A Health Literacy and Self-Efficacy Promotion Program for Preventing Cigarette and E-Cigarette Use Among Upper Secondary School Students in Maha Sarakham Province, Thailand: A Quasi-Experimental Study

Factors Associated with Cigarette and E-cigarette Avoidance Behaviors and the Effectiveness of a Health Literacy and Self-Efficacy Promotion Program (HBSE Program) among High School Students in Maha Sarakham Province: A Two-Phase Study

Status

Active, not recruiting

Phases

Early Phase 1

Study type

Interventional

Source

TCTR

Registry ID

TCTR20260629009

Enrollment

Registered

2026-06-29

Start date

2026-07-06

Completion date

Unknown

Last updated

2026-08-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cigarette smoking Electronic cigarette use Tobacco use prevention Adolescent health behavior Health literacy Self-efficacy cigarette e-cigarette electronic cigarette adolescent high school student health literacy self-efficacy Health Belief Model avoidance behavior tobacco prevention quasi-experimental

Interventions

A 24-week, 4-session program applying the Health Belief Model and Self-Efficacy Theory to prevent cigarette and e-cigarette use. Session 1 (Week 1): rapport building, pretest, and health education on

Experimental Behavioral,Active Comparator Behavioral

HBSE Program (Health Belief and Self-Efficacy Promotion Program),Standard School Health Education (Usual Curriculum)

Eligibility

Sex/Gender

All

Age

15 Years to 18 Years

Inclusion criteria

Inclusion criteria: 1. Enrolled in Grade 10-12 in the study year 2. Studying at a school in Maha Sarakham 3. Taking part voluntarily, without pressure 4. Parent or guardian consent and student assent obtained 5. Able to read and understand the questionnaire well enough to self-report 6. Of sound mind and fully conscious 7. At a school drawn as the intervention or control site 8. Able to attend at least three of the four sessions 9. Consent for the full 24-week program 10. No clashing commitments with the four sessions

Exclusion criteria

Exclusion criteria: 1. Not in Grade 10-12 2. A health condition or cognitive difficulty that prevents understanding the questionnaire and self-reporting 3. Declining to take part, or withdrawing consent during data collection

Design outcomes

Primary

Measure	Time frame
Cigarette and E-cigarette Avoidance Behavior Baseline (Week 1, pretest) and Week 24 (posttest) 20-item self-report behavior scale using a 4-point Likert format	—

Secondary

Measure	Time frame
Health Literacy Regarding Cigarette and E-cigarette Use Baseline (Week 1, pretest) and Week 24 (posttest) 20-item health literacy assessment covering knowledge and understanding of cigarette/e-cigarette harms, legal aspects, and scientific facts (true/false/not sure format).,Self-Efficacy in Avoiding Cigarette and E-cigarette Use Baseline (Week 1, pretest) and Week 24 (posttest) Self-report scale measuring confidence in one's ability to refuse cigarette/e-cigarette use and resist peer pressure in various scenarios.	—

Measure

Time frame

Health Literacy Regarding Cigarette and E-cigarette Use Baseline (Week 1, pretest) and Week 24 (posttest) 20-item health literacy assessment covering knowledge and understanding of cigarette/e-cigarette harms, legal aspects, and scientific facts (true/false/not sure format).,Self-Efficacy in Avoiding Cigarette and E-cigarette Use Baseline (Week 1, pretest) and Week 24 (posttest) Self-report scale measuring confidence in one's ability to refuse cigarette/e-cigarette use and resist peer pressure in various scenarios.

—

Countries

Thailand

Contacts

Public ContactChoosak Nithikathkul

Faculty of Medicine, Mahasarakham University

nithikethkul@msu.ac.th043021021

Outcome results

None listed

Source: TCTR (via WHO ICTRP) · Data processed: Aug 10, 2026