl038.CrossRefPubMed
9.
Lee P-H, Wu DM, Lai H-R, Chu NF: The impacts of a school-wide no smoking strategy and classroom-based smoking prevention curriculum on the smoking behavior of junior high school students. Addict Behav. 2007, 32: 1-18. 10.1016/j.addbeh.2006.03.007.CrossRef
10.
Sun P, Miyano J, Rohrbach LA, Dent CW, Sussman S: Short-term effects of project EX-4: a classroom-based smoking prevention and cessation intervention program. Addict Behav. 2007, 32: 342-350. 10.1016/j.addbeh.2006.05.005.CrossRefPubMed
11.
Johnson CA, Unger JB, Ritt-Olson A, Palmer PH, Cen S, Gallaher P, Chou C-P: Smoking prevention for ethnically diverse adolescents: 2-year outcomes of a multicultural, school-based smoking prevention curriculum in Southern California. Prev Med. 2005, 40: 842-852. 10.1016/j.ypmed.2004.09.032.CrossRefPubMed
12.
Chen X, Fang X, Li X, Stanton B, Lin D: Stay away from tobacco: a pilot trial of a school-based adolescent smoking prevention program in Beijing, China. Nicotine Tob Res. 2006, 8 (2): 227-237. 10.1080/14622200600576479.CrossRefPubMed
13.
Wiehe SE, Garrison MM, Christakis DA, Ebel BE, Rivara FP: A systematic review of school-based smoking prevention trials with long-term follow-up. J Adolesc Health. 2005, 36: 162-169. 10.1016/j.jadohealth.2004.12.003.CrossRefPubMed
14.
Thomas RE, Perera R: School-based programmes for preventing smoking. Cochrane Database Syst Rev. 2006, 3: CD001293-PubMed
15.
Flay BR: School-based smoking prevention programs with the promise of long-term effects. Tob Induc Dis. 2009, 5 (1): 1-18. 10.1186/1617-9625-5-1.CrossRef
16.
Rew L, Wong YJ: A systematic review of associations among religiosity/spirituality and adolescent health attitudes and behaviors. J Adolesc Health. 2006, 38 (4): 433-442. 10.1016/j.jadohealth.2005.02.004.CrossRefPubMed
17.
Sinha JW, Cnaan RA, Gelles RJ: Adolescent risk behaviors and religion: findings from a national study. J Adolesc. 2007, 30 (2): 231-249. 10.1016/j.adolescence.2006.02.005.CrossRefPubMed
18.
Jabbour S, Fouad FM: Religion-based tobacco control interventions: how should WHO proceed?. Bull World Health Organ. 2004, 82 (12): 923-927.PubMed
19.
Cheng H-H, Yeh M-L: Developing and evaluating a smoking cessation program combined with an Internet-assisted instruction program for adolescents with smoking. Patient Educ Couns. 2006, 61: 411-418. 10.1016/j.pec.2005.05.007.CrossRef
20.
Resnicow K, Reddy SP, James S, Gabebodeen Omardien R, Kambaran NS, Langner HG: Comparison of two school-based smoking prevention programs among South African high school students: results of a randomized trial. Ann Behav Med. 2008, 36 (3): 231-243. 10.1007/s12160-008-9072-5.CrossRefPubMed
21.
Saloojee Y, Chaouki N: Tobacco-free Mecca and Medina. 2007, Cairo: World Health Organization, Regional Office for the Eastern Mediterranean
22.
Aal-ish-Sheikh MbI, As-Sa'di A-RbN, Baaz A-AbAb: Fataawaa concerning Tobacco and Cigarettes. 2000, Karachi, Pakistan: Vision Publication
23.
Koumi I, Tsiantis J: Smoking trends in adolescence: report on a Greek school-based, peer-led intervention aimed at prevention. Health Promot Int. 2001, 16 (1): 65-72. 10.1093/heapro/16.1.65.CrossRefPubMed
24.
Centers for Disease Control and Prevention: Department of Health and Human services. 2009 Middle School Youth Risk Behavior Survey. 2009, Atlanta, Georgia: Center for Disease Control and Prevention
25.
Harris-Hayes M, Holtzman GW, Earley JA, Van Dillen LR: Development and preliminary reliability testing of an assessment of patient independence in performing a treatment program: standardized scenarios. J Rehabil Med. 2010, 42 (3): 221-227. 10.2340/16501977-0505.CrossRefPubMedPubMedCentral
26.
Yeretzian JS, Afifi RA: ‘It won’t happen to me’: the knowledge-attitude nexus in adolescent smoking. J Public Health. 2009, 31 (3): 354-359. 10.1093/pubmed/fdp031.CrossRef
