Smoking Prevention Interventions Research Articles

Joining forces: Developing a smoking prevention intervention in social work organisations through co-creation with adolescents and youth workers

BackgroundAdolescents experiencing societal vulnerability confront a higher risk of smoking initiation, thereby perpetuating health disparities. To develop a smoking prevention intervention tailored to these adolescents, employing a participatory approach such as co-creation with adolescents and key stakeholders can ensure alignment with their needs. Navigating a co-creation process, especially concerning a sensitive topic like smoking, remains uncharted territory in existing literature, particularly when engaging with hard-to-reach youth. ObjectiveThis paper describes the co-creative process underpinning the KickAsh!-intervention, a smoking prevention program involving youth workers and 10–15-year-olds experiencing societal vulnerability. MethodsFour youth workers (Mage = 23.75 ± 0.96 years) and nine adolescents (Mage = 13.56 ± 0.73 years) from two social work organisations in Ghent, Belgium, participated in an eight-month co-creation trajectory together with two academic researchers and one design thinking specialist. The Double Diamond Model (DDM) and the Intervention Mapping Protocol (IMP) facilitated this trajectory. The objectives and working methods from each co-creation session are described. ResultsThe outcomes of each co-creation session and how these findings have shaped the development of the KickAsh!-intervention – a comprehensive website consisting of materials developed in collaboration with youth workers and adolescents – are described. ConclusionThis paper emphasises the value of prioritising participatory designs (such as DDM) structured by a theory- and evidence-based framework for intervention development (such as IMP). This approach enabled us to devise intervention strategies rooted in the lived experiences of adolescents and youth workers, ensuring practicality within the given context. The developed KickAsh!-intervention closely aligns with the preferences of both adolescents and youth workers. It prioritises creative elements informed by theory and scientific evidence with the expectation of achieving impact. However, further research is needed to evaluate the effectiveness of the KickAsh!- intervention.

Effect of a peer-led prevention program (P2P) on smoking in vocational high school students: Results from a two-school-year cluster-randomized trial.

The aim of this work was to measure the impact of P2P (i.e. peer-to-peer), a peer-led smoking prevention intervention, on daily smoking prevalence of adolescents over 2 school years. A cluster-randomized controlled trial was performed over a 16-month follow-up (trial status: closed to follow-up). P2P was implemented 1-3 and 13-15 months after baseline. Assessments took place at baseline and 4, 10 and 16 months after baseline. The research team, assessors and adolescents were blinded to the study-arm assignment only at baseline. Fifteen vocational high schools in France were randomized into two clusters, using a 1:1 allocation ratio per French department (n intervention = 7, n control = 8). Participants comprised a sample of 2010 students in year 11 (i.e. 15-16 years) in vocational high schools. A total of 437 students could not be assessed at baseline (absent or left school), yielding a total sample of 1573 students (n intervention = 749, n control = 824). The P2P programme trained voluntary students to become peer educators and design smoking prevention actions for their schoolmates in the intervention group (n = 945 students), compared with a passive control group (n = 1065 students). The primary outcome was change from baseline in the prevalence of self-reported daily smoking (i.e. at least one cigarette per day) at 16 months. The 'time × group' interaction indicated that, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 16 months [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.20, 0.53]. Similarly, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 4months (OR = 0.50, 95% CI = 0.30, 0.82) and 10months (OR = 0.60, 95% CI = 0.37, 0.98). No adverse events of P2P2 were reported. A cluster-randomized trial found evidence that the peer-led P2P (peer-to-peer) smoking prevention intervention reduced the uptake of daily smoking among high school students in France over 16 months.

Exploring a Potential Interaction Between the Effect of Specific Maternal Smoking Patterns and Comorbid Antenatal Depression in Causing Postpartum Depression.

