Abstract

PurposeRelationships between subjective social status (SSS) and health-risk behaviors have received less attention than those between SSS and health. Inconsistent associations between school-based SSS and smoking or drinking might be because it is a single measure reflecting several status dimensions. We investigated how adolescent smoking and drinking are associated with “objective” socioeconomic status (SES), subjective SES, and three dimensions of school-based SSS. MethodsScottish 13–15 years-olds (N = 2,503) completed questionnaires in school-based surveys, providing information on: “objective” SES (residential deprivation, family affluence); subjective SES (MacArthur Scale youth version); and three school-based SSS dimensions (“SSS-peer”, “SSS-scholastic” and “SSS-sports”). We examined associations between each status measure and smoking (ever and weekly) and drinking (ever and usually five or more drinks) and investigated variations according to gender and age. ResultsSmoking and heavier drinking were positively associated with residential deprivation; associations with family affluence and subjective SES were weak or nonexistent. Both substances were related to each school-based SSS measure, and these associations were equally strong or stronger than those with deprivation. Although SSS-peer was positively associated with both smoking and (especially heavier) drinking, SSS-scholastic and SSS-sports were negatively associated with both substances. There were no gender differences in the associations and few according to age. ConclusionsSubjective school-based status has stronger associations with adolescent smoking and drinking than “objective” or subjective SES. However, different dimensions of school-based status relate to adolescent smoking and drinking in opposing directions, meaning one measure based on several dimensions might show inconsistent relationships with adolescent substance use.

Highlights

  • Relationships between subjective social status (SSS) and health-risk behaviors have received less attention than those between SSS and health

  • Different dimensions of school-based status relate to adolescent smoking and drinking in opposing directions, meaning one measure based on several dimensions might show inconsistent relationships with adolescent substance use

  • In mutually adjusted models, associations with age remained largely unchanged, but those with socioeconomic status (SES) all weakened. Both ever and weekly smoking remained strongly associated with residential deprivation, relationships with family affluence and subjective SES reduced to nonsignificance

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Summary

Introduction

Relationships between subjective social status (SSS) and health-risk behaviors have received less attention than those between SSS and health. We investigated how adolescent smoking and drinking are associated with “objective” socioeconomic status (SES), subjective SES, and three dimensions of school-based SSS. Results: Smoking and heavier drinking were positively associated with residential deprivation; associations with family affluence and subjective SES were weak or nonexistent Both substances were related to each school-based SSS measure, and these associations were strong or stronger than those with deprivation. Different dimensions of school-based status relate to adolescent smoking and drinking in opposing directions, meaning one measure based on several dimensions might show inconsistent relationships with adolescent substance use. A single, “overall” schoolbased status measure based on several dimensions (e.g., “friends,” “grades,” “sports”) might show inconsistent relationships with adolescent substance use because these different dimensions are associated with smoking and drinking in different directions. There is a vast literature relating to associations between adolescent smoking and drinking and socioeconomic status (SES) as represented by “objective” variables, such as parental

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