American Journal of Educational Research
ISSN (Print): 2327-6126 ISSN (Online): 2327-6150 Website: https://www.sciepub.com/journal/education Editor-in-chief: Ratko Pavlović
Open Access
Journal Browser
Go
American Journal of Educational Research. 2024, 12(1), 1-11
DOI: 10.12691/education-12-1-1
Open AccessArticle

Effect of Using Web- Based Health Education Sessions on Smoking Cessation among University Students

Doaa M. Nasr-Eldein Ali1, , Sahar M. Soliman2 and Rania M. Gad El-Bastwese3

1Assistant lecturer, Department of Community Health Nursing, Faculty of Nursing, Mansoura University, Egypt

2Professor, Department of Community Health Nursing, Faculty of Nursing, Mansoura University, Egypt

3Assist. Professor, Department of community health Nursing, Faculty of Nursing, Mansoura University, Egypt

Pub. Date: January 01, 2024

Cite this paper:
Doaa M. Nasr-Eldein Ali, Sahar M. Soliman and Rania M. Gad El-Bastwese. Effect of Using Web- Based Health Education Sessions on Smoking Cessation among University Students. American Journal of Educational Research. 2024; 12(1):1-11. doi: 10.12691/education-12-1-1

Abstract

Smoking is one of the major public health problems worldwide, particularly among young adults. It is a major contributor to the global burden of diseases, including cancer, cardiovascular, and pulmonary diseases, and the harmful effects of smoking on non-smokers. Smoking cessation reduces health risks and improves quality of life for any age. The World Health Organization revealed that implementing tobacco control measures is a public health priority. Web-based interventions are a promising approach to supporting the behavioural health change of young adults who spend a significant proportion of their time using the internet. The study aims to assess the effect of using web-based health education sessions on smoking cessation among university students. Method: A quasi-experimental study design was used throughout this study on the World Wide Web (WWW) for globalization. The researchers used convenience sampling techniques to select 120 university students’ smokers and purposive sampling techniques to select 15 professional experts to evaluate the web-based health education sessions. The researchers used four self-administered questionnaires for data collection as follows: socio-demographic and economic characteristics of students, knowledge, subjective smoking behaviour, and attitude of students regarding smoking. This study was conducted in four stages: preliminary assessment stage, development stage, implementation stage, and evaluation stage. Results: The study revealed that there was a significant improvement in the students’ knowledge about smoking after the completion of web-based sessions (P≤ 0.05), with a significant reduction in the number of cigarettes consumed per day, with a percent change of 52.01%. The prevalence of smoking abstinence rates has significantly increased from 6.7% after 1-month post-web-based sessions to 25% at 3-month follow-up. There was a significant increase in attitude scores. In addition, all experts reported that the design of the health education sessions was clear and attractive. The students described the sessions as useful and attractive sessions that were uploaded on an accessible and easy-to-navigate website. Conclusion: Web-based sessions have been demonstrated as an effective tool for smoking cessation interventions. The developed web-based sessions resulted in improvements in students’ knowledge, smoking behaviour, and attitude regarding smoking, so it is recommended to evaluate medium- and long-term smoking cessation follow-up at 6 months and 12 months

Keywords:
smoking smoking cessation young adults university students web-based education

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Malik, M., Javed, D., Hussain, A., & Essien, E. J. (2019). Smoking habits and attitude toward smoking cessation interventions among healthcare professionals in Pakistan. Journal of Family Medicine and Primary Care, 8(1), 166-170.
 
[2]  World Health Organization (2022). Tobacco. Available at: https://www. who.int/news-room/fact-sheets/detail/tobacco.
 
[3]  World Health Organization (2021). WHO updated fact sheet on tobacco. Available from: https:// www. who. int/ en/ news- room/ fact- sheets/ detail/tobacco.
 
[4]  Ministry of Health and Population (MOHP) & WHO (2017). Egypt STEPS Survey 2017 fact sheet, WHO STEPS non communicable disease risk factor surveillance. Retrieved from .
 
[5]  Jenssen, B. P., Walley, S. C., Groner, J. A., Rahmandar, M., Boykan, R., Mih, B., ... & Caldwell, A. L. (2019). E-cigarettes and similar devices. Pediatrics, 143(2).‏, e20183652. [CrossRef] [PubMed].
 
[6]  Bennett, B. L., Deiner, M., & Pokhrel, P. (2017). College anti-smoking policies and student smoking behavior: a review of the literature. Tobacco Induced Diseases, 15(1), 1-11.
 
[7]  Burns, S., Hart, E., Jancey, J., Hallett, J., Crawford, G., & Portsmouth, L. (2016). A cross sectional evaluation of a total smoking ban at a large Australian university. BMC Research Notes, 9(1), 1-9.
 