To explore a potential interaction between the effect of specific maternal smoking patterns and the presence of antenatal depression, as independent exposures, in causing postpartum depression (PPD). This case-control study of participants with singleton term births (N = 51220) was based on data from the 2017-2018 Pregnancy Risk Assessment Monitoring System. Multivariable log-binomial regression models examined the main effects of smoking patterns and self-reported symptoms of antenatal depression on the risk of PPD on the adjusted risk ratio (aRR) scale and tested a two-way interaction adjusting for covariates selected in a directed acyclic graph (DAG). The interaction effects were measured on the additive scale using relative excess risk due to interaction (RERI), the attributable proportion of interaction (AP), and the synergy index (SI). Causal effects were defined in a counterfactual framework. The E-value quantified the potential impact of unobserved/unknown covariates, conditional on observed covariates. Among 6841 women in the sample who self-reported PPD, 35.7% also reported symptoms of antenatal depression. Out of 3921 (7.7%) women who reported smoking during pregnancy, 32.6% smoked at high intensity (≥10 cigarettes/day) in all three trimesters and 36.6% had symptoms of antenatal depression. The main effect of PPD was the strongest for women who smoked at high intensity throughout pregnancy (aRR 1.65; 95% CI: 1.63, 1.68). A synergistic interaction was detected, and the effect of all maternal smoking patterns was augmented, particularly in late pregnancy for Increasers and Reducers. Strong associations and interaction effects between maternal smoking patterns and co-occurring antenatal depression support smoking prevention and cessation interventions during pregnancy to lower the likelihood of PPD.

Assessing the Impact of a Health Education Anti-Smoking Program for Students: A Follow-Up Investigation.

In this follow-up study, we aimed to assess the effectiveness of the "I do not smoke, I exercise" anti-smoking preventive health education program. The program was based on the theory of planned behavior supplemented with life skills teaching and targeted at high school students. The intervention comprised ten one-hour online sessions, administered by physical education instructors. The study cohort comprised 222 students (109 boys, 113 girls) from 11 secondary schools, with an average age of 16.42 ± 1.36 years. Data collection involved pre- and post-intervention self-assessment questionnaires. The examined variables included attitudes towards smoking, intention to smoke, subjective norm, perceived behavioral control (PBC), knowledge about smoking, smoking behavior, exercise behavior, attitudes toward the program's implementation, and satisfaction with the program. A separate paired samples t-test revealed a significant improvement in students' knowledge about smoking (t217 = -5.605, p < 0.001, d = 0.38) and perceived behavioral control (t220 = -2.166, p < 0.05, d = 0.15) following the intervention. However, no significant changes were observed in the remaining variables. In addition, students' overall satisfaction with the implementation of the present health education program was high (M = 5.72 ± 1.39). These findings suggest that the health education smoking prevention intervention incorporates techniques and strategies that influence the perceived behavioral control variable, emphasizing students' strong interest in educationally theorized programs integrating technology into their design. Future studies should consider further examination of tobacco control strategies within the high school context.

Preventing smoking initiation in adolescents living in vulnerable socioeconomic conditions: Study protocol of the KickAsh!-intervention.

Adolescents living in vulnerable socioeconomic conditions are confronted with tobacco-related health disparities. As school-based interventions appear to be less effective among these youngsters, other approaches are necessary. One promising avenue is youth social work settings that offer sport and recreational activities (SR-settings). SR-settings have been examined as a levering context for health promotion, but evidence regarding smoking prevention is currently lacking. This study describes the protocol of a non-randomised cluster controlled trial evaluating a smoking prevention intervention for adolescents. At least 24 SR-settings are needed for the intervention and control group. A mixed-method design will be used. Quantitative measures will be used to assess effectiveness, involving validated questionnaires on smoking initiation behaviour and influencing factors (i.e. attitude, self-efficacy, social influence and risk perception). In addition, feasibility will be assessed with regard to intervention fidelity, dose and reach. Data will be collected at baseline, three and nine months following the intervention. To gain deeper understanding on the impact and underlying processes of the intervention, we will conduct qualitative interviews with users (adolescents) and implementers (youth workers within the SR-settings) of the intervention. Conducting this trial will offer novel insights into the effectiveness of a smoking prevention intervention designed for adolescents living in vulnerable socioeconomic conditions. A mixed-method design will enable to measure impact, implementation and underlying processes of the intervention. Overall, this design will enhance our understanding on the suitability of SR-settings as contexts for smoking prevention initiatives targeting hard-to-reach youth. This trial is registered on Clinicaltrials.gov: NCT05920772.

