Educational Models for Tobacco Exposure Awareness

NCT07473245 | Completed

• 1 other identifier: KarabukU-SHMYO-SE-1
• Study Type: interventional
• Target: 107
• Locations: 1 country
• Sites: 1

Brief Summary

This is a randomized controlled trial comparing the effects of peer education and traditional education on increasing knowledge and awareness of secondhand and thirdhand tobacco smoke exposure among geriatric care program students. Tobacco use and passive smoking are serious public health problems that cause millions of deaths each year and are highly prevalent among university students. Not only smoke dispersed in the air (secondhand smoke), but also toxic residues that accumulate on surfaces and can be absorbed through the skin and ingestion (thirdhand smoke) carry carcinogenic risks. It is a professional obligation for these students, who are the health professionals of the future, to protect the vulnerable elderly population they will serve from this exposure (especially residues carried on clothing/hair). It is also aimed to protect their own health against the risk of smoking triggered by occupational stress. Traditional education that only imparts information may be insufficient in changing behavior. Peer education based on Social Learning Theory offers a sincere and effective alternative that encounters less resistance among young people. While existing experimental studies in the literature generally focus on "active smoking and motivation to quit," this study fills an important gap by focusing on passive and third-hand exposure. If successful, this peer education model could be implemented as a standardized educational module at the national level in university campuses. Research hypotheses: H1: Students who receive peer education have higher levels of knowledge about secondhand smoke than students who receive traditional education. H2: Students who receive peer education have higher levels of awareness about thirdhand smoke than students who receive traditional education. H3: There is a difference between the pre- and post-intervention and between the experimental and control groups in terms of students' average scores for their awareness level of secondhand smoke. H4: There is a difference between the pre- and post-intervention and between the experimental and control groups in terms of students' average scores for their knowledge level of thirdhand smoke.

Conditions

Tobacco Smoke Pollution; Peer Group Guidance; Health Education; Passive Smoking

Keywords

Peer Education, Health Education, Passive Smoking, Third Hand Smoke

Outcome Measures

Primary Outcomes (2)

• Change in passive exposure knowledge level measured 21 days after the start

  Passive Exposure Information Test Developed by Hançer Tok and colleagues (2023) to determine individuals' knowledge levels regarding secondhand tobacco smoke. The scale consists of 13 items and has four subscales: Awareness (1-5), Cancer (6-7), Passive Effects (8-11), and Drinkable-Undrinkable Areas (12-13). Items are answered as "True / False / Don't know"; correct answers are scored as 1 point, while incorrect and "don't know" answers are scored as 0 points. The total score obtainable from the scale ranges from 0 to 13, with higher scores indicating a higher level of knowledge. The Cronbach's alpha value of the scale is reported as 0.749.

  start time (T0), immediately after the intervention (T1), and 21 days after the intervention (T2).

• Change in Third-Hand Smoke Awareness Measured 21 Days After Baseline

  Third-Hand Smoke Awareness Scale It was developed to measure individual beliefs and awareness regarding third-hand tobacco smoke. The original form of the scale was developed by Haardörfer and colleagues (2017), and the Turkish adaptation and validity-reliability study was conducted by Önal and colleagues (2021). The scale consists of 9 items and has two subscales: Health Effects (5 items) and Environmental Persistence (4 items). Items are scored on a 5-point Likert scale (1=Strongly disagree, 5=Strongly agree) and there are no reverse items. The total score that can be obtained from the scale ranges from 9 to 45, with high scores indicating a high level of awareness regarding thirdhand tobacco smoke. The Cronbach's alpha coefficient of the scale was reported as 0.712.

  start time (T0), immediately after the intervention (T1), and 21 days after the intervention (T2).

