Document Type : Original Article


1 Department of Public Health,

2 Department of Public Health

3 Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz

4 Department of Biostatistics, School of Health, Hamadan University of Medical Sciences, Hamadan,

5 Department of Public Health, School of Health, Shahid Beheshti University of Medical Sciences, Tehran

6 Department of Public Health, School of Health, Bushehr University of Medical Sciences, Bush


The most important preventive measure is technique to resist against peer pressure. Any
educational program should design with an emphasis upon theories of behavioral change and
based on effective educational program. To investigate the interventions through educational
program in prevention of cigarette smoking, this paper has used the Extended Parallel
Process Model (EPPM). Materials and Methods: This study is a quasi‑experimental study.
Two middle schools were randomly selected from male students in Shiraz. Therefore, we
randomly selected 120 students for the experimental group and 120 students for the control
group. After diagnostic evaluation, educational interventions on the consequences of smoking
and preventive skills were applied. Results: Our results indicated that there was a significant
difference between students in the control and experimental groups in the means of perceived
susceptibility (P < 0.000, t = 6.84), perceived severity (P < 0.000, t = −11.46), perceived
response efficacy (P < 0.000, t = −7.07), perceived self‑efficacy (P < 0.000, t = −11.64),
and preventive behavior (P < 0.000, t = −24.36). Conclusions: EPPM along with educating
skills necessary to resist against peer pressure had significant level of efficiency in improving
preventive behavior of cigarette smoking among adolescents. However, this study recommends
further studies on ways of increasing perceived susceptibility in cigarette smoking among


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