A Smoking Intervention Program for Primary Four Students in Hong Kong: What it can and cannot achieve

The study aimed to assess the feasibility of a smoking prevention intervention program in primary schools in Hong Kong; increase awareness of the purpose of tobacco advertising; record any changes in attitude towards smoking; and measure the effects of the program on the children's knowledge of the harmful effects of smoking on health. Six classes from two primary schools in Hong Kong were involved in the study. The sample of 205 pupils in Primary 4, aged 9–10 years, were presented with a smoking prevention program of three lessons, including homework assignments. The intervention was evaluated by the analysis of pre- and post-test results and through personal interviews with the teachers. There were statistically significant changes in the responses of the children between pre- and post-tests, with a reduction in "don't know" answers and increase, in most cases, in correct responses. There were more improvements in knowledge than in attitude. There were no significant changes in the responses to questions about current behavior or future intention to smoke. School-based smoking prevention programs for primary schools in Hong Kong should be further developed and evaluated. Additional studies with larger numbers of children need to be conducted and implementation should occur quickly once efficacy has been demonstrated by evaluation. We hypothesize that a longer, spiral curriculum spanning Primary 4, 5 and 6 would be more effective in preventing the uptake of smoking, although this shorter program is a feasible and acceptable alternative to the absence of any program.