Effectiveness of Health Education Campaigns for Adolescent Smoking Cessation Programs
Keywords:
Smoking cessation, Health campaigns, Message framing, Peer norms, Adolescent healthAbstract
Objective: This study investigates the impact of health education campaigns on adolescent cessation in smoking, considering intensity of campaign exposure, message framing and quality, and interactivity and channel mix, and the role of parents, controlling for peer smoking norms as a potential moderator.
Methods: To test main and conditional effects, this study included both direct and moderation analyses and utilized an observational design; structured questionnaires and regression were also employed.
Results: All campaign-related predictors had a significant and positive effect on adolescent smoking cessation. The campaign exposure and message quality increased awareness and intention to quit, whereas interactivity and channel mix were the most important driver for behavioural change. Parental involvement also made a significant contribution, since it can strengthen the anti-smoking attitudes. Crucially, all relationships were moderated by peer smoking norms, with the impact of campaigns being augmented in socially supportive contexts and attenuated when permissive smoking attitudes were present.
Novelty: The novelty of this research is that a multi- dimensional model describing the relationship between program design and social context is advanced which offer a solution for the discrepancies in prior studies. It is one of the first to evaluate peer norms as a mediator over various campaign components simultaneously, providing new thinking for both theorizing and application.
Implications for Research: Results highlight the importance of socio-ecological models in considering program quality and peer influence. Adolescent populations of various cultural groups should be examined in future studies to maximize health education programs worldwide and further consolidate the evidence for targeted interventions.
Downloads
References
Aboujaoude, E., Savage, M. W., Starcevic, V., & Salame, W. O. (2015). Cyberbullying: Review of an Old Problem Gone Viral. Journal of Adolescent Health, 57(1), 10–18. https://doi.org/https://doi.org/10.1016/j.jadohealth.2015.04.011
Addissouky, T. A., El Sayed, I. E. T., Ali, M. M. A., Wang, Y., El Baz, A., Elarabany, N., & Khalil, A. A. (2024). Oxidative stress and inflammation: elucidating mechanisms of smoking-attributable pathology for therapeutic targeting. Bulletin of the National Research Centre, 48(1), 16. https://doi.org/10.1186/s42269-024-01174-6
Andrykowski, M. A., Beacham, A. O., Schmidt, J. E., & Harper, F. W. K. (2006). Application of the theory of planned behavior to understand intentions to engage in physical and psychosocial health behaviors after cancer diagnosis. Psycho-Oncology, 15(9), 759–771. https://doi.org/https://doi.org/10.1002/pon.1007
Brennan, M., Scott, S., & Bergin, P. (2020). Sudden unexpected death in epilepsy (SUDEP) in New Zealand; A retrospective review. New Zealand Medical Journal, 133(1508), 65–71.
Cacciatore, S., Mao, S., Nuñez, M. V., Massaro, C., Spadafora, L., Bernardi, M., Perone, F., Sabouret, P., Biondi-Zoccai, G., Banach, M., Calvani, R., Tosato, M., Marzetti, E., & Landi, F. (2025). Urban health inequities and healthy longevity: traditional and emerging risk factors across the cities and policy implications. Aging Clinical and Experimental Research, 37(1), 143. https://doi.org/10.1007/s40520-025-03052-1
Cassoff, J., Knäuper, B., Michaelsen, S., & Gruber, R. (2013). School-based sleep promotion programs: Effectiveness, feasibility and insights for future research. Sleep Medicine Reviews, 17(3), 207–214. https://doi.org/https://doi.org/10.1016/j.smrv.2012.07.001
Dodge, K. A., Dishion, T. J., & Lansford, J. E. (2006). Deviant Peer Influences in Intervention and Public Policy for Youth. Social Policy Report, 20(1), 1–20. https://doi.org/https://doi.org/10.1002/j.2379-3988.2006.tb00046.x
Dolan, S., Nowell, L., & McCaffrey, G. (2022). Pragmatism as a philosophical foundation to integrate education, practice, research and policy across the nursing profession. Journal of Advanced Nursing, 78(10), e118–e129. https://doi.org/https://doi.org/10.1111/jan.15373
