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Effectiveness of facilitator-driven and peer-led educational interventions on tobacco use intention among adolescents: a school-based cluster randomized trial protocol

Year: 2026

Type: article

Abstract: Tobacco use remains a major preventable risk factor for non-communicable diseases (NCDs), with initiation frequently occurring during adolescence. Despite the implementation of several school-based tobacco prevention programmes, evidence on the effectiveness of peer-led educational approaches in the Indian context remains limited. This study aims to evaluate the effectiveness of a combined facilitator-driven and peer-led educational intervention in reducing the intention to use tobacco among school-going adolescents. The study will be conducted in 2 phases: Phase 1 will involve a qualitative study using in-depth interviews (IDI)with key stakeholders, including teachers, parents, psychologists, medico-social workers, students, and representatives of the national health programmes. The findings from this phase will be used to develop a culturally appropriate, evidence-based educational module. Phase 2 will comprise a school-based cluster randomized controlled trial involving 400 Class 8 students from 10 private English-medium schools in Mangalore. Schools will be randomly allocated to intervention and control arms. Both groups will receive facilitator-driven tobacco prevention education, while the intervention group will additionally receive peer-led reinforcement sessions delivered by trained peer educators. The primary outcome will be the change in intention to use tobacco, assessed using a validated Likert-scale instrument. Secondary outcomes will include changes in knowledge, attitudes, perceptions, risk perception, and patterns of tobacco use from baseline. The findings are expected to generate evidence on the effectiveness of integrating peer-led reinforcement with facilitator driven education and may inform the development of scalable and sustainable school-based tobacco prevention strategies in India.

Source: MethodsX

DOI: 10.1016/j.mex.2026.104214