[8]  Lee, J. G., Ranney, L. M., & Goldstein, A. O. (2013). Cigarette butts near building entrances: what is the impact of smoke-free college campus policies? Tobacco Control, 22(2), 107–112.
 
[9]  Lin, B., Xie, L., Xie, X., Yan, Y., Zhang, L., & Xiao, L. (2023). Predictors for quitting smoking in smoking cessation clinics among female smokers in China. Tobacco Induced Diseases, 21(26), 1-13.
 
[10]  Golechha, M. (2016). Health promotion methods for smoking prevention and cessation: A comprehensive review of effectiveness and the way forward. International Journal of Preventive Medicine 7(7).
 
[11]  Varela, C., Ruiz, J., Andrés, A., Roy, R., Fusté, A., & Saldaña, C. (2016). Advantages and disadvantages of using the website SurveyMonkey in a real study: Psychopathological profile in people with normal-weight, overweight and obesity in a community sample. E-methodology, 2016(3), 77-89.
 
[12]  Varela, C., Oda-Montecinos, C., Andrés, A., & Saldaña, C. (2021). Effectiveness of web-based feedback interventions for people with overweight and obesity: systematic review and network meta-analysis of randomized controlled trials. Journal of Eating Disorders, 9(1), 75, 1-14.
 
[13]  Ryan, C., Bergin, M., Chalder, T., & Wells, J. S. (2017). Web‐based interventions for the management of stress in the workplace: Focus, form, and efficacy. Journal of Occupational health, 59(3), 215-236.
 
[14]  De Sousa, D., Fogel, A., Azevedo, J., & Padrão, P. (2022). The effectiveness of web-based interventions to promote health behaviour change in adolescents: a systematic review. Nutrients, 14(6), 1258.
 
[15]  Hill Rice, V., Heath, L., Livingstone-Banks, J., & Hartmann-Boyce, J. (2017). Nursing interventions for smoking cessation. Cochrane Database of Systematic Reviews, 12 (12), CD001188.
 
[16]  Substance Abuse and Mental Health Services Administration (2014). Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. In. Edited by Department of Health and Human Services, vol. NSDUH Series H-48, HHS Publication No. (SMA) 14–4863. Rockville. MD: Substance Abuse Mental Health Services Administration.
 
[17]  Jamal, A., Agaku, I. T., O’Connor, E., King, B. A., Kenemer, J. B., & Neff, L. (2014). Current cigarette smoking among adults—United States, 2005–2013. Morbidity and Mortality Weekly Report, 63(47), 1108-1112.
 
[18]  Ramo, D. E., Thrul, J., Delucchi, K. L., Ling, P. M., Hall, S. M., & Prochaska, J. J. (2015). The Tobacco Status Project (TSP): Study protocol for a randomized controlled trial of a Facebook smoking cessation intervention for young adults. BMC public health, 15(1), 1-9.
 
[19]  Essa-Hadad, J., Linn, S., & Rafaeli, S. (2015). A web-based program to increase knowledge and reduce cigarette and nargila smoking among Arab university students in Israel: mixed-methods study to test acceptability. Journal of medical Internet research, 17(2), e39. 1-12
 
[20]  El-Gilany, A., El-Wehady, A., & El-Wasify, M. (2012). Updating and validation of the socioeconomic status scale for health research in Egypt. Eastern Mediterranean health journal, 18(9).
 
[21]  Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The Fagerström test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. British journal of addiction, 86(9), 1119-1127.
 
[22]  Mbatchou Ngahane, B. H., Atangana Ekobo, H., & Kuaban, C. (2015). Prevalence and determinants of cigarette smoking among college students: a cross-sectional study in Douala, Cameroon. Archives of Public Health, 73(47), 1-7.
 
[23]  Guan, A., Kim-Mozeleski, J. E., Tan, J. Y., McPhee, S. J., Burke, N. J., Sun, A., ... & Tsoh, J. Y. (2020). Serious quit attempts and cessation implications for Asian American male smokers. Addictive behaviors, 100, 106129.
 
[24]  Starr, G., Rogers, T., Schooley, M., Porter, S., Wiesen, E., Jamison, N. (2005) Key outcome indicators for evaluating comprehensive tobacco control programs. Atlanta, GA: Centers for Disease Control and Prevention.
 
[25]  Klemperer, E. M., Mermelstein, R., Baker, T. B., Hughes, J. R., Fiore, M. C., Piper, M. E., ... & Cook, J. W. (2020). Predictors of smoking cessation attempts and success following motivation-phase interventions among people initially unwilling to quit smoking. Nicotine and Tobacco Research, 22(9), 1446-1452.
 
[26]  Haddad, L. G., & Malak, M. Z. (2002). Smoking habits and attitudes towards smoking among university students in Jordan. International journal of nursing studies, 39(8), 793-802.
 
