A Pilot RCT on the Feasibility of an Online Quiz Game to Promote Tobacco-related Knowledge, Attitudes and Behaviours Among Primary School Students

Students and parents will be asked their comments towards intervention in the phone interview: [Students] 1) Did you find the quiz platform interesting or engaging? Why? 2) On a scale of 0 to 10, how much did you enjoy using the quiz platform? [Parents] 1) Do you think using a quiz competition format increases your child's motivation to learn? 2) Are there specific features or functionalities you think would enhance the platform for both parents and students? Students will be asked 'Do you think the interface of the online quiz competition platform is easy to use?' We will measure the number of times that the website developer or the students reported technical problems.

We will also measure the participation rate of students during the online quiz competition period.

Students reported their opinions towards 5 statements in pre and post tests: [Pre-test] 1) Tar causes addiction; 2) Exposure to secondhand smoke increases the risk of cancer; 3) The harm from e-cigarettes is less than that of traditional cigarettes; 4) Tobacco companies use various flavours to attract children to use e-cigarettes; 5) The Hong Kong government has already banned the sale of heated tobacco products. [Post-test] 1) Occasional smoking is harmless to health; 2) Exposure to secondhand smoke increases the risk of death; 3) E-cigarettes contain carcinogens; 4) Tobacco companies promote heated tobacco products through social media platforms; 5) The Hong Kong government has already banned the sale of e-cigarettes. All the statements have 5 options from definitely no to definitely yes. The options were recoded, as appropriate, with higher scores indicating knowing more about the harms and misleading marketing strategies of ASPs.

Students will report their opinions towards 5 statements: 1) Smokers are more stylish; 2) Adults should have the freedom to smoke in their homes; 3) Using e-cigarettes can bring a bit of enjoyment; 4) Tobacco companies have a contribution to society; 5) The government should implement a total ban on smoking. All the statements have 5 options from definitely no to definitely yes. The options will be recoded, as appropriate, with higher scores indicating knowing more about the harms and misleading marketing strategies of ASPs.

Students were asked: If one of your good friends offers you an e-cigarette or heated tobacco product, ask you to have a few puffs, and no one will know about this as no more smoking in the future. Will you use them? There will be 5 options from definitely no to definitely yes.

Students were asked: In the past 7 days, how many days (0-7) 1) was someone smoking next to you when you were at home? 2) do you smell secondhand smoke drifting in from outside when you were at home? 3) was someone smoking next to you when you were outside home? 4) you can smell cigarette smoke on objects or people when you are at home and no one is smoking, and you don't see any smoke?

Students were asked: 1) Which of the following tobacco products have you ever used? 2) In the past 30 days, which of the following tobacco products have you used?