Irene Moor1, Katharina Rathmann2, Michela Lenzi3, Timo-Kolja Pförtner2, Gera E Nagelhout4, Margreet de Looze5, Pernille Bendtsen6, Marc Willemsen4, Lasse Kannas7, Anton E Kunst8, Matthias Richter2. 1. 1 Institute of Medical Sociology (IMS), Medical Faculty, Martin Luther University Halle-Wittenberg, Germany irene.moor@medizin.uni-halle.de. 2. 1 Institute of Medical Sociology (IMS), Medical Faculty, Martin Luther University Halle-Wittenberg, Germany. 3. 2 Department of Developmental and Social Psychology, University of Padua, Italy. 4. 3 Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands 4 Alliance Smokefree Holland, The Hague, The Netherlands. 5. 5 Department of Interdisciplinary Social Sciences, Faculty of Social and Behavioural Sciences, Utrecht University, The Netherlands. 6. 6 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 7. 7 Department of Health Sciences, University of Jyväskylä, Finland. 8. 8 Department of Public Health, AMC, University of Amsterdam, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Tobacco-related heath inequalities are a major public health concern, with smoking being more prevalent among lower socioeconomic groups. The aim of this study is to investigate the mechanisms leading to socioeconomic inequalities in smoking among 15-year-old adolescents by examining the mediating role of psychosocial factors in the peer group, family and school environment. METHODS: Data were derived from the international WHO-collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, including 52 907 15-year-old students from 35 European and North American countries. Socioeconomic position was measured by the Family Affluence Scale. Multilevel logistic regression models were conducted to examine the contribution of family, school and peer factors in explaining the association between family affluence and weekly smoking. RESULTS: Across countries, adolescents from low affluent families had an increased risk of weekly smoking (OR(boys) 1.14, confidence interval (CI) 1.05-1.23; OR(girls) 1.36, CI 1.26-1.46) compared with adolescents from high affluent families. Family and school factors mediated the association between family affluence and smoking to a high extent up to 100% (boys) and 81% (girls) in joint analyses. The most important single factors were family structure, relationships with parents, academic achievement and school satisfaction. Peer factors did not mediate the association between family affluence and adolescent smoking. CONCLUSION: The association between socioeconomic status and adolescent weekly smoking can largely be explained by an unequal distribution of family- and school-related factors. Focusing on the parent-adolescent relationship and adolescent school achievement can help to better understand inequalities in adolescent smoking behaviour.
BACKGROUND:Tobacco-related heath inequalities are a major public health concern, with smoking being more prevalent among lower socioeconomic groups. The aim of this study is to investigate the mechanisms leading to socioeconomic inequalities in smoking among 15-year-old adolescents by examining the mediating role of psychosocial factors in the peer group, family and school environment. METHODS: Data were derived from the international WHO-collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, including 52 907 15-year-old students from 35 European and North American countries. Socioeconomic position was measured by the Family Affluence Scale. Multilevel logistic regression models were conducted to examine the contribution of family, school and peer factors in explaining the association between family affluence and weekly smoking. RESULTS: Across countries, adolescents from low affluent families had an increased risk of weekly smoking (OR(boys) 1.14, confidence interval (CI) 1.05-1.23; OR(girls) 1.36, CI 1.26-1.46) compared with adolescents from high affluent families. Family and school factors mediated the association between family affluence and smoking to a high extent up to 100% (boys) and 81% (girls) in joint analyses. The most important single factors were family structure, relationships with parents, academic achievement and school satisfaction. Peer factors did not mediate the association between family affluence and adolescent smoking. CONCLUSION: The association between socioeconomic status and adolescent weekly smoking can largely be explained by an unequal distribution of family- and school-related factors. Focusing on the parent-adolescent relationship and adolescent school achievement can help to better understand inequalities in adolescent smoking behaviour.
Authors: Henrik Dobewall; Leena Koivusilta; Sakari Karvonen; Pirjo Lindfors; Jaana M Kinnunen; Mari-Pauliina Vainikainen; Arja Rimpelä Journal: Eur J Public Health Date: 2020-06-01 Impact factor: 3.367
Authors: Jie Wu; Hong Wu; Juan Wang; Jianxiong Deng; Xue Gao; Yan Xu; Guoliang Huang; Jinghui Huang; Lan Guo; Ciyong Lu Journal: Medicine (Baltimore) Date: 2015-12 Impact factor: 1.817