Social modeling in the school environment, student characteristics, and smoking susceptibility: A multi-level analysis

Abstract

Purpose To examine how social models in the school environment and individual student characteristics are related to smoking susceptibility. Methods Using data from the School Smoking Profile Project, multi-level logistic regression analysis was used to identify school and student characteristics related to smoking susceptibility among 6679 never smokers from 29 secondary schools in Ontario, Canada. Results If a nonsmoking student attended a school where there was student smoking on the school periphery, he or she was less likely to be susceptible to smoking (OR 0.71, 95% CI 0.57–0.89). A significant contextual interaction between the smoking on the school periphery and friends’ disapproval of smoking was identified (β = 0.68 [0.23], p < .01]; students with friends who disapprove of smoking were more likely to be susceptible to smoking if they attended a school with student smoking on the school periphery. Conclusion Nonsmoking students who attend a school with student smoking on the school periphery are at an increased risk for being susceptible to smoking if they have friends who disapprove of smoking. Future school-based smoking prevention programs might benefit from targeting both individual students and entire schools with programming activities.