{
  "abstract": "Background Adolescence is a critical period for tobacco initiation, and intention to use tobacco strongly predicts uptake. In Nigeria, adolescent tobacco use is a growing concern requiring early prevention. We evaluated a Health Belief Model (HBM)-based tobacco-education intervention on knowledge, harm-perception and intention to use tobacco among in-school adolescents in Ibadan, Nigeria.Methods A two-arm, parallel, cluster-randomised controlled trial was conducted among 720 students aged 12–19 years. Schools were randomly assigned to an intervention group (IG) or a control group (CG). IG participants received a 45 min HBM-based tobacco education session reinforced with culturally adapted posters and notebooks developed from the WHO Tobacco Control Manual for Secondary Schools; the CG participants received a general health lecture. Assessments were conducted at baseline, immediately postintervention and at 6 months. The primary outcome was intention to use tobacco; secondary outcomes included tobacco-related knowledge and harm-perception. Analyses followed intention-to-treat principles. Cluster-adjusted logistic generalised estimating equation models were used to estimate intervention effects on intention.Results At baseline, intention to use tobacco was identical in both groups (13.6%). At 6-month follow-up, intention declined in the IG (8.9%) but increased in the CG (14.4%). In cluster-adjusted analyses, IG participants had lower odds of reporting intention to use tobacco than CG participants (adjusted OR 0.57, 95% CI 0.35 to 0.94), with no evidence of effect modification by age group. The IG also showed greater improvements in knowledge and harm-perception.Conclusions This brief, theory-driven, culturally adapted school-based intervention reduced intention to use tobacco and improved tobacco-related knowledge and harm-perception among adolescents. The findings support the integration of evidence-based tobacco education into adolescent tobacco prevention strategies in low-income and middle-income countries.Trial registration number PACTR202103802475677.",
  "authors": [
    {
      "affiliations": [
        "Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria",
        "School of Public Health, University of Nevada Reno, Reno, Nevada, USA"
      ],
      "name": "Omotayo Francis Fagbule"
    },
    {
      "affiliations": [
        "Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria"
      ],
      "name": "Ejiro Idiga"
    },
    {
      "affiliations": [
        "Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria",
        "Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria"
      ],
      "name": "Mary Ebelechukwu Osuh"
    },
    {
      "affiliations": [
        "Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria",
        "Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria"
      ],
      "name": "Folake Barakat Lawal"
    },
    {
      "affiliations": [
        "School of Public Health, University of Nevada Reno, Reno, Nevada, USA",
        "Ozmen Institue for Global Studies, University of Nevada Reno, Reno, Nevada, USA"
      ],
      "name": "Eric Crosbie"
    },
    {
      "affiliations": [
        "Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria",
        "Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria"
      ],
      "name": "Olushola Ibiyemi"
    },
    {
      "affiliations": [
        "Department of Population Health, The University of Kansas School of Medicine, Kansas City, Kansas, USA"
      ],
      "name": "Babalola Faseru"
    },
    {
      "affiliations": [
        "Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria",
        "Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria"
      ],
      "name": "Gbemisola Aderemi Oke"
    }
  ],
  "title": "Effectiveness of a school-based health education intervention on tobacco use intention among adolescents: a cluster-randomised controlled trial",
  "uid": "cdb391ec-cd60-5875-85f0-b7908ff19dcb"
}