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Introduction Tobacco use remains a global epidemic as 22% of adults smoke, with this rate increasing annually ( Egypt holds the highest tobacco consumption in the Arab world and the second highest in the Eastern Mediterranean region (MENA), as 23.8 and 19.7% of adults have or currently use tobacco, respectively ( Adolescent smoking in Egypt presents another significant public health problem, as 31.3% of 1315 aged pupils have used tobacco and 13.6% are current tobacco users ( Without effective interventions, high adolescent smoking rates will result in a heavy public health burden for a country as large and young as Egypt with 60% of its 91.51 million people aged below 24 years ( Prevention of smoking initiation is prioritised in the WHO global agenda for tobacco epidemic control ( Over the past three decades, many countries have used school-based interventions to prevent adolescents smoking (4850)