A Randomized Controlled Trial of a Theory-Informed School-Based Intervention to Prevent Waterpipe Tobacco Smoking: Changes in Knowledge, Attitude, and Behaviors in 6th and 7th Graders in Lebanon

Rima Nakkash, Tamara Lotfi, Dima Bteddini, Pascale Haddad, Hala Najm, Lina Jbara, Hala Alaouie, Lama Al Aridi, Ahmad Al Mulla, Ziyad Mahfoud and Rima A. Afifi
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Rima Nakkash: Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
Tamara Lotfi: Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
Dima Bteddini: Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
Pascale Haddad: Independent consultant, Dusseldorf 40210, Germany
Hala Najm: Soins Infirmiers et Développement Communautaire (SIDC), Sin El Fil 1100, Lebanon
Lina Jbara: Academic Coordinator, Sorbonne University Abu Dhabi, 38044 Abu Dhabi, United Arab Emirates
Hala Alaouie: Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
Lama Al Aridi: Independent consultant, Aley 1501, Lebanon
Ahmad Al Mulla: Department of Medicine, Hamad Medical Corporation, Doha 4147, Qatar
Ziyad Mahfoud: Department of Global and Public Health, Weill-Cornell Medicine, Doha 24144, Qatar
Rima A. Afifi: Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon

IJERPH, 2018, vol. 15, issue 9, 1-17

Abstract: Waterpipe tobacco smoking (WTS) is spreading worldwide. Research has indicated health consequences of WTS similar to cigarettes. Prevalence of WTS is high among young people. In Lebanon, current use rates of 35% have been documented among 13–15 year olds. We evaluated a school-based intervention. Method : We conducted a randomized-controlled-trial of a theory-informed WTS intervention. The intervention consisted of ten sessions based on social cognitive theory and the social influences approach. Thirty-one schools participated: 14 intervention and 17 control; a total of 1279 students completed pre and post assessments. We measured knowledge, attitudes and self-reported behaviors related to WTS using Chi-square tests and regression analyses to compare results between the two study arms. Results : The intervention increased knowledge of intervention group compared to control group participants—about WTS constituents and health consequences; and shifted attitudes of intervention group participants to be even more unfavorable towards WTS. We found no impact of the intervention on WTS behaviors. Discussion : The effectiveness of the intervention on knowledge and attitudes supports previous research. The lack of intervention effect on behavior is not surprising given the timing of the post assessment immediately after the intervention, and the social context that was supportive of waterpipe use.

Keywords: waterpipe; intervention; Lebanon; school; evaluation; RCT (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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