Technology-based interventions for tobacco smoking prevention and treatment: a 20-year bibliometric analysis (2003-2022).

Substance abuse, particularly tobacco smoking, is a significant global public health concern. Efforts have been made to reduce smoking prevalence and promote cessation, but challenges, such as nicotine addiction, marketing tactics by tobacco industry, and cultural acceptability hinder progress. Technology has emerged as a potential tool to address these challenges by providing innovative scalable interventions. The objective of the study was to analyze and map scientific literature on technology-based intervention for tobacco prevention and treatment. A bibliometric methodology was conducted. Scopus database was used to retrieve relevant research articles published between 2003 and 2022. The analysis included publication trends, key contributors, research hotspots, research themes, the most impactful articles, and emerging research topics. A total of 639 articles were found, with a slow and fluctuating growth pattern observed after 2011. The Journal of Medical Internet Research was the most prominent journal in the field. The United States was the leading country in the field, followed up by the United Kingdom, and the Netherlands. Research hotspots included smoking cessation, randomized controlled trials, and technology-based methods such as internet, mHealth, smartphone apps, text messages, and social media. Four primary research themes were identified: development of smartphone applications, efficacy of text messaging interventions, acceptance and effectiveness of smartphone applications, and interventions targeting young adults and students using mobile phone and social media platforms. The top 10 cited articles demonstrated effectiveness of digital interventions in promoting smoking cessation rates and reducing relapse rates. Emerging research topics included the use of virtual reality interventions, interventions for specific populations through personalized tools, and technology-based interventions in non-Western countries. The findings of the current study highlight the potential of technology to address the challenges associated with tobacco smoking. Further future research in this area is warranted to continue advancing the field and developing effective and evidence-based interventions to combat tobacco smoking.

A Smoking Prevention Intervention in an Online Community Game: Results from a Pilot Trial

Abstract Background Innovative methods for smoking prevention interventions need to be investigated to increase attractiveness, access hard-to-reach populations, and increase effectiveness. We studied the feasibility and immediate effects of an intervention to reinforce norms and behaviors of young people related to antismoking, integrated into a popular online community game. Methods A pilot randomized controlled trial was conducted through the HABBO online community. The intervention group was exposed to repeated discussion sessions with small groups of peer players and two facilitators once a week for 1 month (four sessions), inside the game. The control group had access to antismoking information websites. Process indicators (attractiveness, participation) and immediate outcomes (norms and intentions with regard to smoking) were assessed by questionnaire. Results One hundred sixteen players were invited to participate in the intervention; 10 did not meet eligibility criteria, 30 were allocated to the intervention group, and 76 to the control group. Median age was 23. Twenty-four percent were not in education, employment, or training. A median of eight players attended each session and the median number of exchange chats by session was 399; 70% of chat time was occupied by the players. Twenty players attended all four sessions. Immediate norms, representations, and intentions were evaluated in 39 players and showed small differences between groups. Conclusions Delivering and evaluating a smoking prevention intervention in an online game is feasible. In the targeted online community game, the intervention was attractive and allowed the delivery of innovative interventions to audiences with diverse social profiles. Long-term effects, sustainability, and evaluation methodology are discussed. Key messages • Entertainment video games (which have no initial interest in health issues) can be used as a field of intervention in public health. • Innovative contexts for delivering public health actions make it possible to reach audiences that more traditional interventions would not reach and open up prospects for reducing social inequalities.

