Abstract
BackgroundSmoking prevalence is higher among low socio-economic status (LSES) groups, and this difference may originate from a higher intention to smoke in childhood. This study aims to identify factors that explain differences in intention to smoke between children living in high socio-economic status (HSES) and LSES neighbourhoods.MethodsCross-sectional data were derived from the baseline assessment of a smoking prevention intervention study. Dutch primary school children, aged 10 – 11 years (N = 2,612), completed a web-based questionnaire about their attitude, subjective norm, self-efficacy expectations, modelling and intention to smoke. Linear and logistic regression analyses were performed to assess potential individual cognitive (attitude, subjective norm and self-efficacy) and social environmental (modelling) mediators between SES and intention to smoke.ResultsMultiple mediation models indicated that modelling mediated the association between SES (B = -0.09 (p < 0.01)) and intention to smoke (B = 1.06 (p < 0.01)). Mainly the father, mother and other family members mediated this association. Gender did not moderate the association between SES and intention to smoke and the potential mediators indicating that there are no differences in mediating factors between boys and girls.ConclusionsThis study indicates that future smoking prevention studies may focus on the social environment to prevent smoking onset. However, replication of this study is warranted.Trial registrationThis study was approved by the Medical Ethics Committee of the Atrium-Orbis-Zuyd Hospital (NL32093.096.11 / MEC 11-T-25) and registered in the Dutch Trial Register (NTR3116).
Highlights
Smoking prevalence is higher among low socio-economic status (LSES) groups, and this difference may originate from a higher intention to smoke in childhood
Smoking is more prevalent in low socio-economic status (LSES) than in high socio-economic status (HSES) adolescents (28% vs. 18%) [1] and this difference in smoking is an important contributor to socio-economic differences in health [2]
In-depth analyses showed that especially the smoking behaviour of the mother, father and other family members mediated the association between SES and the intention to engage in smoking
Summary
Smoking prevalence is higher among low socio-economic status (LSES) groups, and this difference may originate from a higher intention to smoke in childhood. Prior research [10,11,12] has indicated that LSES adolescents engage more often in smoking as compared to HSES adolescents and it is likely that this difference originates from a higher intention to start smoking at a younger age. It is unclear which factors predict or explain the difference in intention to start smoking between LSES and HSES children. Higher self-efficacy levels have a more preventive effect for smoking initiation than lower selfefficacy levels in young adolescents [10,17,18]
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