{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T22:27:03Z","timestamp":1787956023931,"version":"build-2784847793"},"reference-count":62,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2026,3,24]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A two-arm, parallel, cluster-randomised controlled trial was conducted among 720 students aged 12\u201319 years. Schools were randomly assigned to an intervention group (IG) or a control group (CG). IG participants received a 45\u2009min HBM-based tobacco education session reinforced with culturally adapted posters and notebooks developed from the\n                      <jats:italic>WHO Tobacco Control Manual for Secondary Schools<\/jats:italic>\n                      ; 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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%\u2009CI 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>PACTR202103802475677.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2025-059880","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T17:20:15Z","timestamp":1775496015000},"page":"tc-2025-059880","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of a school-based health education intervention on tobacco use intention among adolescents: a cluster-randomised controlled trial"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1351-9659","authenticated-orcid":false,"given":"Omotayo Francis","family":"Fagbule","sequence":"first","affiliation":[{"name":"Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria"},{"name":"School of Public Health, University of Nevada Reno, Reno, Nevada, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ejiro","family":"Idiga","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ebelechukwu","family":"Osuh","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria"},{"name":"Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Folake Barakat","family":"Lawal","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria"},{"name":"Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6219-298X","authenticated-orcid":false,"given":"Eric","family":"Crosbie","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Nevada Reno, Reno, Nevada, USA"},{"name":"Ozmen Institue for Global Studies, University of Nevada Reno, Reno, Nevada, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olushola","family":"Ibiyemi","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria"},{"name":"Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3805-1850","authenticated-orcid":false,"given":"Babalola","family":"Faseru","sequence":"additional","affiliation":[{"name":"Department of Population Health, The University of Kansas School of Medicine, Kansas City, Kansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gbemisola Aderemi","family":"Oke","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria"},{"name":"Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"2026040610200724000_tc-2025-059880v1.1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.20.266932"},{"key":"2026040610200724000_tc-2025-059880v1.2","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2021-056540"},{"key":"2026040610200724000_tc-2025-059880v1.3","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2011-050147"},{"key":"2026040610200724000_tc-2025-059880v1.4","unstructured":"Blecher E , Ross H . 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