Evans, W. D. (2008). Social Marketing Campaigns and Children’s Media Use. The Future of Children, 18(1), 181–203. http://www.jstor.org/stable/20053124
Guyer, B., Ma, S., Grason, H., Frick, K. D., Perry, D. F., Sharkey, A., & McIntosh, J. (2009). Early Childhood Health Promotion and Its Life Course Health Consequences. Academic Pediatrics, 9(3), 142-149.e71. https://doi.org/https://doi.org/10.1016/j.acap.2008.12.007
Hagedoorn, J., Haugh, H., Robson, P., & Sugar, K. (2023). Social innovation, goal orientation, and openness: insights from social enterprise hybrids. Small Business Economics, 60(1), 173–198. https://doi.org/10.1007/s11187-022-00643-4
Huang, Y.-J., Lee, P.-H., Hsieh, S.-H., Chiu, Y.-C., & Chan, T.-C. (2024). Understanding factors influencing adoption of air pollution protective measures using the knowledge-attitude-behavior model. Scientific Reports, 14(1), 28414. https://doi.org/10.1038/s41598-024-79905-y
Lamkin, L., Davis, B., & Kamen, A. (1998). Rationale for Tobacco Cessation Interventions for Youth. Preventive Medicine, 27(5, Part B), A3–A8. https://doi.org/https://doi.org/10.1006/pmed.1998.0386
Mabhala, M., Esealuka, W. A., Yohannes, A., Nwufo, A. N., Paulus, L., Tefera, M., & Keeling, J. (2025). Exploring the social context of smoking behaviours: insights from stop-smoking advisors in deprived communities in Northwest of England UK. BMC Public Health, 25(1), 1914. https://doi.org/10.1186/s12889-025-23110-7
Makadia, L. D., Roper, P. J., Andrews, J. O., & Tingen, M. S. (2017). Tobacco Use and Smoke Exposure in Children: New Trends, Harm, and Strategies to Improve Health Outcomes. Current Allergy and Asthma Reports, 17(8), 55. https://doi.org/10.1007/s11882-017-0723-0
Mathers, M., Toumbourou, J. W., Catalano, R. F., Williams, J., & Patton, G. C. (2006). Consequences of youth tobacco use: a review of prospective behavioural studies. Addiction, 101(7), 948–958. https://doi.org/https://doi.org/10.1111/j.1360-0443.2006.01438.x
Moitra, P., Madan, J., & Verma, P. (2021). Impact of a behaviourally focused nutrition education intervention on attitudes and practices related to eating habits and activity levels in Indian adolescents. Public Health Nutrition, 24(9), 2715–2726. https://doi.org/DOI: 10.1017/S1368980021000203
Ninkron, P., & Khuntiterakul, P. (2025). Creating mental immunity to reduce the risk associated with substance abuse among junior high school students in Nakhon Pathom Province, Thailand. Children and Youth Services Review, 169, 108092. https://doi.org/https://doi.org/10.1016/j.childyouth.2024.108092
Nirmala, M., Bao, H., Jansen, B., Koh, M. W. A., Kok, L. W., Ng, J. J., & Lee, E. W. J. (2025). Sit is not lit: Examining the impact of message framing, modality, and peer influence on attitudes and intentions to reduce sedentary behavior. Social Science & Medicine, 366, 117683. https://doi.org/https://doi.org/10.1016/j.socscimed.2025.117683
Noar, S. M., Rohde, J. A., Barker, J. O., Hall, M. G., & Brewer, N. T. (2020). Pictorial Cigarette Pack Warnings Increase Some Risk Appraisals But Not Risk Beliefs: A Meta-Analysis. Human Communication Research, 46(2–3), 250–272. https://doi.org/10.1093/hcr/hqz016
Orr, N., Chollet, A., Rizzo, A. J., Shaw, N., Farmer, C., Young, H., Rigby, E., Berry, V., Bonell, C., & Melendez-Torres, G. J. (2022). School-based interventions for preventing dating and relationship violence and gender-based violence: A systematic review and synthesis of theories of change. Review of Education, 10(3), e3382. https://doi.org/https://doi.org/10.1002/rev3.3382
Papadopoulou, C., Hultman, M., & Oghazi, P. (2025). Authenticity Perceptions of Informational and Transformational Advertising: Decoding the Role of Construal Level Mindset. Psychology & Marketing, 42(3), 817–841. https://doi.org/https://doi.org/10.1002/mar.22153
Park, M. (2020). How Smoking Advocates are Connected Online: An Examination of Online Social Relationships Supporting Smoking Behaviors. Journal of Health Communication, 25(1), 82–90. https://doi.org/10.1080/10810730.2019.1709924
