Effectiveness of the Department of Health Brief Tobacco Intervention on Smoking Cessation Among Senior High School Students in Ipil, Zamboanga Sibugay, Philippines

Abstract

Adolescent smoking remains a pressing public health concern, particularly in rural areas where access to cessation support is limited. The Department of Health’s Brief Tobacco Intervention (BTI) program provides structured, low-resource counseling based on the 5 A’s Framework and Prochaska’s Readiness to Change Model. This study aimed to evaluate the effectiveness of the BTI program in reducing smoking behavior and nicotine dependence among Grade 12 students in Ipil, Zamboanga Sibugay. A mixed-methods design was employed, involving 25 identified smokers from a cohort of 233 senior high school students. Quantitative data were collected using pre- and post-intervention surveys, including the Fagerström Test for Nicotine Dependence (FTND), with follow-up assessments at 1 week, 1 month, and 3 months. Relapse rates were monitored with additional follow-up sessions. Qualitative data were obtained through two focus group discussions involving students, BTI providers, senior high school teachers, and Rural Health Unit staff, and were analyzed thematically. At one week, 8 participants (32%) reported abstinence; however, relapse rates increased to 52% at one and three months, with only 32% maintaining abstinence. FTND scores showed a consistent decline, indicating reduced nicotine dependence even among those who relapsed. Four participants (16%) were lost to follow-up. Qualitative findings identified peer pressure, academic stress, and family smoking behaviors as key contributing factors. The BTI program demonstrated effectiveness in initiating smoking cessation, although sustained abstinence was challenged by environmental and psychosocial influences. Continued counseling, school-based integration, and tailored interventions are recommended to enhance long-term cessation outcomes.