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Free full text in Europe PMC. Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous; the dramatic health consequences are too far in the future to fathom. A free photoageing mobile app Smokerface was implemented by medical students in secondary schools via a novel method called mirroring. This is the first randomised trial to measure the effectiveness of the mirroring approach on smoking behaviour in secondary schools.
The mirroring intervention, which lasts 45 min, is implemented by Brazilian medical students in at least 35 secondary school classes with 21 participants each at least 35 classes with 21 participants for control in February in the city of Itauna, Brazil. External block randomisation via computer is performed on the class level with a allocation. In addition to sociodemographic data, smoking behaviour is measured via a paperβpencil questionnaire before, 3 and 6 months postintervention plus a random carbon monoxide breathing test at baseline and end line.
The primary outcome is cigarette smoking in the past week at 6 months follow-up. Smoking behaviour smoking onset, quitting and effects on the different genders are studied as secondary outcomes. Analysis is by intention to treat. Ethical approval is obtained from the ethics committee of the University of Itauna in Brazil. Results will be disseminated at conferences, in peer-reviewed journals, throughout the Education Against Tobacco network social media channels and on our websites.
This is the first study measuring the longitudinal effectiveness of the mirroring intervention in changing smoking behaviour. External randomisation via computer and a relatively high number of clusters ensure good comparability between groups. For the reason that intervention and control classes are located in the same schools, cluster effects cannot be excluded.