[27]  Weinberger, A. H., Reutenauer, E. L., Allen, T. M., Termine, A., Vessicchio, J. C., Sacco, K. A., ... & George, T. P. (2007). Reliability of the fagerström test for nicotine dependence, minnesota nicotine withdrawal scale, and tiffany questionnaire for smoking urges in smokers with and without schizophrenia. Drug and alcohol dependence, 86(2-3), 278-282.
 
[28]  Cohen, J. (1992). A power primer. Psychological bulletin, 112(1), 155.
 
[29]  Lee, E. Y., Hesketh, K. D., Rhodes, R. E., Rinaldi, C. M., Spence, J. C., & Carson, V. (2018). Role of parental and environmental characteristics in toddlers’ physical activity and screen time: Bayesian analysis of structural equation models. International Journal of Behavioral Nutrition and Physical Activity, 15(1), 1-14.
 
[30]  Zhou, X., Wei, X., Cheng, A., Liu, Z., Su, Z., Li, J., ... & Wang, C. (2023). Mobile Phone–Based Interventions for Smoking Cessation Among Young People: Systematic Review and Meta-Analysis. JMIR mHealth and uHealth, 11(1), e48253, 1-16.
 
[31]  Reitsma, M. B., Flor, L. S., Mullany, E. C., Gupta, V., Hay, S. I., & Gakidou, E. (2021). Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and initiation among young people in 204 countries and territories, 1990–2019. The Lancet Public Health, 6(7), e472-e481.
 
[32]  Puigdomènech, E., Trujillo-Gómez, J. M., Martín-Cantera, C., Díaz-Gete, L., Manzano-Montero, M., Sánchez-Fondevila, J., ... & Grupo Estudio. (2015). Information and communication technologies for approaching smokers: a descriptive study in primary healthcare. BMC Public Health, 15 (2), 1-14.
 
[33]  International Telecommunications Union (ITU) (2023). Individuals using the internet. URL: https://www.itu.int/en/ITU-D/Statistics/Pages/stat/default.aspx.
 
[34]  Berg, C. J., Stratton, E., Sokol, M., Santamaria, A., Bryant, L., & Rodriguez, R. (2014). Novel incentives and messaging in an online college smoking intervention. American Journal of Health Behavior, 38(5), 668-680.
 
[35]  Villanti, A. C., Peasley-Miklus, C., Cha, S., Schulz, J., Klemperer, E. M., LePine, S. E., ... & Graham, A. L. (2022). Tailored text message and web intervention for smoking cessation in US socioeconomically-disadvantaged young adults: A randomized controlled trial. Preventive medicine, 165 (Pt B), 107209.
 
[36]  Ramo, D. E., Thrul, J., Delucchi, K. L., Hall, S., Ling, P. M., Belohlavek, A., & Prochaska, J. J. (2018). A randomized controlled evaluation of the tobacco status project, a Facebook intervention for young adults. Addiction, 113(9), 1683-1695.
 
[37]  Chiocca, E. (2015). Advanced Pediatric Assessment, Second Edition, Springer Publishing Company, pp. 10-17.
 
[38]  Kliegman, R. (2016). Behavioral disorders, Nelson textbook of pediatrics, 20 editions, Elsevier, Philadelphia, 124-127.
 
[39]  Mahfoz, F.F.A. (2018). Smoking intervention program for male secondary school students. Egyptian Journal of Health Care, 9 (3), 324-347.
 
[40]  Sherman, J. J., & Smith, B. L. (2019). Effect of a smoking cessation educational intervention on knowledge and confidence of pharmacy students versus community leaders. Pharmacy Practice (Granada), 17(1), ‏1302, 1-7.
 
[41]  Semwal, M., Whiting, P., Bajpai, R., Bajpai, S., Kyaw, B. M., & Tudor Car, L. (2019). Digital education for health professions on smoking cessation management: Systematic review by the Digital Health Education Collaboration. Journal of Medical Internet Research, 21(3), e13000. 1-12.
 
[42]  Graham, A. L., Carpenter, K. M., Cha, S., Cole, S., Jacobs, M. A., Raskob, M., & Cole-Lewis, H. (2016). Systematic review and meta-analysis of Internet interventions for smoking cessation among adults. Substance abuse and rehabilitation, 7, 55-69.
 
[43]  An, L., Schillo, B., Saul, J., Wendling, A., Klatt, C., Berg, C., ... & Luxenberg, M. (2008). Utilization of smoking cessation informational, interactive, and online community resources as predictors of abstinence: cohort study. Journal of medical Internet research, 10(5), e55., 1-12.
 
[44]  Choi, S. H., Waltje, A. H., Ronis, D. L., Noonan, D., Hong, O., Richardson, C., ... & Duffy, S. A. (2014, June). Randomized controlled trial of the Tobacco Tactics website versus 1-800-QUIT-NOW telephone line among Operating Engineers. In Tobacco Induced Diseases 12 (1), 1-1. BioMed Central.
 
