Abstract
BackgroundSmoking among Japanese adolescents has decreased noticeably. However, little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016.MethodsWe conducted a repeated cross-sectional study using data from three surveys of high school students in Okinawa, Japan, in 2008, 2012, and 2016. The study participants consisted of 7902 students in grades 10 through 12 (15–18 years). Smoking was assessed as current cigarette use. SES indicators included familial SES (parental education and family structure) and student’s own SES (school type). To evaluate absolute and relative inequalities, prevalence differences (PDs) and ratios (PRs) between low and high SES groups were estimated. The slope index of inequality (SII) and relative index of inequality (RII) were also calculated.ResultsSmoking prevalence among boys and girls significantly declined from 11.5% and 6.2% in 2008 to 4.7% and 1.9% in 2016, respectively. Similar decreasing trends in smoking were found among most of the SES groups. The PDs and SII for parental education in boys and family structure in girls decreased over time while those for school type persisted among boys and girls. The PRs and RII for school type in boys increased while those for other SES indicators among both sexes remained stable over time.ConclusionsSmoking among Japanese adolescents has been declining and time trends of socioeconomic inequalities in smoking varied by absolute and relative measures. Further policies and/or interventions to reduce smoking inequalities should focus on the context of schools, especially in vocational high schools.
Highlights
Smoking among Japanese adolescents has decreased noticeably
There were no significant trends among boys with the highest parental education (P for trend = 0.183) and girls belonging to the “others” group for family structure (P for trend = 0.111)
The slope index of inequality (SII) for parental education in boys and family structure in girls decreased over time (P for trend = 0.005 and 0.006)
Summary
Smoking among Japanese adolescents has decreased noticeably. Little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016. Time trends in smoking prevalence among young people have shown a steady decline at the global level [4]. The cross-national studies, such as the European School Survey Project on Alcohol and Other Drugs and the Health Behaviour in School-aged Children study have shown that a general decreasing trend in cigarette smoking was observed in many European countries [5, 6]. The prevalence of smoking among Japanese adolescents was trending downward over time [7, 8]. Nationwide surveys of high school students showed that current smoking prevalence among boys was 30.7% in 1996 and 3.5% in 2014, whereas among girls it was 12.6% and 1.4%, respectively [7]
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