Background
This study aimed to evaluate the effectiveness and engagement of an interactive simulation-based online smoking prevention program compared to a traditional offline program for Korean adolescents.
Methods
A total of 1,008 adolescents from elementary, middle, high, and alternative schools in Chungcheongnam-do Province, South Korea participated in this study from October 1 to 31, 2021. The offline program consisted of 2-hour lectures by teachers, whereas the online program included six interactive peer-oriented video modules. The evaluation compared and analyzed the survey results measuring changes in smoking-related knowledge and attitudes before and after each program, as well as the level of interest in and satisfaction with education.
Results
When comparing the pre- and post-intervention scores between the two groups, no statistically significant differences were found except for a decreased belief that smoking helps relieve stress (F=12.125, P=0.001). However, withingroup comparisons revealed that the online smoking prevention program led to positive changes in most smokingrelated knowledge and attitude items, including reduced beliefs about smoking as a stress reliever (P<0.001) and lower misconceptions about the harm of e-cigarettes (P<0.001). In terms of engagement and satisfaction, the online program received significantly higher scores for interest (P<0.001), knowledge improvement (P<0.001), and program recommendations (P=0.021).
Conclusion
The online smoking prevention program was as effective as the traditional offline approach in enhancing smoking-related knowledge and attitudes. Moreover, its superior engagement and time efficiency highlight its strong potential as an effective alternative or complementary strategy to conventional school-based programs.

Citations

• Adapting and Implementing a School-Based “Implementation Intentions” Program Within FRESHAIR4Life to Prevent Smoking Initiation Among Adolescents in Greece: A Study Protocol
  Izolde Bouloukaki, Antonios Christodoulakis, Sevasti Peraki, Floor A. Van Den Brand, Faraz Siddiqui, Theodoros Krasanakis, Antonia Aravantinou-Karlatou, Purva Abhyankar, Siân Williams, Julia van Koeveringe, Rianne MJJ van der Kleij, Ioanna Tsiligianni
  Healthcare.2026; 14(7): 938.     CrossRef
• Adolescence and young adulthood: a critical period for lifelong health
  Su-Min Jeong
  Korean Journal of Family Medicine.2026; 47(3): 187.     CrossRef