Impact of implementation of a smoking prevention intervention on vocational students’ smoking status

Abstract Introduction Smoking prevalence is high in vocational education across Europe. School-based programs to reduce smoking among older adolescents and young adults are sparse. School tobacco policies are often used though the evidence for their effectiveness is inconclusive. The implementation process of far-reaching smoking prevention initiatives such as tobacco policies can be challenging due to, e.g., nicotine dependency and attitudes towards smoking. We investigated the association between implementation of a smoking prevention intervention and students’ smoking status. Methods The “Focus” intervention combined a comprehensive school tobacco policy with educational activities and access to smoking cessation support. It was tested in a cluster-randomized controlled trial in 14 Danish vocational schools. Based on a conceptual model, we calculated an individual level implementation score for all students in the intervention arm, including schools’ delivery (principal and teacher surveys) and students’ receipt (student surveys) of the intervention components at 4-5 month-follow-up. We compared odds for smoking daily or weekly (regular smoking) for students with low, medium, and high implementation with students in control schools using multilevel logistic regression models (N = 1112). Results Students with high implementation had significantly lower odds for smoking compared to the control group (OR: 0.37, 95% CI: 0.18-0.78) whereas students with medium (OR: 1.72, 95% CI: 0.95-3.12) and low (OR: 1.26, 95% CI: 0.68-2.34) implementation had higher odds, although insignificant. Conclusions High implementation of the “Focus” intervention was associated with less smoking. Tendencies in the opposite direction for lower implementation may indicate a complex, non-linear relationship between implementation level and smoking behavior. This suggests that careful implementation efforts are needed to reduce smoking in older adolescent and young adult school settings. Key messages • Our study suggests that efforts to support implementation of smoking prevention interventions are needed to reduce smoking in vocational education and similar settings. • To capture the complexity of the implementation process, we use an individual level measure of implementation based on a conceptual model and multiple data sources.

Selection homophily and peer influence for adolescents’ smoking and vaping norms and outcomes in high and middle-income settings

The MECHANISMS study investigates how social norms for adolescent smoking and vaping are transmitted through school friendship networks, and is the first study to use behavioral economics methodology to assess smoking-related social norms. Here, we investigate the effects of selection homophily (the tendency to form friendships with similar peers) and peer influence (a social process whereby an individual’s behavior or attitudes are affected by peers acting as reference points for the individual) on experimentally measured smoking and vaping norms, and other smoking outcomes, in adolescents from high and middle-income settings. Full school year groups in six secondary schools in Northern Ireland (United Kingdom) and six secondary schools in Bogotá (Colombia) participated (n = 1344/1444, participation = 93.1%, target age 12–13 years). Over one semester, pupils received one previously tested school-based smoking prevention program (ASSIST or Dead Cool). Outcomes included experimentally measured smoking/vaping norms, self-report and objectively measured smoking behavior, and self-report smoking norms, intentions, susceptibility, attitudes, and psycho-social antecedents. We investigated selection homophily and peer influence using regressions and SIENA modeling. Regression results demonstrate lagged and contemporaneous selection homophily (odds ratios [ORs] = 0.87–1.26, p ≤ 0.01), and peer influence effects for various outcomes from average responses of friends, school classes, or school year groups (standardized coefficients [βs] = 0.07–0.55, ORs = 1.14–1.31, p ≤ 0.01). SIENA models showed that comparable proportions of smoking/vaping-based similarity between friends were due to selection homophily (32.8%) and peer influence (39.2%). A higher percentage of similarity between friends was due to selection homophily and/or peer influence for ASSIST schools compared to Dead Cool. Selection homophily was also more important in Bogotá, whilst peer influence was stronger in Northern Ireland. These findings support using social norms strategies in adolescent smoking prevention interventions. Future research should consider selection homophily and social influence jointly, and examine whether these findings translate to other high and low-middle-income settings with varying cultures and norms.

How Do Adolescent Smoking Prevention Interventions Work in Different Contextual Settings? A Qualitative Comparative Study Between the UK and Colombia.