Study Arms (2)

Experimental Group

ACTIVE COMPARATOR

The intervention group will undergo peer education training 1. Selection: Based on academic achievement (≥2.50), leadership qualities, and volunteer experience, a total of 8 peer educators will be selected, 4 from each of the 1st and 2nd grades. 2. Training: Candidates will receive a 2-week (4 sessions) training on tobacco awareness and group dynamics, guided by the expert-approved "Peer Educator Guide"; those scoring ≥80 on the final exam will be assigned to the field. 3. Implementation: Seven to eight students will be assigned to eight different groups led by peer educators through simple random sampling. Face-to-face theoretical sessions will be held during the first seven days of the 15-day program; environmental risk mapping on campus and clinical field observation at hospitals where internships are conducted will take place between the 8th and 15th days. 4. Monitoring: Weekly follow-up meetings will be held under the researcher's leadership to maintain the training standard.

Behavioral: Peer Education

Control Group

ACTIVE COMPARATOR

The basic structure of the traditional training program to be applied to the intervention group is summarized as follows: Implementer and Method: The training will be conducted by the researcher himself. In a classic classroom environment; PowerPoint presentations, straightforward narration, and question-and-answer techniques will be used. Content and Duration: The training, whose content validity is ensured by the Davis Technique, is planned to take place face-to-face outside of class hours so as not to interfere with students' classes. It will be conducted in two separate 40-minute sessions once a week over a total period of 15 days. Timing and Monitoring: To prevent time-related deviations, peer education will be conducted simultaneously with one-on-one sessions. In both groups, the process will begin immediately after the briefing and pre-test (T0) data collection and will end simultaneously on the day the training ends.

Behavioral: traditional education

Interventions

Peer Education BEHAVIORAL

A structured peer education model is planned to be implemented for the intervention group. The process will be carried out in five main stages: selection of peer educators, training, formation of groups, implementation of the intervention, and supervision (monitoring).

Experimental Group

traditional education BEHAVIORAL

The application will be conducted by the researcher and is based on standard teaching methods representing the traditional education model. In this context, tobacco exposure awareness training for students will be conducted in a traditional classroom setting using PowerPoint presentations, straightforward explanations, and question-and-answer techniques.

Control Group

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Be enrolled in the first or second year of the Elderly Care Program at Karabük University School of Health Services,
• Agree to participate in the study voluntarily,
• Be able to participate in the training process and follow-up measurements (T0, T1, and T2),
• Be able to respond to Google Forms applications via a device with internet access (phone, tablet, computer)

You may not qualify if:

• Receiving any training on tobacco use, secondhand and thirdhand smoke exposure within 6 months,
• Participants who incomplete survey forms or leave at least one scale blank,
• Students who do not participate in training programs and for whom follow-up measurements cannot be taken,
• Those who cannot complete all stages of the study due to health reasons or absenteeism.

Sponsors & Collaborators

• Karabuk University: lead

Study Sites (1)

Karabuk University School of Health Services Vocational College Elderly Care Program

Karabük, Safranbolu, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Health Education

Condition Hierarchy (Ancestors)

Adherence Interventions; Medication Adherence; Patient Compliance; Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: To prevent "selection bias" in assigning participants to groups in the study, the "Sequential Numbering, Closed Envelope Method" will be used. Random Assignment List: Participants will first be divided into two separate groups: "1st Grade" and "2nd Grade." Using a Computer-Assisted Simple Random Number Table, two different "Group Assignment Lists" (Experimental and Control) will be created separately for each group. Preparation of Envelopes: Opaque envelopes of different colors will be prepared for each class level. Group assignment cards will be placed inside the envelopes according to the randomly generated lists. Implementation: Participants will be invited to an informational meeting before the training begins. At the briefing meeting, participants will be asked about their grade levels in order of arrival. Then, they will be asked to draw the next numbered sealed envelope from the box corresponding to their grade level, completing the group assignment process.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer

Model Details: This study was designed as a randomized controlled, two-arm, pre-test-post-test experimental research to compare the effectiveness of peer education and traditional education methods in increasing university students' awareness levels regarding secondary and tertiary smoke exposure, two main dimensions of tobacco smoke exposure.

Study Record Dates

• First Submitted: February 26, 2026
• First Posted: March 16, 2026
• Study Start: May 4, 2026
• Primary Completion: June 5, 2026
• Study Completion: June 5, 2026
• Last Updated: June 8, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)