{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T08:02:56Z","timestamp":1780992176783,"version":"3.54.1"},"reference-count":47,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:00:00Z","timestamp":1780704000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Adolescents\u2019 tobacco susceptibility is a strong predictor of future initiation; yet rigorously evaluated school-based interventions in low- and middle-income countries (LMICs) remain scarce. This study compared the effectiveness of dentist-led lectures versus self-directed learning in improving tobacco-related knowledge and reducing tobacco susceptibility among Nigerian adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology:<\/jats:title>\n                    <jats:p>\n                      Parallel, 2-arm, cluster-randomized controlled trial involving 720 students (13-19\u2009years) across 8 secondary schools in Ibadan, Nigeria, stratified by school type (public vs private). Schools were randomized to the Dentist-Led Lecture Group (DLG) or Self-Directed Learning Group (SLG). The DLG received a single 45-minute tobacco education lecture; the SLG received customized anti-tobacco notebooks and posters. Outcomes were tobacco-related knowledge scores and susceptibility to tobacco use, assessed at baseline, immediate post-intervention, and 6-month follow-up. Analyses included\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests, repeated-measures ANOVA, McNemar tests, and logistic generalized estimating equation (GEE) with exchangeable correlation structure and robust standard errors (\u03b1\u2009=\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean (standard deviation) knowledge scores improved from baseline to 6\u2009months in both groups (DLG: 5.2 [3.1]-9.7 [2.3]; SLG: 4.7 [3.5]-8.8 [2.7]; both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), with no between-group difference (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.200). Baseline susceptibility was comparable (DLG 16.4%; SLG 20.3%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.178). At 6\u2009months, susceptibility declined in DLG to 7.3% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and SLG to 15.0% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.251). Prespecified subgroup analyses showed susceptibility decreased in private schools for both groups (DLG 18.9%-6.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.002; SLG 17.0%-8.0%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.012), but not in public schools (DLG 14.1%-8.0%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.152; SLG 23.6%-24.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.688). In GEE models averaged across time points, SLG participants had higher population-averaged odds of susceptibility than DLG (aOR\u2009=\u20091.98, 95% confidence interval: 1.45-2.70).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Both interventions improved tobacco-related knowledge at similar rates, but dentist-led education was associated with lower odds of tobacco susceptibility. This trial demonstrates the value of scalable school-based approaches for adolescent tobacco prevention in LMICs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342261451822","type":"journal-article","created":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T05:07:19Z","timestamp":1780808839000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effectiveness of Dentist-Led Lecture Versus Self-Directed Learning on Tobacco Knowledge and Susceptibility Among Nigerian Adolescents: A School-Based Cluster-Randomized Controlled Trial"],"prefix":"10.1177","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, Nigeria"},{"name":"School of Public Health, University of Nevada, Reno (UNR), NV, USA"}],"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, Nigeria"},{"name":"Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, 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, Nigeria"},{"name":"Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Nigeria"}],"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, Nigeria"},{"name":"Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Nigeria"}],"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, Nigeria"},{"name":"Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030442"},{"key":"e_1_3_3_3_2","unstructured":"World Health Organization. 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