Background and aims: Most consumers of tobacco begin to consume it before age 18. The aim of this study was to determine the effect of community and school-based interventions to reduce tobacco consumption in high school students.
Methods: This was a randomized community intervention trial. We first selected two economically and culturally similar cities including Ajabshir and Malekan in East Azerbaijan province, Iran, then one city, Ajabshir, was randomly selected for intervention. The intervention included educational activities and community-based environmental policies. Final year high school students including 1965 and 2457 were participants of the study in the intervention and control group, respectively. The outcome was reduction in the prevalence of tobacco use. All analysis conducted in SPSS version 19 using paired t test, analysis of covariance, independent t-test and chi square.
Results: Finally 1885 and 2302 participants in intervention and control groups (cities) were analyzed, respectively. Intervention significantly increased the awareness and prevented the adverse changes in attitude and attention to tobacco use (P<0.001). After the intervention, onset of cigarette and hookah smoking in control group was more than in intervention group (P<0.001). Cigarette and hookah smoking at 1 and 6 months in both groups increased, but consumption in the past 30 days was higher in the intervention group (P<0.001). Attempting to quit cigarette increased in the intervention group and reduced in the control group (P<0.001). Attempting to quit the hookah declined in both groups. In intervention group, there was significant increased attempt to quit cigarette smoking in families (P<0.001). Teachers were cited as the most effective educational resource by students.
Conclusion: In control group, onset of tobacco smoking in the last six months has been impressive. It shows a new wave of consumers that need to serious and urgent attention to prevent adolescent's tobacco use. Our experience showed that teacher's existence in the program, face-to-face explanation the tobacco importance for the authorities and participation as well as inter-sectorial coordination can be effective methods to tobacco prevention and control.
- Community intervention trial
- tobacco use
- community-based intervention.
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