title: Photoaging Mobile Apps in School-Based Tobacco Prevention: The Mirroring Approach.
abstract: Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous. Adolescent smoking can best be prevented through health education at schools. Interventions that take advantage of the broad availability of mobile phones as well as adolescents' interest in their appearance may be a novel way to improve prevention.
  
  
  
  In this first pilot study, we aimed to use mobile phone technology in accordance with the theory of planned behavior to improve school-based tobacco prevention.
  
  
  
  We used a free photoaging mobile phone app ("Smokerface") in three German secondary schools via a novel method called mirroring. The students' altered three-dimensional selfies on mobile phones or tablets were "mirrored" via a projector in front of their whole grade. Using an anonymous questionnaire, we then measured on a 5-point Likert scale the perceptions of the intervention among 125 students of both genders (average age 12.75 years).
  
  
  
  A majority of the students perceived the intervention as fun (77/125, 61.6%), claimed that the intervention motivated them not to smoke (79/125, 63.2%), and stated that they learned new benefits of non-smoking (81/125, 64.8%). Only a minority of students disagreed or fully disagreed that they learned new benefits of non-smoking (16/125, 12.8%) or that they were themselves motivated not to smoke (18/125, 14.4%).
  
  
  
  We have presented a novel method to integrate photoaging in school-based tobacco prevention that affects student peer groups and considers the predictors of smoking in accordance with the theory of planned behavior.
authors.affiliation: Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research, Justus-Liebig-University of Giessen, Giessen, Germany. titus.brinker@gmail.com.
authors.forename: Titus Josef
authors.identifier: 0000-0002-3620-5919
authors.initials: TJ
authors.lastname: Brinker
authors.forename: Werner
authors.identifier: 0000-0003-1946-0894
authors.initials: W
authors.lastname: Seeger
authors.forename: Fabian
authors.identifier: 0000-0003-3621-4396
authors.initials: F
authors.lastname: Buslaff
mesh_terms: D000293:Adolescent; D000375:Aging; D040421:Cell Phone; D002648:Child; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D063731:Mobile Applications; D009042:Motivation; D010379:Peer Group; D010781:Photography; D010865:Pilot Projects; D012572:School Health Services; D012574:Schools; D000074606:Smoking Prevention; D013334:Students; D011795:Surveys and Questionnaires
keywords: adolescent smoking; adolescents; apps; photoaging; secondary schools; smoking; smoking cessation; smoking prevention; tobacco; tobacco prevention