Adolescent smoking is associated with significant health and social risks. Previous research has demonstrated the effectiveness of interventions based on behavior change theories in preventing adolescent smoking uptake. However, evidence from the theory-based perspective of evaluation is limited, especially for how such complex interventions work, and how they work when implemented in different contextual settings. A comparative qualitative analysis was conducted to explore various influences on behavior change among participants taking part in two smoking prevention interventions in Northern Ireland and Bogotá. Twenty-sevenfocus groups were conducted in 12 schools (6 in Northern Ireland and 6 in Bogota, n = 195 pupils participated; aged 11-15years). The Theoretical Domains Framework guided a content analysis of the data. We found similarities across settings in terms of knowledge, skills, and beliefs related to smoking or vaping behavior change, as well as differences in contextual resources and social influence. Different environmental resources included availability to purchase tobacco products in the neighborhoods and previous information about tobacco risk. Participants in both interventions perceived behavioral change outcomes related to personal skills and intention to not smoke or vape. These findings have highlighted how both individual factors and contextual resources influence behavior change for smoking prevention in practice. Local contextual factors and social influences affecting pupils should be taken into account in the implementation and evaluation of health behavior change interventions. In particular, this study supports using social and contextual influence strategies in interventions to reduce the onset of adolescent smoking and vaping.

Avoid Smoking: mHealth Evidence and Theory-Based Intervention to Promote Smoking Prevention Behaviors

Background: Mobile technologies and devices effectively maintain health and well-being is a promising opportunity for health policymakers and relevant stakeholders. Objectives: The current study aimed to evaluate a mhealth program to promote smoking prevention behaviors among university students in northern Iraq. The integrative model of factors influencing smoking behavior (IMFISB) was used as a theoretical framework. Methods: This quasi-experimental research study was conducted on 150 Kurdish students of Raparin University in northern Iraq. University students were randomly divided into intervention (n = 75) or control (n = 75) groups. The mhealth theory-based intervention program was evaluated using the mobile application (Avoid Smoking) in eight sessions. The data was collected using a questionnaire before and two months after the program’s implementation and analyzed in SPSS software version 16. Results: The effect size was estimated as "small" for belief, value, and family pressure. The effect size was estimated as “medium" for knowledge, attitude, peer pressure, self-image, and intention. The average response for smoking prevention behaviors was 15.17, which significantly increased to 16.88 after program implementation among the intervention group (P &lt; 0.001), and the effect size was estimated to be "medium" for smoking prevention behaviors. Conclusions: Based on the results, smoking prevention interventions can be effective among students using mobile health evidence-based interventions.

Negative impact of smoking on lung function: comparing FEV1/FVC values in smokers and non-smokers.

Cigarette smoking has been reported as the significant adverse effects on lung function, which can be evaluated by measuring forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the ratio of FEV1 to FVC (FEV1/FVC) values. This study investigated the prevalence of tobacco use and nicotine dependence among college students and their stress levels to inform targeted interventions for smoking prevention and cessation. A total of 429 participants were interviewed face-to-face, of which 71.6% were female and 28.4% were male. Pulmonary function tests were exclusively administered to the 9.8% of participants who reported using tobacco. Our findings revealed a low prevalence of nicotine dependence among college students, with only 6.8% exhibiting moderate or high levels of dependence. Students who reported tobacco use were found to have moderate stress levels,suggesting a potential association between smoking and stress. Chi-square tests revealed that gender, school affiliation,and nicotine dependence were significantly associated with smoking behavior. Long-term smoking (>5 years) was found to be associated with negative health outcomes, such as higher BMI, and increased smoking per day. The analysis of lung function parameters showed that smoking frequency and duration were negatively associated with lung function, while nicotine dependence increased with smoking frequency and duration. Our study suggests that targeted prevention and cessation programs should address these factors to reduce smoking rates among college students.

Tobacco prevention interventions - developing life skills through playful activities among children and preteens: A systematic review

