Abstract
AimsTo examine the association between peer relations, self‐rated health and smoking behaviour in vocational school setting.BackgroundSmoking in adolescence causes health and socioeconomic inequality in adulthood. There is evidence that smokers are physically less active, have lower academic aspirations and perceive poorer health than non‐smokers.MethodThe study was conducted in spring 2013 and involved 34,776 vocational students who took part in the School Health Promotion Study in Finland. The associations between adolescent smoking habits and peer relations and smokers' self‐rated health were studied adjusting for the respondents' age, parental education and family type.ResultsA substantial proportion of the respondents, 37% of the girls and 36% of the boys, reported smoking daily, 15% of the girls and 14% boys smoked occasionally with a further 15% of the girls and 13% of the boys stating that they were ex‐smokers. Of the girls, 33% and 38% of the boys were non‐smokers. Adjusted multinomial regression revealed that having a close friend or friends predicted smoking among girls and boys. Additionally, the adjusted model indicated that being a bully and/or a bully + bully‐victim was associated with smoking behaviour in boys only. Boys and girls who rated their health as moderate or poor were more often daily smokers; in girls, this was also the case in occasional smokers.ConclusionSmoking prevention aimed at vocational schools should take into consideration the norms and expectations related to peer relations which strongly influence adolescents' smoking habits.
Highlights
Smoking among adolescents is a major public health concern as smoking poses many health risks such as substance use (O'Loughlin, Dugas, O'Loughlin, Karp, & Sylvestre, 2014) and lower level of physi‐ cal activity (Kauranen, 2013) leading to health inequalities in adult‐ hood (World Health Organization, 2015)
Studies conducted in Australia and the USA among middle and high school students found that both bullies and bullies that have been bullied them‐ selves reported the greatest levels of substance misuse and smok‐ ing while bullying victims and students not involved in bullying were less likely to abuse substances (Kelly et al, 2015; Radliff et al, 2012) those bullied during childhood were more likely to be regular smokers by the age of 18 (Niemelä et al, 2011)
There are studies conducted in primary and secondary schools ex‐ amining the association between peer relations with smoking but fewer studies have investigated peer relations related to adolescent smoking in the vocational school setting, even though there has been a traditionally high prevalence of vocational school students who are smokers
Summary
Smoking among adolescents is a major public health concern as smoking poses many health risks such as substance use (O'Loughlin, Dugas, O'Loughlin, Karp, & Sylvestre, 2014) and lower level of physi‐ cal activity (Kauranen, 2013) leading to health inequalities in adult‐ hood (World Health Organization, 2015). Smoking rates among adolescents’ studying for different vocations are much higher than among high school students. It was estimated in 2013 that about 36% of those Finnish adolescents learning a specific trade in vocational schools are smoking daily, compared with only 8% of their previous classmates that continued to the academically focused upper secondary school after ninth grade. This relationship has been noted in other. Early smoking initiators have reported poorer health than later initiators and this poorer self‐rated health remains even after smoking cessation among boys who started to smoke at an early age (Hansen et al, 2015)
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