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Background <p>The prevalence of hookah smoking among females, including university students, is increasing and is considered a high-risk behavior; therefore, designing and implementing effective interventions is crucial. This study aimed to determine the effect of an educational program based on an integrated model of the Theory of Planned Behavior (TPB) and the Prototype Willingness Model (PWM) on hookah smoking among female university students.</p> Methods <p>A quasi-experimental study was conducted on 100 female university students residing in dormitories from October 2024 to January 2025. Four dormitories were randomly assigned to intervention and control groups. Students were recruited through convenience sampling, proportionate to the population of each dormitory. Based on the integrated model, the educational program was delivered to the intervention group in four sessions. Data were collected using a demographic information form and a self-developed questionnaire to assess the integrated model constructs at baseline and three months post-intervention. Data were analyzed using t-tests, chi-square tests, and the Mann–Whitney U test (SPSS v26).</p> Results <p>Scores for positive attitude towards hookah smoking (<i>P</i> = 0.01), subjective norms (<i>P</i> = 0.04), behavioral willingness (<i>P</i> = 0.02), prototype favorability (<i>P</i> = 0.03), and perceived behavioral control (<i>P</i> = 0.02) significantly decreased in the intervention group. Behavioral intention, however, significantly increased (<i>P</i> = 0.03). No significant differences were observed in prototype similarity (<i>P</i> = 0.81). Although the prevalence of hookah users after the intervention did not differ significantly between the two groups (<i>P</i> = 0.41), the frequency of hookah use (<i>P</i> = 0.02) and the duration of each smoking session (<i>p</i> = 0.03) were significantly different between the groups.</p> Conclusion <p>The integrated model-based educational intervention led to significant reductions in both the frequency of hookah use and the duration of each smoking session. This model can be employed as an innovative and practical approach to modify students’ behavior.</p>

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The effect of an educational program on Hookah smoking among female university students: applying the integrated model of theory of planned behavior and prototype willingness model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月12日

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  • Zahra Khalilzadeh-Farsangi,
  • Zahra Arab Borzu,
  • Fereshteh Najafi

摘要

Background

The prevalence of hookah smoking among females, including university students, is increasing and is considered a high-risk behavior; therefore, designing and implementing effective interventions is crucial. This study aimed to determine the effect of an educational program based on an integrated model of the Theory of Planned Behavior (TPB) and the Prototype Willingness Model (PWM) on hookah smoking among female university students.

Methods

A quasi-experimental study was conducted on 100 female university students residing in dormitories from October 2024 to January 2025. Four dormitories were randomly assigned to intervention and control groups. Students were recruited through convenience sampling, proportionate to the population of each dormitory. Based on the integrated model, the educational program was delivered to the intervention group in four sessions. Data were collected using a demographic information form and a self-developed questionnaire to assess the integrated model constructs at baseline and three months post-intervention. Data were analyzed using t-tests, chi-square tests, and the Mann–Whitney U test (SPSS v26).

Results

Scores for positive attitude towards hookah smoking (P = 0.01), subjective norms (P = 0.04), behavioral willingness (P = 0.02), prototype favorability (P = 0.03), and perceived behavioral control (P = 0.02) significantly decreased in the intervention group. Behavioral intention, however, significantly increased (P = 0.03). No significant differences were observed in prototype similarity (P = 0.81). Although the prevalence of hookah users after the intervention did not differ significantly between the two groups (P = 0.41), the frequency of hookah use (P = 0.02) and the duration of each smoking session (p = 0.03) were significantly different between the groups.

Conclusion

The integrated model-based educational intervention led to significant reductions in both the frequency of hookah use and the duration of each smoking session. This model can be employed as an innovative and practical approach to modify students’ behavior.