title: Effects of a randomized controlled trial to assess the six-months effects of a school based smoking prevention program in Saudi Arabia.
abstract: To examine the efficacy of a smoking prevention program which aimed to address smoking related cognitions and smoking behavior among Saudi adolescents age 13 to 15.
  
  
  
  A randomized controlled trial was used. Respondents in the experimental group (N=698) received five in-school sessions, while those in the control group (N=683) received no smoking prevention information (usual curriculum). Post-intervention data was collected six months after baseline. Logistic regression analysis was applied to assess effects on smoking initiation, and linear regression analysis was applied to assess changes in beliefs and analysis of covariance (ANCOVA) was used to assess intervention effects. All analyses were adjusted for the nested structure of students within schools.
  
  
  
  At post-intervention respondents from the experimental group reported in comparison with those from the control group a significantly more negative attitude towards smoking, stronger social norms against smoking, higher self-efficacy towards non-smoking, more action planning to remain a non-smoker, and lower intentions to smoke in the future. Smoking initiation was 3.2% in the experimental group and 8.8% in the control group (p<0.01).
  
  
  
  The prevention program reinforced non-smoking cognitions and non-smoking behavior. Therefore it is recommended to implement the program at a national level in Saudi-Arabia. Future studies are recommended to assess long term program effects and the conditions favoring national implementation of the program.
authors.affiliation: Maastricht University, School for Public Health and Primary Care (Caphri), P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: m.mohammed@maastrichtuniversity.nl.
authors.forename: Mutaz
authors.initials: M
authors.lastname: Mohammed
authors.affiliation: Maastricht University, School for Public Health and Primary Care (Caphri), P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: m.eggers@maastrichtuniversity.nl.
authors.forename: Sander Matthijs
authors.initials: SM
authors.lastname: Eggers
authors.affiliation: School Health Program, Dawadmy School Health Unit Saudi Arabia, Saudi Arabia, Dawadmi, -11911, -P.O Box 760. Electronic address: f2008sa@hotmail.com.
authors.forename: Fahad F
authors.initials: FF
authors.lastname: Alotaiby
authors.affiliation: Maastricht University, School for Public Health and Primary Care (Caphri), P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: n.devries@maastrichtuniversity.nl.
authors.forename: Nanne
authors.initials: N
authors.lastname: de Vries
authors.affiliation: Maastricht University, School for Public Health and Primary Care (Caphri), P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: hein.devries@maastrichtuniversity.nl.
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
mesh_terms: D000293:Adolescent; D003479:Curriculum; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D012529:Saudi Arabia; D012572:School Health Services / Q000458:organization & administration; D012574:Schools; D020377:Self Efficacy; D000074606:Smoking Prevention; D066262:Social Norms
keywords: Saudi Arabia; adolescents; randomized trial; smoking prevention; social influence