In children and adolescents, risky behaviours such as tobacco use may be addressed by developing life skills. In the field of tobacco prevention, the deployment of playful activities for the development of life skills has received little attention. This review describes the methods and results of tobacco prevention interventions using playful activities to develop life skills in children and preteens. A literature search was conducted in the PubMed, Web of Science and PsycInfo databases. Articles were included in the review based on the following five criteria: (1) the article totally or partially concerns a study of a tobacco prevention intervention; (2) the subjects were children and preteens aged between 6 and 12 years (with an average age within this age range or with an interval including all or part of this age range), from a general or specific population; (3) the intervention was a life skills development action or program; (4) playful activities were employed; (5) design, implementation, evaluation methods and/or results are available in the article. A total of 11 studies, composed of 9 interventions, were included in this systematic review. Most were carried out in school settings (n = 8/11) and involved teachers (n = 7/11). Web-based interventions (video games, mobile health games/websites and e-learning programs) were the playful activities most often used (n = 4/11). The majority of the interventions aimed to develop social skills such as the ability to resist pressure (n = 9/11). In this review, there were only four randomized controlled trial (n = 4/11). The evaluation was immediately after the RCTs. Among the measured outcome variables, knowledge (n = 8/11), attitudes (n = 5/11), intentions (n = 5/11), self-efficacy (n = 4/11) and skills (n = 3/11) were the most assessed. Only two of the studies reviewed here conducted a process evaluation (n = 2/11). This systematic review provides guidance for future youth smoking prevention interventions. Among these, a process evaluation is strongly suggested, as well as the use of appropriate variables and validated scales to assess the effectiveness of prevention programs. In addition, participatory research must allow for the design of adapted and relevant interventions, but also for the proper development of intervention research methodologies in health promotion.

Prevalence of Use and Knowledge about Tobacco Products and Their Harmful Effects among University Students in Southern Croatia.

Understanding students' attitudes toward smoking and tobacco products is essential for effective smoking prevention interventions. This questionnaire-based cross-sectional survey aims to determine the prevalence of use and knowledge about cigarettes, heated tobacco products, and electronic cigarettes and their harmful effects among university students. The survey was conducted using a self-administered online questionnaire among 1184 students. Questions were related to the respondents' demographic characteristics, tobacco use patterns, and opinions about exposure to health warnings and tobacco product advertising messages. Data were analyzed using descriptive statistics and generalized linear regression analysis. The results showed that 30.2% of the students use tobacco products (74.5% smoked conventional cigarettes; 7.9% used electronic cigarettes; and 17.6% used heated tobacco products). The median (interquartile range) score of the students' knowledge (maximum = 27) was 16 (12-22). The results showed that students from technical, social, humanities, natural, and biotechnology scientific programs had lower levels of knowledge about tobacco products and their harmful effects than biomedical students (p ≤ 0.001). In addition, past and current use of tobacco products was significantly associated with higher overall knowledge of tobacco products and their harmful effects (adjusted odds ratio (OR) 1.90, % confidence interval (CI) 1.09-3.31, p = 0.023; OR 1.41, CI 1.08-1.84, p = 0.011). The research findings confirm the lack of knowledge and misconceptions about the harmful effects associated with tobacco product use. They also emphasize the need for better prevention and awareness of the harmful effects of smoking on human health.

Exploring the mechanistic pathways of how social network influences social norms in adolescent smoking prevention interventions

We know little about how smoking prevention interventions might leverage social network structures to enhance protective social norms. In this study we combined statistical and network science methods to explore how social networks influence social norms related to adolescent smoking in school-specific settings in Northern Ireland and Colombia. Pupils (12–15 years old) participated in two smoking prevention interventions in both countries (n = 1344). A Latent Transition Analysis identified three groups characterized by descriptive and injunctive norms towards smoking. We employed a Separable Temporal Random Graph Model to analyze homophily in social norms and conducted a descriptive analysis of the changes in the students’ and their friends’ social norms over time to account for social influence. The results showed that students were more likely to be friends with others who had social norms against smoking. However, students with social norms favorable towards smoking had more friends with similar views than the students with perceived norms against smoking, underlining the importance of network thresholds. Our results support the notation that the ASSIST intervention takes advantage of friendship networks to leverage greater change in the students' smoking social norms than the Dead Cool intervention, reiterating that social norms are subject to social influence.

Systematic review of intervention functions, theoretical constructs and cultural adaptations of school-based smoking prevention interventions in low-income and middle-income countries

ObjectiveTo identify the approaches and strategies used for ensuring cultural appropriateness, intervention functions and theoretical constructs of the effective and ineffective school-based smoking prevention interventions that were implemented in low-income...

