BBackground: Cigarette smoking is a major public health threat to the world with rising concerns during the COVID-19 pandemic.
Objectives: To evaluate the effectiveness of a health belief model (HBM)-based educational intervention in improving knowledge, beliefs, self-reported smoking behaviors, and nicotine dependence among university medical students.
Methods: A randomized controlled health education intervention was performed using permuted blocks randomization. Students in the intervention group (n=133) received health education intervention based on the HBM constructs and incorporated smoking related COVID-19 risks. Control subjects (n=129) received basic health education including smoking health related risks. The outcomes measured were: students' knowledge, beliefs, self-reported smoking behaviors, and nicotine dependence. Data were collected at baseline and 30 days post-intervention.
Results: After the intervention, percentages of students who had high knowledge and belief scores had significantly increased from ˂5%to >45% in the intervention group(p < 0.001).Mean nicotine dependence scores and percentages of daily and heavy smokers among students showed more improvement in the intervention group (3.9±1.5, 35.3%, 5.3%) compared to the control group (5±1.8, 48.8% and 12.4% respectively)(p < 0.001)at 30 days post-intervention. Perceived COVID-19 risk susceptibility and risk severity significantly predict post-intervention reduction in moderate/heavy smoking (p < 0.01 and p < 0.001 respectively) and high nicotine dependence (p < 0.01) in the intervention group.
Conclusions: This intervention significantly improved knowledge, beliefs, self-reported smoking behaviors and nicotine dependence in medical students. Further research is needed for investigating the effectiveness of applying more complex and longer intervention.