Pinto, J., Read, K., Tarabey, E., & Bishop, F. L. (2025). Training needs for (UK) professional standards authority accredited register and regulated traditional, complementary and integrative medicine professions for supporting patients to make lifestyle and health behaviour changes: A rapid narrative review. European Journal of Integrative Medicine, 78, 102517. https://doi.org/https://doi.org/10.1016/j.eujim.2025.102517
Raabe, Isabel J, Boda, Zsófia, & Stadtfeld, Christoph. (2019). The Social Pipeline: How Friend Influence and Peer Exposure Widen the STEM Gender Gap. Sociology of Education, 92(2), 105–123. https://doi.org/10.1177/0038040718824095
Rhodes, R. E., & Courneya, K. S. (2003). Investigating multiple components of attitude, subjective norm, and perceived control: An examination of the theory of planned behaviour in the exercise domain. British Journal of Social Psychology, 42(1), 129–146. https://doi.org/https://doi.org/10.1348/014466603763276162
Rockhill, C. M., Ramtekkar, U., Becker, T. D., Greenhill, L., Hayek, M., Vasa, R. A., Abright, A. R., Diamond, J. M., Nazario Rodríguez, L., & Walter, H. J. (2025). Clinical Practice Guideline: Assessment and Treatment of Adolescents and Young Adults With Substance Use Disorders and Problematic Substance Use (Excluding Tobacco). Journal of the American Academy of Child & Adolescent Psychiatry. https://doi.org/https://doi.org/10.1016/j.jaac.2025.08.006
Santiago, S., Mahoney, C., Murray Michael P., & Benoza, G. (2019). “The Real Cost”: Reaching At-Risk Youth in a Fragmented Media Environment. American Journal of Preventive Medicine, 56(2, Supplement 1), S49–S56. https://doi.org/https://doi.org/10.1016/j.amepre.2018.07.041
Simons, D.-L., Bradbury, R. B., & Evans, K. L. (2025). Impacts of ecosystem service message framing and dynamic social norms on public support for tropical forest restoration. Conservation Biology, 39(2), e14373. https://doi.org/https://doi.org/10.1111/cobi.14373
Slimmen, S., Timmermans, O., Lechner, L., & Oenema, A. (2024). A socio-ecological approach of evidence on associations between social environmental factors and mental health outcomes of young adults: A systematic review. Social Sciences & Humanities Open, 10, 101068. https://doi.org/https://doi.org/10.1016/j.ssaho.2024.101068
Steiner, T. J., Jensen, R., Katsarava, Z., Linde, M., MacGregor, E. A., Osipova, V., Paemeleire, K., Olesen, J., Peters, M., & Martelletti, P. (2019). Aids to management of headache disorders in primary care (2nd edition). The Journal of Headache and Pain, 20(1), 57. https://doi.org/10.1186/s10194-018-0899-2
Vahedi, Z., Sibalis, A., & Sutherland, J. E. (2018). Are media literacy interventions effective at changing attitudes and intentions towards risky health behaviors in adolescents? A meta-analytic review. Journal of Adolescence, 67, 140–152. https://doi.org/https://doi.org/10.1016/j.adolescence.2018.06.007
Vranken, S., Geusens, F., Christiaens, C., Greene, K., & Beullens, K. (2025). “Don’t vape, nobody uses these poisonous sticks”: A content analysis of adolescents’ self-generated anti-smoking and anti-vaping messages. Social Science & Medicine, 382, 118342. https://doi.org/https://doi.org/10.1016/j.socscimed.2025.118342
Walsh, H., McNeill, A., & Duaso, M. (2025). Factors Influencing Co-Use of Tobacco and Cannabis Amongst Young Adults in UK Further Education Colleges: A Qualitative Study. Drug and Alcohol Review, n/a(n/a). https://doi.org/https://doi.org/10.1111/dar.70002
Yasui, M., & Dishion, T. J. (2007). The Ethnic Context of Child and Adolescent Problem Behavior: Implications for Child and Family Interventions. Clinical Child and Family Psychology Review, 10(2), 137–179. https://doi.org/10.1007/s10567-007-0021-9
Yetkin, N. A., Büyükoğlan, H., Sönmez, M. F., tutar, N., Gülmez, I., & Yilmaz, I. (2020). The protective effects of thymoquinone on lung damage caused by cigarette smoke. Biotechnic & Histochemistry, 95(4), 268–275. https://doi.org/10.1080/10520295.2019.1681511
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Abdul Al Yasmine, Shymah Haleym (Author)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Applied Health Promotion Science (AHPROCE) © 2024 by PT. Inovasi Analisis Data is licensed under CC BY-SA 4.0


















