Abstract
BackgroundSmoking remains a major public health concern. School-based social networks influence uptake of smoking among peers. During the past two decades, the UK macro-systemic context within which schools are nested and interact with has changed, with anti-smoking norms having become set at a more macro-systemic level. Whilst the overall prevalence of smoking in the UK has decreased, inequality has prevailed. It is plausible that the influence of school-based social networks on smoking uptake may vary according to socioeconomic status. Therefore, this study aims to understand how social influence on smoking among adolescents has changed in line with variance within and between contexts according to time and geography.MethodsThe following databases will be searched: Medline, PsycINFO, Embase, Applied Social Sciences Index and s (ASSIA), British Education Index, Sociological abstracts, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC) and Scopus. Additional searches will include reference checking of key papers, citation tracking, word of mouth and grey literature searches. The search strategies will incorporate terms relating to smoking, adolescents, schools, peers, network analysis and qualitative research. Titles and abstracts and full texts will be independently screened and assessed for quality by at least two researchers. Included studies will be assessed for quality, and data will be extracted for synthesis, including participant characteristics, setting and tobacco control context, study design and methods, analysis and results and conclusions. Quantitative findings will be narratively synthesised, whilst a lines of argument synthesis combined with refutational analysis will be employed to synthesise qualitative data. Both sets of findings will be charted on a timeline to add context to network findings and obtain an enhanced understanding of changes over time.DiscussionThis protocol is for a mixed methods synthesis of both social network findings, to investigate social structures and qualitative studies, to elicit contextual information. The review will synthesise changes in the context of social influence on adolescent smoking over time and geographically. As context is increasingly recognised as a key source of complexity, this enhanced understanding will help to inform future interventions targeting smoking through social influence. This will help to enhance their relevance to context, subsequent effectiveness and targeting of inequalities.Systematic review registrationPROSPERO CRD42019137358
Highlights
Smoking remains a major public health concern
Quantitative network data will be qualitised, before combining the key themes from both quantitative and qualitative studies by visually charting them against a timeline to combine both. To date, both primary research and systematic reviews have demonstrated the social influence of smoking among adolescents [41]
Social network and qualitative data have yet to be combined to achieve a greater understanding of the context within which this social influence takes place
Summary
Smoking remains a major public health concern. School-based social networks influence uptake of smoking among peers. Whilst youth smoking is at an all-time low, smoking uptake remains a major public health concern; recent data indicate for example that nearly 1 in 10 young people in Wales, United Kingdom (UK), leave school as smokers [1]. Valente et al [5] employed social network analysis to show that ‘popular’ children who had more leverage over school norms were themselves more likely to be smokers or to view smoking as acceptable. To date, both primary research and systematic reviews have demonstrated the utility of social network analysis in investigating the link between peer influence and tobacco smoking as well as understanding complex systems [8]. Abel and colleagues [9] advocate for visual display of networks, cluster analysis and qualitative data to triangulate and enhance understanding of the context surrounding social interactions
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