Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2015 Oct 24:15:1088.
doi: 10.1186/s12889-015-2428-4.

Six-months follow-up of a cluster randomized trial of school-based smoking prevention education programs in Aceh, Indonesia

Teuku Tahlil  1 , Richard J Woodman  2 , John Coveney  3 , Paul R Ward  4
Affiliations
Randomized Controlled Trial

Six-months follow-up of a cluster randomized trial of school-based smoking prevention education programs in Aceh, Indonesia

Teuku Tahlil et al. BMC Public Health. .

Abstract

Background: Smoking prevention programs have been taught in schools to reduce the high smoking prevalence and its related problems among adolescent populations. Although short-term benefits have been observed, the long-term effectiveness of such programs appear to be inconsistent. This study aims at investigating the long-term impact of both health and Islamic focused interventions amongst students in Indonesia.

Methods: At 6 months after completion of the interventions, 427 of the original 447 participants (control group = 128, intervention groups = 299) from a school-based cluster randomized control trial were re-assessed for their smoking knowledge, attitudes, intentions and behaviours using a self-report questionnaire. Data was analyzed according to the study's 2 × 2 factorial design with adjustment for baseline scores, school and classroom clustering effects and multiple comparisons.

Results: Compared to the control group, significant long term effects were found for the health-based intervention program in improved health (β = 4.3 ± 0.4, p < 0.001), Islamic (β = 1.1 ± 0.4, p = 0.01) knowledge and a reduction of smoking attitudes (β = -11.5 ± 1.8, p < 0.001). For the Islamic-based intervention programs there was an improvement of health (β = 3.7 ± 0.4, p < 0.001) and Islamic (β = 2.2 ± 0.5, p < 0.001) knowledge and a reduction towards smoking attitude (β = -6.0 ± 1.9, p < 0.01) and smoking behaviors in the past month (OR = 0.1, 95 % CI = 0.0-0.8, p = 0.03). The effects were greater but less than additive in the combined group for health (β = -3.2 ± 0.9, p < 0.001 for interaction) and Islamic knowledge (β = -2.3 ± 0.9, p = 0.01 for interaction) but were additive for smoking attitudes (β = 6.1 ± 3.2, p = 0.07 for interaction). No significant effects on smoking intentions were observed at 6 months follow-up in the health or Islamic-based intervention programs.

Conclusion: School-based programs can provide long term benefits on Indonesian adolescents' smoking knowledge and attitudes. Tailoring program intervention components with participants' religious background might maximise program effectiveness. A larger and more encompassing study is now required to confirm the effectiveness of this new Indonesia culturally-based program. Adolescents in similar areas might also benefit from this type of school-based smoking cessation program.

Trial registration: Australian New Zealand Clinical Trial Registry, ACTRN12612001070820.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Study Participants by groups from baseline to 6 months follow-up
Fig. 2
Fig. 2
Groups comparison in knowledge, attitudes, intentions and behaviors at 6 months follow-up
See this image and copyright information in PMC

References

    1. World Health Organization . Enforcing bans on tobacco advertising, promotion and sponsorship: WHO Report on the global tobacco epidemic. Geneva: World Health Organization; 2013.
    1. World Health Organization . Global tuberculosis control: WHO report 2010. Geneva: World Health Organization; 2010.
    1. Centers for Disease Control and Prevention . The health consequences of smoking-50 years of progress. A report of the surgeon general. 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; 2014.
    1. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60. doi: 10.1016/S0140-6736(12)61766-8. - DOI - PMC - PubMed
    1. World Health Organization . WHO report on the global tobacco epidemic 2008: The MPOWER package. Geneva: World Health Organization; 2008.

Publication types

MeSH terms