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

a:4:{i:0;s:415:"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.";i:1;s:485:"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 x 2 factorial design with adjustment for baseline scores, school and classroom clustering effects and multiple comparisons.";i:2;s:1037:"Results: Compared to the control group, significant long term effects were found for the health-based intervention program in improved health (beta = 4.3 +/- 0.4, p < 0.001), Islamic (beta = 1.1 +/- 0.4, p = 0.01) knowledge and a reduction of smoking attitudes (beta = -11.5 +/- 1.8, p < 0.001). For the Islamic-based intervention programs there was an improvement of health (beta = 3.7 +/- 0.4, p < 0.001) and Islamic (beta = 2.2 +/- 0.5, p < 0.001) knowledge and a reduction towards smoking attitude (beta = -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 (beta = -3.2 +/- 0.9, p < 0.001 for interaction) and Islamic knowledge (beta = -2.3 +/- 0.9, p = 0.01 for interaction) but were additive for smoking attitudes (beta = 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.";i:3;s:480:"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.";}