Effect of an anti-tobacco programme of health education on changes in health behaviours among junior high school adolescents in Białystok, Poland.

INTRODUCTION: School health education programmes are among the instruments for the prevention of tobacco smoking among children and adolescents. Knowledge obtained in evaluation studies of these programmes indicates the degree of their effectiveness and serves to improve their quality.

OBJECTIVE: Recognition and evaluation of the effect of two-year anti-tobacco programme of health education on the changes in the level of knowledge, attitudes and behaviours of adolescents.

MATERIALS AND METHOD: An intervention study was originated in May 2007, and covered 859 first-year schoolchildren from eight public junior high schools in Białystok in Poland, from among 3,318 schoolchildren attending 33 schools. The sample was selected by means of two-stage stratified sampling with consideration of two groups: an intervention group covered with educational actions (417 schoolchildren), and a control group (442 schoolchildren), where anti-tobacco education was not carried out. Before the educational programme and after its completion an evaluation of knowledge, attitudes and behaviours of junior high school adolescents was performed with respect to nicotinism, based on a survey. The educational part consisted in conducting within 2 years, 4 educational classes and 2 competitions concerning tobacco-related problems.

RESULTS: After two years, in the group of adolescents covered by the educational programme a significant increase was observed - by 11.6% - in the percentage of schoolchildren who were familiar with the negative effects of tobacco smoking, and an increase by 4.4% of those who were convinced that smoking is harmful. With respect to adolescents' attitudes, the effect of the programme was noted in only one of six components analyzed. After completion of the two-year educational programme, both in the group covered by this programme and the control group, the percentage of smokers significantly increased (by 12.8% and 12.7%, respectively).

CONCLUSIONS: It is necessary to evaluate the health education programme from the aspect of both the actual hard effects of the anti-nicotine programme (changes in behaviour), and indirect effects - soft (knowledge, skills) which are a basis for the potential verification of the programme in order to increase its effectiveness.