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Smoking and tobacco
Protocol
Photoaging smartphone app promoting poster campaign to reduce smoking prevalence in secondary schools: the Smokerface Randomized Trial: design and baseline characteristics
  1. Titus J Brinker1,
  2. Julia Holzapfel1,
  3. Tanja G Baudson2,
  4. Katharina Sies3,
  5. Lena Jakob3,
  6. Hannah Maria Baumert3,
  7. Marlene Heckl4,
  8. Ana Cirac4,
  9. Janina L Suhre5,
  10. Verena Mathes1,
  11. Fabian N Fries6,
  12. Hannah Spielmann6,
  13. Nancy Rigotti7,
  14. Werner Seeger1,
  15. Felix Herth8,
  16. David A Groneberg9,
  17. Tobias Raupach10,
  18. Henning Gall1,
  19. Claudia Bauer8,
  20. Pat Marek11,
  21. Anil Batra12,
  22. Chase H Harrison13,
  23. Lava Taha14,
  24. Andreas Owczarek1,
  25. Felix J Hofmann1,
  26. Roger Thomas15,
  27. Ute Mons16,
  28. Michael Kreuter8
  1. 1Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
  2. 2University of Duisburg-Essen, Essen, Germany
  3. 3University of Freiburg, Freiburg im Breisgau, Germany
  4. 4Technical University of Munich, Munich, Germany
  5. 5University of Bonn, Bonn, Germany
  6. 6Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany
  7. 7Massachusetts General Hospital, Boston, Massachusetts, USA
  8. 8Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), Member of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
  9. 9Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt, Germany
  10. 10Department of Cardiology and Pneumology, University Medical Centre, Göttingen, Germany
  11. 11Division of Public Health Sciences, Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
  12. 12Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
  13. 13Department of Government, Faculty of Arts and Sciences, Harvard University, Cambridge, Massachusetts, USA
  14. 14University of Erlangen-Nuremberg, Erlangen, Germany
  15. 15University of Calgary, Health Sciences Centre, Calgary, Alberta, Canada
  16. 16Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
  1. Correspondence to Titus J Brinker; titus.brinker{at}gmail.com

Abstract

Introduction Smoking is the largest cause of preventable death globally. Most smokers smoke their first cigarette in early adolescence. We took advantage of the widespread availability of mobile phones and adolescents’ interest in appearance to develop a free photoaging app which is promoted via a poster campaign in secondary schools. This study aims to evaluate its effectiveness regarding smoking prevalence and students’ attitudes towards smoking.

Methods and analysis A randomised controlled trial is conducted with 9851 students of both genders with an average age of 12 years in grades 6 and 7 of 126 secondary schools in Germany. At present, cigarette smoking prevalence in our sample is 4.7%, with 4.6% of the students currently using e-cigarettes (1.6% use both). The prospective experimental study design includes measurements at baseline and at 6, 12 and 24 months postintervention via a questionnaire plus a random cotinine saliva sample at 24 months postintervention. The study groups consist of randomised schools receiving the Smokerface poster campaign and control schools with comparable baseline data (no intervention). The primary end point is the difference of change in smoking prevalence in the intervention group versus the difference in the control group at 24 months follow-up. Longitudinal changes in smoking-related attitudes, the number of new smokers and quitters and the change in the number of never-smokers will be compared between the two groups as secondary outcomes.

Ethics and dissemination Ethical approval was obtained from the ethics committee of the University of Gießen and the ministries of cultural affairs, both in Germany. Results will be disseminated at conferences, in peer-reviewed journals, on our websites and throughout the multinational Education Against Tobacco network.

Trial registration number NCT02544360, Pre-results.

  • Smokerface
  • tobacco prevention
  • mobile apps
  • schools
  • photoaging

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-014288

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    Footnotes

    • Contributors TJB wrote the manuscript, designed all figures, contributed substantially to the development of the questionnaire and supported statistical analysis for the item selection, coordinated and conducted parts of the pilot study, initiated and designed the study, raised the funds, invented, conceived and pretested the posters; invented, conceived and optimised the Smokerface and the Smokerstop app, coordinated the conduct of the study and conducted the baseline analysis and will support outcome analysis. JH organised, coordinated and conducted data collection of 58 schools in the region of Thüringen, implemented the intervention in this region, pretested the questionnaire, conducted the pilot study, contributed to baseline analysis, supported the design of the posters and will conduct statistical analysis. NR and UM proofread the manuscript and made substantial contributions to the design of the study. MK, CB and FH coordinated the data collection of 32 schools in the Rhine-Neckar region of Germany, contributed to the study design and proofread the manuscript. TGB contributed substantially to the development of the questionnaire, conducted the statistical analysis for the item selection, wrote most of the section describing the questionnaire as well as most of the section on the Theory of Planned Behavior (expanded on in the long version of the protocol) and proofread the manuscript. WS and HG support the coordination of the study and proofread the manuscript. TR, RT and DAG contributed to the design of the questionnaire and proofread the manuscript. KS, LJ and HMB coordinated the data collection in 12 schools in Freiburg, implemented the intervention in this region and proofread the manuscript. FNF and HS coordinated the data collection in seven schools in Rhineland-Palatinate, implemented the intervention in this region and proofread the manuscript. MH and AC coordinated the data collection in eight schools in Munich, implemented the intervention in this region and proofread the manuscript. JLS coordinated the data collection in three schools in Bonn, implemented the intervention in this region and proofread the manuscript. VM coordinated the data collection in five schools in Fulda, implemented the intervention in this region and proofread the manuscript. PM contributed to the study design and proofread the manuscript. AB contributed to the design of the study and proofread the manuscript. CHH contributed to the design of the questionnaire and proofread the manuscript. LT coordinated the data collection in two schools in Erlangen, implemented the intervention in this region and proofread the manuscript. FJH substantially contributed to the concept of data entry and proofread the manuscript. AO substantially contributed to the protocol for data collection, critically reviewed the design of the study and proofread the final manuscript.

    • Funding The Smokerface Randomized Trial was funded by the German Heart Foundation (Bockenheimer Landstraße 94–96, 60323 Frankfurt am Main, Germany). The German Heart Foundation had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review, or approval of the manuscript.

    • Competing interests There are no financial competing interests with regards to the Smokerface App. The Smokerface App is free and contains no advertising. It was designed for charitable causes.

    • Ethics approval Ethics committee of the University of Giessen and the ministries of cultural affairs of the six federal states participating in Germany including its amendment to collect cotinine saliva samples.

    • Provenance and peer review Not commissioned; peer reviewed for ethical and funding approval prior to submission.

    • Data sharing statement The translated posters for print and details on the development of the questionnaire can be freely accessed (after this manuscript is published) on our website educationtobacco.org/smokerface-randomized-trial.