BACKGROUND-AIM:
Adolescents remain the potentially at-risk group, with social norms and peer pressure being strong drivers for early initiation of tobacco use in Indonesia. To this end, we developed and evaluated an interactive participatory school-based tobacco prevention model and assessed its potential for scale-up in West Kalimantan.

METHODS:
A quasi-experimental pre–post study was conducted in four junior secondary schools with 600 students aged 12–18 years. Participatory strategies were used in the intervention to involve peer educators. Outcomes were knowledge, attitudes, behavioral intentions, and refusal self-efficacy measured using validated questionnaires. The statistical analysis involved paired t-tests (or Wilcoxon signed-rank tests) for pre–post comparisons and McNemar tests for paired categorical variables (eg, intention to smoke). Cohen’s d was used to estimate effect sizes with significance set at p<0.05.

RESULTS:
Quality of education mean knowledge scores were significantly improved (62.3±12.5 vs 78.6±10.4; p<0.001, d=1.42). Attitudes toward tobacco were more favorable (from 3.1±0.6 to 4.0±0.5; p<0.001). Refusal self-efficacy increased (58.7±13.2 to 75.9±11.6; p<0.001, d=1.30). The percentage of students who planned to smoke decreased from 18.5% to 9.2% (p<0.001). Qualitative results support high acceptability and engagement.

CONCLUSIONS:
The concept has proven efficacious in diminishing youth tobacco use by addressing fundamental behavioral determinants of smoking and preventing young people from vaping, dynamic and participative school-based discovery methods for addiction prevention are still an underused research area. This model is effective, acceptable and presents an opportunity for a larger scale implementation in Indonesia and similar settings. A youth-led movement to achieve the first tobacco- and nicotine-free generation