Comparison of the Effect of Board Game and Tobacco Cessation Education on Nicotine Addiction in Adolescent Smokers: a Randomized Controlled Trial.

Tobacco use is one of the leading preventable causes of death.Tobacco use is a major risk factor for cardiovascular and respiratory diseases, more than 20 different types or subtypes of cancer, and many other debilitating health conditions. The risk of morbidity and mortality increases with the increase of tobacco use. There are many methods such as smoking cessation pharmacotherapy, nicotine replacement therapy, cognitive behavioral therapies. One of them is the education aiming at behavior change organized according to the Transtheoretic Model (TTM) . The main purpose of the model is to prevent addiction by applying the change stages without any medical support. However, these techniques have been reported to be limited in quitting success. This situation necessitated the use of different techniques. One of these techniques is games. The game; It is a conscious activity that provides socialization, does not have a specific financial gain/profit purpose, is carried out in a certain time period, according to binding rules, has a special purpose and provides an extraordinary life.Since it is very easy to reach information thanks to technology in our age, teaching activities with traditional methods are boring and cannot provide motivation. Therefore, games can create learning environments that make education fun. While the use of games in health education exposes individuals to subjects, it aims to create an internal motivation, targeting protection and improvement of health.

The sample size of the study was Cohen's effect size calculation. The effect size is generally defined as the size of the difference between the null hypotheses and alternative hypotheses, which is an indicator of the practical significance of the research results. Cohen's effect size calculation varies according to the study design. For our study, the ANOVA effect formula was used which is the intergroup interaction (relationship) test in repeated measurements. For 4 groups and 3 repeated measurements, the total sample size of based on a power of 0.80, with an effect size of 0.175 and a Type I error rate of 0.05 was calculated 80.

Study inclusion criteria were studying at XXX High School, having at least one cigarette a day and volunteering to participate in the study. There were 106 students who smoked regularly every day and were willing to participate in the study. Therefore we calculated the power of study with Type I error rate of 0.05, effect size of 0.175 and 106 samples as 0.91.

For the randomization; after baseline assessment, eligible students was given an automatic number using Java's built-in random number generator and randomly assigned to four equally-probability groups. Randomization was done by a research blind person in the EXCEL program. Research personnel were blind to allocation at initial randomization but were informed after assignment to groups. Participants were informed about which group they were allocated to. There were 26 participants in the BG group, 25 in the TCE group, 26 in the Cİ group, and 26 in the CG.

For the measurements were used Socio-demographic feature identification form,Fagerstrom test for nicotine dependence,Stages of Change Scale.