Abstract
Background: Associations of the strength of school smoking policies with cigarette, e-cigarette and cannabis use in Wales were examined. Methods: Nationally representative cross-sectional survey of pupils aged 11–16 years (N=7376) in Wales. Senior management team members from 67 schools completed questionnaires about school smoking policies, substance use education and tobacco cessation initiatives. Multi-level, logistic regression analyses investigated self-reported cigarette, e-cigarette and cannabis use, for all students and those aged 15–16 years. Results: Prevalence of current smoking, e-cigarette use and cannabis use in the past month were 5.3%, 11.5% and 2.9%, respectively. Of schools that provided details about smoking policies (66/67), 39.4% were strong (written policy applied to everyone in all locations), 43.9% were moderate (written policy not applied to everyone in all locations) and 16.7% had no written policy. There was no evidence of an association of school smoking policies with pupils’ tobacco or e-cigarette use. However, students from schools with a moderate policy [OR = 0.47; 95% (confidence interval) CI: 0.26–0.84] were less likely to have used cannabis in the past month compared to schools with no written policy. This trend was stronger for students aged 15–16 years (moderate policy: OR = 0.42; 95% CI: 0.22–0.80; strong policy: OR = 0.45; 95% CI: 0.23–0.87). Conclusions: School smoking policies may exert less influence on young people’s smoking behaviours than they did during times of higher adolescent smoking prevalence. Longitudinal studies are needed to examine the potential influence of school smoking policies on cannabis use and mechanisms explaining this association.
Highlights
Tobacco use is commonly initiated during youth.[1]
Questionnaires were completed by 7376 students (49.1% girls and 50.9% boys) at the 67 schools
An average of 15.9% (SD = 8.7) of students within schools were entitled to free school meals (FSMs)
Summary
Tobacco use is commonly initiated during youth.[1]. recent decades have seen growing emphasis on preventing uptake of smoking among young people.[2]. Earlier studies investigating school substance use policies have shown that universal smoking bans and restrictions are associated with a lower likelihood of smoking behaviour and smoking prevalence among youth.[11]. Weaker associations between school smoking policies and tobacco use have been observed in more recent studies.[11]. In part this may be because school smoking policies have become more common and more consistent in their universality, perhaps limiting variance in practice between schools.[9,12,13]. Methods: Crosssectional data of children aged 5–6 years old in Bavaria (n = 22 944) were collected in 2004/5 and 2005/6 (S1 and S2) before the ban and after in 2008/9 and 2012/13 (S4 and S6) Parents reported their child’s home SHS exposure, in enclosed public areas and private cars. Social inequalities still exist and should be addressed to further minimise SHS exposure
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