Background: Smoking remains a major global public health challenge. As smoking often begins in early adolescence, early preventive programs are essential, yet research focusing exclusively on elementary school students is limited. This study measured smoking prevalence, smoking-related knowledge and attitudes, and the impact of a school-based intervention on these outcomes among 12–13-year-old students in Larissa, Greece. Methods: A total of 769 students participated (response rate: 75%). Knowledge, attitudes, and smoking prevalence were assessed at baseline. The intervention group (n = 316) was exposed to audiovisual and printed materials, and both groups were followed up at three- and twelve months post-intervention. Multivariable linear mixed-effects models and generalized estimating equations were used to evaluate intervention effects. Results: Baseline characteristics were balanced between groups. A statistically significant stage × group interaction was observed, indicating improvements in smoking-related knowledge and attitudes (p < 0.001) and a reduced likelihood of smoking initiation (p = 0.011) in the intervention group. Conclusions: This school-based intervention demonstrated significant improvements in knowledge and attitudes toward smoking and reduced the likelihood of smoking initiation. These findings support integrating early prevention programs into school curricula as a potentially effective approach to improving smoking-related outcomes.
Panagiotidou et al. (Sun,) studied this question.
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