Results
substance abuse
The study involved 114 adolescents aged 13 to 15, with an equal distribution of 50% in the intervention group and 50% in the control group. The subjects had a mean age of 14.0 years with a standard deviation of 6.85.Most adolescents in both groups were the first child in their families (50 individuals, 43.8%). Most (46 individuals, 40.3%) came from families with two children. Furthermore, the parents of most adolescents (111 individuals, 97.3%) reported no history of smoking or substance abuse (Table 
Comparison of the frequency distribution of demographic characteristics of adolescents in the two groups of intervention and controlBefore the training, no significant differences existed between the intervention and control groups regarding knowledge scores on substance and internet addiction, total attitude scores towards substances and the Internet, their subscales, and academic achievement (P > 0.05).However, following gamification-based training, there was a significant increase in the mean knowledge scores on substance and internet addiction in the intervention group (P < 0.001). This increase in addiction knowledge persisted immediately after training and one month later (P < 0.001) (Table 
Comparison of mean scores of (substance abuse and Internet) knowledge in and between the intervention and control groupsAfter the addiction prevention training, significant differences were observed in various aspects for the intervention group compared to the control group. Specifically, the intervention group showed statistically significant improvements in their total attitude scores toward substances and their subscales, total attitude scores toward the Internet and its subscales, and academic achievement (P < 0.001).Furthermore, within the intervention group, the mean score for the tendency toward substance abuse showed a significant increase immediately after the intervention, and this increase was sustained one month later. The intervention group also demonstrated significant improvements in the mean scores for reluctance to actively participate in prevention, incorrect belief in the positive effects of substances, lack of active resistance to substance abuse, and incorrect belief in the high prevalence of substance abuse.Immediately and one month after the intervention, the intervention group demonstrated statistically significant differences compared to the control group, with more pronounced changes. Specifically, the intervention group’s attitude toward substances significantly decreased, indicating the development of a more negative attitude toward substances (P < 0.001).In contrast, the intervention group’s average score for their attitude toward the Internet significantly increased immediately and one month after the intervention, suggesting a more positive attitude. Academic achievement also saw an increase only in the intervention group immediately and one month after training, highlighting the positive impact of the training on individuals’ Internet attitudes and academic performance among adolescents in the intervention group (Tables 
Comparison of mean attitudes toward drugs in and between the intervention and control groups
Comparison of the mean score of Internet attitude and academic achievement score in and between the intervention and control groups