CONCLUSIONS: A school-based media literacy curriculum is more effective than a standard educational program in teaching media literacy and improving perceptions of the true prevalence of smoking among adolescents. Keywords: adolescents; attitudes; media education; media literacy; normative beliefs; school-based; smoking; social influences; tobacco; youth. Citation: Primack BA, Douglas EL, Land SR, Miller E, Fine MJ. Comparison of media literacy and usual education to prevent tobacco use: a cluster-randomized trial. J Sch Health. 2014; 84: 106-115. Received on January 3, 2012 Accepted on December 2, 2012