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Randomized Controlled Trial
. 2025 Aug;19(8):e70119.
doi: 10.1111/crj.70119.

Effect of Educational Intervention Based on Theory of Planned Behavior on Reducing Smoking and Hookah Use Among High School Male Students

Ali Zarei  1 , Abbas Shamsalinia  2 , Asiyeh Yari  3 , Pooyan Afzali Hasirini  4 , Ali Khani Jeihooni  5
Affiliations
Randomized Controlled Trial

Effect of Educational Intervention Based on Theory of Planned Behavior on Reducing Smoking and Hookah Use Among High School Male Students

Ali Zarei et al. Clin Respir J. 2025 Aug.

Abstract

Background: Using smoking and hookah has increased among high school students in recent years. Therefore, the present study aimed to determine the effect of educational intervention based on the theory of planned behaviour (TPB) on reducing smoking and hookah use among high school students.

Methods: This experimental study was conducted on 300 high school male students in Fasa City, Fars Province, Iran, in 2021-2022. Subjects were selected using a simple sampling method and were randomly divided into intervention (n = 150) and control (n = 150) groups. The educational intervention for the experimental group included 7 sessions of 45-55 min using small group discussion, question and answer, practical demonstrations, video clips, PowerPoint, and booklets. Before the intervention and 3 months after the educational intervention, both experimental and control groups completed the questionnaire. Data were analyzed using SPSS 22 software through Chi-square, independent t-test, paired t-test, and McNemar test.

Results: The mean age of the experimental and control groups was 17.89 + 1.46 and 17.1 + 1.58 years. The results showed that before the educational intervention, there was no significant difference between the experimental and control groups in terms of awareness, attitude, subjective norms, perceived behavioral control, and behavioral intention; however, 4 months after the educational intervention, there was a significant increase in the experimental group. Also, before the educational intervention, there was no significant difference between the two groups in terms of current smoking and hookah use; however, 4 months after the intervention, there was a significant difference between the two groups.

Conclusion: Implementing the TPB-directed instructional sessions resulted in reducing smoking and hookah use among high school students.

Keywords: hookah; smoking; students; theory of planned behavior (TPB).

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

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FIGURE 1
Study population selection chart.
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