27.
Rosendahl KI, Galanti MR, Gilljam H, Ahlbom A: Knowledge about tobacco and subsequent use of cigarettes and smokeless tobacco among Swedish adolescents. J Adolesc Health. 2005, 37 (3): 224-228. 10.1016/j.jadohealth.2004.08.021.CrossRefPubMed
28.
29.
Tober DM, Budiani D: Introduction: Why islam, health and the body?. Body & Society. 2007, 13: 1-13.CrossRef
30.
31.
Taylor K: Smoking still popular despite Ulema edict. The Jakarta Post. Sun, 02/01/2009 edn. 2009, Jakarta: PT Bina Tenggara
32.
Jarvis MJ, Goddard E, McNeill A: Do attitudes predict uptake of smoking in teenagers? Case not proven. Soc Sci Med. 1990, 31 (9): 997-1000. 10.1016/0277-9536(90)90109-6.CrossRefPubMed
33.
Scollo MM, Winstanley MHE: Tobacco in Australia: Facts and Issues. 2008, Melbourne: Cancer Council Victoria, 3
34.
Resnicow K, Zhang N, Vaughan RD, Reddy SP, James S, Murray DM: When intraclass correlation coefficients go awry: a case study from a school-based smoking prevention study in south africa. Am J Public Health. 2010, 100 (9): 1714-1718. 10.2105/AJPH.2009.160879.CrossRefPubMedPubMedCentral
35.
Schofield MJ, Lynagh M, Mishra G: Evaluation of a health promoting schools program to reduce smoking in australian secondary schools. Health Educ Res. 2003, 18 (6): 678-692. 10.1093/her/cyf048.CrossRefPubMed
36.
George D, Mallery P: SPSS for windows step by step: A simple guide and reference. 2006, Boston: Pearson Education, Inc., 6
37.
Stanton WR, Barnett AG, Silva PA: Adolescents’ intentions to smoke as a predictor of smoking. Prev Med. 2005, 40 (2): 221-226. 10.1016/j.ypmed.2004.05.026.CrossRefPubMed
38.
Janega JB, Murray DM, Varnell SP, Blitstein JL, Birnbaum AS, Lytle LA: Assessing the most powerful analysis method for school-based intervention studies with alcohol, tobacco, and other drug outcomes. Addict Behav. 2004, 29 (3): 595-606. 10.1016/j.addbeh.2004.01.002.CrossRefPubMed
39.
Perry CP, Stigler MPMPH, Arora MM, Reddy KM: Preventing tobacco use among young people in india: project MYTRI. Am J Public Health. 2009, 99 (5): 899-10.2105/AJPH.2008.145433.CrossRefPubMedPubMedCentral
40.
Hanewinkel R, Asshauer M: Fifteen-month follow-up results of a school-based life-skills approach to smoking prevention. Health Educ Res. 2004, 19 (2): 125-137. 10.1093/her/cyg018.CrossRefPubMed
41.
Rundall TG, Bruvold WH: A meta-analysis of school-based smoking and alcohol use prevention programs. Health Educ Quart. 1988, 15 (3): 317-334. 10.1177/109019818801500306.CrossRef
42.
Dobbins M, DeCorby K, Manske S, Goldblatt E: Review: effective practices for school-based tobacco use prevention. Prev Med. 2008, 46: 289-297. 10.1016/j.ypmed.2007.10.003.CrossRefPubMed
Metadata
Title
The impact of education programs on smoking prevention: a randomized controlled trial among 11 to 14 year olds in Aceh, Indonesia
Authors
Teuku Tahlil
Richard J Woodman
John Coveney
Paul R Ward
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-367

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue

Debate

Biobanking across the phenome - at the center of chronic disease research

Research article

Impact of human papillomavirus-related genital diseases on quality of life and psychosocial wellbeing: results of an observational, health-related quality of life study in the UK

Study protocol

Study protocol of a randomized controlled trial to improve cancer prevention behaviors in adolescents and adults using a web-based intervention supplemented with SMS

Research article

A cross-sectional study to assess knowledge about HIV/AIDS transmission and prevention measures in company workers in Ecuador

Research article

Improving immunisation timeliness in Aboriginal children through personalised calendars

Research article

The impact of a cardiovascular health awareness program (CHAP) on reducing blood pressure: a prospective cohort study