Effectiveness of Decoding Interactive Cognition-based Education (DICE) technique on the knowledge, attitude and practices of tobacco use and control among the dental undergraduates in Belagavi city: A randomized controlled trial

Tobacco use is a leading preventable cause of morbidity and mortality in India, with high prevalence among young adults, including dental undergraduates. Despite existing legislation like COTPA, there remains a gap in knowledge, attitude, and practices (KAP) regarding tobacco use and control. This randomized controlled trial aimed to evaluate the effectiveness of the Decoding Interactive Cognition-based Education (DICE) technique compared to conventional teaching methods among dental undergraduates in Belagavi city. Participants were randomly assigned to either a control group, which received a 10–15-minute lecture-based session, or an intervention group, which engaged in a DICE game-based learning session that promoted interactive and critical thinking through gameplay and debriefing. KAP assessments were conducted at baseline, immediately post-intervention, and after 21 days. Findings revealed improvements in both groups, but the DICE group showed significantly greater and sustained gains in all three domains. The results suggest that the DICE technique is a more effective and engaging educational strategy for enhancing tobacco-related knowledge, shaping positive attitudes, and encouraging healthier practices among dental students.