<![CDATA[Background: Smoking behavior in school-age children is an urgent public health problem in Indonesia due to the high prevalence of first-time smokers and the lack of interesting and easy-to-understand health education for children. One of the widely used educational media is animated videos, which are considered effective in attracting attention, increasing understanding, and changing children's behavior related to the dangers of smoking. This study aimed to analyze the influence of animation video-based education on the knowledge, attitudes, and intentions of smoking among elementary school students in Batealit District.Method: This quasi-experimental study used a pretest–posttest with a control group design. The study was conducted on 184 students in grades IV–VI, who were divided into an intervention group (receiving education through four animated videos) and a control group (without intervention). The research instrument is in the form of a questionnaire of knowledge, attitudes, and intentions, which have been tested for validity and reliability. Data analysis included Wilcoxon and Mann–Whitney tests, as well as the Linear Mixed Model to control confounding variables, such as pocket money.Result: The results showed a significant improvement in knowledge, attitudes, and smoking intentions in the intervention group, by 13.56%, 7.02%, and 4.25%, respectively, after adjustment. The overall difference between the intervention and control groups was significant (p < 0.05). Education through animated videos is effective in increasing knowledge, attitudes, and negative intentions toward smoking in elementary school students. This method can be widely implemented as a strategy to prevent smoking from an early age.]]>