Towards Healthy Adolescents: A Review of Smoking Impact According to Dental Perspectives

Nowadays, tobacco companies target to recruit new smokers among adolescents due to this age group was easy to be influenced by smoking behaviours. This narrative review aimed to explore the possible impact of smoking among adolescents. Knowing the negative impacts of smoking might result in avoiding continuing the habit or preventing from initiation of the habit. The literature search on PubMed, SCOPUS, and Epistemonikos database with related search terms of “adolescents”, “smoking” and “impact”. Only papers published within the year 2017 to 2021 and in the English language were included. However, articles without full text were excluded from this review. Fourteen articles were selected and divided impacts into three categories which are effect on oral health, effect on general health and other impacts. Possible impacts of smoking among adolescents were identified, and it could be beneficial in the development of customized smoking prevention or smoking cessation intervention for adolescents.

Prevalence of Smoking Various Tobacco Types in the Kazakhstani Adult Population in 2021: A Cross-Sectional Study.

Tobacco use was the second-leading risk factor for death, accounting for 15.4% of total deaths in 2019. In 2019, 20.4% (2.7 million) of the adult population in Kazakhstan, 36.5% of men, and 6.0% of women smoked tobacco. A cross-sectional study of a random sample (n = 1201) was conducted between October and December 2021 in accordance with the STEPwise approach. The tobacco-use questions were focused on current and previous smoking status, initiation and duration of smoking, amount of tobacco use, exposure to secondhand smoke, and information related to quitting smoking. From 20.8% of smokers, 93.8% of men and 80.2% of women use tobacco products daily, χ2 = 10.983, p-score < 0.001. The earliest initiation of smoking was 6 years old. The prevalence of smoking tobacco products in Kazakhstan is 20.8%, which means that every fifth adult smokes. In addition, the proportion of smokers among men was 38.5%, and among women, it was 10.1%. A total of 93.8% of men and 80.2% of women smoked daily. The role of healthcare professionals in smoking prevention is very low, and only 16.9% of respondents have been advised to quit smoking in the last 12 months. New interventions for tobacco smoking prevention are urgently needed in Kazakhstan.

Developing and pre-testing a digital decision-tree smartphone application for smoking prevention and cessation among HIV care providers.

The diagnosis and continuous care of chronic conditions such as HIV infection present potential teachable moments for delivering smoking prevention and cessation interventions for patients. We designed and pre-tested a prototype of a smartphone application(app), Decision-T, specifically designed to assist healthcare providers when providing personalized smoking prevention and cessation services to their patients. We developed the Decision-T app based on transtheoretical algorithm for smoking prevention and cessation following the 5-A's model. We employed a mixed-methods approach among 18 HIV-care providers recruited from Houston Metropolitan Area for pre-testing the app. Each provider participated in three mock sessions, and the average time spent at each session was measured. We measured accuracy by comparing the smoking prevention and cessation treatment offered by the HIV-care provider using the app to that chosen by the tobacco specialist who designed the case. The system usability scale (SUS) was used to assess usability quantitatively , while individual interview transcripts were analyzed to determine usability qualitatively. STATA-17/SE and Nvivo-V12 were used for quantitative and qualitative analysis, respectively. The average time for completing each mock session was 5 min 17 s. The participants achieved an overall average accuracy of 89.9%. The average SUS score achieved was 87.5(±10.26). After analyzing the transcripts, five themes (app's contents are beneficial and straightforward, design is easy to understand, user's experience is uncomplicated, tech is intuitive, and app needs improvements) emerged. The decision-T app can potentially increase HIV-care providers' engagement in offering smoking prevention and cessation behavioral and pharmacotherapy recommendations to their patients briefly and accurately.

P2.11-03 Smoking Prevention Intervention With School Classes in University Hospital by Thoracic Surgeon und Pulmonologist

Smoking prevention in schoolchildren to inform and prevent smoking initiation has been widely studied, however the potential effect of interventions provided in a hospital setting is unknown. An intervention program named “Schoolchildren smoking prevention in the hospital” was developed in which the health aspects of smoking and its individual consequences were presented in an interactive informational event provided by a thoracic surgeon and a pulmonologist. We aimed to assess the feasibility and the short-term effect of smoking-related knowledge improvement in schoolchildren in a hospital setting.