[45]  Park, E., & Drake, E. (2015). Systematic review: internet‐based program for youth smoking prevention and cessation. Journal of Nursing Scholarship, 47(1), 43-50.
 
[46]  Tzelepis, F., Mitchell, A., Wilson, L., Byrnes, E., Haschek, A., Leigh, L., & Oldmeadow, C. (2021). The long-term effectiveness of internet-based interventions on multiple health risk behaviors: systematic review and robust variance estimation meta-analysis. Journal of Medical Internet Research, 23(12), e23513. ‏1-10.
 
[47]  Bashirian, S., Barati, M., Karami, M., Hamzeh, B., & Ezati, E. (2021). The effect of a web-based educational program on prevention of hookah smoking among adolescent girls: application of theory of planned behavior. Addiction & Health, 13(4), 259- 67.
 
[48]  Richardson, A., Graham, A. L., Cobb, N., Xiao, H., Mushro, A., Abrams, D., & Vallone, D. (2013). Engagement promotes abstinence in a web-based cessation intervention: cohort study. Journal of medical Internet research, 15(1), e14. 1-17.
 
[49]  Do, H. P., Tran, B. X., Le Pham, Q., Nguyen, L. H., Tran, T. T., Latkin, C. A., ... & Baker, P. R. (2018). Which eHealth interventions are most effective for smoking cessation? A systematic review. Patient preference and adherence,12, 2065-2084.
 
[50]  Skov‐Ettrup, L. S., Dalum, P., Bech, M., & Tolstrup, J. S. (2016). The effectiveness of telephone counselling and internet‐and text‐message‐based support for smoking cessation: results from a randomized controlled trial. Addiction, 111(7), 1257-1266.‏
 
[51]  Goldenhersch, E., Thrul, J., Ungaretti, J., Rosencovich, N., Waitman, C., & Ceberio, M. R. (2020). Virtual reality smartphone-based intervention for smoking cessation: pilot randomized controlled trial on initial clinical efficacy and adherence. Journal of medical Internet research, 22(7), e17571, 1-15.
 
[52]  Lin, Y., Tudor-Sfetea, C., Siddiqui, S., Sherwani, Y., Ahmed, M., & Eisingerich, A. B. (2018). Effective behavioral changes through a digital mHealth app: Exploring the impact of hedonic well-being, psychological empowerment and inspiration. JMIR mHealth and uHealth, 6(6), e10024.
 
[53]  Lyons, E. J., Lewis, Z. H., Mayson, B. G., & Rowland, J. L. (2014). Behavior change techniques implemented in electronic lifestyle activity monitors: a systematic content analysis. Journal of medical Internet research, 16(8), e192.
 
[54]  Civljak, M., Stead, L.F., Hartmann-Boyce, J., Sheikh, A., & Car, J. (2013). Internet-based interventions for smoking cessation. Cochrane Database systematic reviews 7: CD007078.
 
[55]  Calhoun, P. S., Datta, S., Olsen, M., Smith, V. A., Moore, S. D., Hair, L. P., ... & Bastian, L. A. (2016). Comparative effectiveness of an internet-based smoking cessation intervention versus clinic-based specialty care for veterans. Journal of substance abuse treatment, 69, 19-27.
 
[56]  Nădăşan, V., Foley, K. L., Pénzes, M., Paulik, E., Mihăicuţă, Ş., Ábrám, Z., ... & Urbán, R. (2017). The short-term effects of ASPIRA: a web-based, multimedia smoking prevention program for adolescents in Romania: a cluster randomized trial. Nicotine & Tobacco Research, 19(8), 908-915.
 
[57]  Cremers, H. P., Mercken, L., Candel, M., de Vries, H., & Oenema, A. (2015). A web-based, computer-tailored smoking prevention program to prevent children from starting to smoke after transferring to secondary school: randomized controlled trial. Journal of medical Internet research, 17(3), e3794.
 
[58]  Siemer, L., Ben Allouch, S., Pieterse, M. E., Brusse-Keizer, M., Sanderman, R., & Postel, M. G. (2020). Patients’ user experience of a blended face-to-face and web-based smoking cessation treatment: qualitative study. JMIR Formative Research, 4(6), e14550. ‏1-15.
 
[59]  Curtis, B. (2012). Understanding tailored Internet smoking cessation messages: A reasoned action approach. The Annals of the American Academy of Political and Social Science, 640(1), 136-149.
 
[60]  Heidarnia, A., Barati, M., Niknami, S., Allahverdipour, H., & Bashirian, S. (2016). Effect of a web-based educational program on prevention of tobacco smoking among male adolescents: an application of prototype willingness model. Journal of Education and Community Health, 3(1), 1-11. https:// www. who. int/ en/ news- room/ fact- sheets/ detail/ tobacco.