Effectiveness of online tobacco control education : a cross-sectional study among healthcare professionals

Abstract

Introduction: Online education platforms offer promising solutions for tobacco control capacity building. This study evaluated an online tobacco control course's effectiveness on healthcare professionals' knowledge, attitudes, and behavioral intentions. Methods: A cross-sectional survey was conducted among healthcare workers and medical students (n=719) in a Chinese city, January 2023. Participants were categorized as course participants (n=387) or non-participants (n=332). The validated survey instrument (Cronbach's α=0.963) assessed tobacco-related knowledge, attitudes, and behavioral intentions using 5-point Likert scales. Statistical analyses included t-tests, effect size, and multivariable regression. Results: Course participants demonstrated significantly higher knowledge scores across multiple domains compared to non-participants. Regarding specific tobacco harms, participants showed greater awareness that smoking causes stroke (4.21 ± 0.90 vs 3.86 ± 1.04, p<0.001, Cohen's d=0.37), heart disease (4.27 ± 0.85 vs 3.93 ± 1.03, p<0.001, d=0.36), and erectile dysfunction (4.05 ± 0.97 vs 3.72 ± 1.12, p<0.001, d=0.32). For secondhand smoke, participants better recognized risks of adult cardiovascular disease (4.26 ± 0.81 vs 4.04 ± 0.90, p=0.001, d=0.26) and pediatric respiratory illness (4.37 ± 0.73 vs 4.15 ± 0.83, p<0.001, d=0.28). Participants also showed more positive attitudes toward tobacco control policies and greater behavioral intentions for tobacco control advocacy. In multivariable analysis adjusting for demographics and smoking status, course participation remained significantly associated with higher knowledge scores (β=0.28; 95% CI: 0.18–0.38, p<0.001), more positive attitudes (β=0.22; 95% CI: 0.12–0.32, p<0.001), and stronger behavioral intentions (β=0.31; 95% CI: 0.19–0.43, p<0.001). Conclusions: The online tobacco control course significantly improved participants' knowledge of tobacco harms and strengthened their support for tobacco control measures. These findings suggest that digital health education platforms may be valuable tools for tobacco control capacity building, though further longitudinal studies are needed to establish causal relationships and assess long-term effectiveness.