School Smoking Research Articles

The association of voter turnout with county-level coronavirus disease 2019 occurrence early in the pandemic

PurposeThe ongoing coronavirus disease 2019 (COVID-19) severely impacted both health and the economy. Absent an effective vaccine, preventive measures used, some of which are being relaxed, have included school closures, restriction of movement, and banning of large gatherings. Our goal was to estimate the association of voter turnout with county-level COVID-19 risks. MethodsWe used publicly available data on voter turnout in the March 10 primary in three states, COVID-19 confirmed cases by day and county, and county-level census data. We used zero-inflated negative binomial regression to estimate the association of voter turnout with COVID-19 incidence, adjusted for county-level population density and proportions: over age 65 years, female, Black, with college education, with high school education, poor, obese, and smokers. ResultsCOVID-19 risk was associated with voter turnout, most strongly in Michigan during the week starting 3 days postelection (risk ratio, 1.24; 95% confidence interval, 1.16–1.33). For longer periods, the association was progressively weaker (risk ratio 0.98–1.03). ConclusionsDespite increased absentee-ballot voting in the primary, our results suggest an association of voter turnout in at least one state with a detectable increase in risks associated with and perhaps due to greater exposures related to the primary.

Opinion of adolescent school smokers about smoking cessation counseling and treatment in health services: a cross-sectional study, Goiás, Brazil, 2018.

Objective To know the opinion of adolescent school smokers about smoking cessation counseling and treatment, and to investigate whether negative opinion was associated with lack of motivation to stop smoking. Methods This was a cross-sectional study carried out in Goiás state, Brazil, with an intentional sample of adolescent students, in 2018. Poisson regression was used. Results One hundred and thirty adolescents took part. Most of them expressed a positive opinion on the three smoking cessation interventions surveyed: medical counseling (76.2%), dental counseling (70.0%), and smoking cessation treatment (66.2%). Negative opinions were more frequent among adolescents who were not motivated to stop smoking (p<0.05). Regression analyses revealed that lack of motivation to quit smoking was associated with a negative opinion about each intervention. Conclusion The adolescents had a positive opinion about counseling and treatment for smoking cessation in health services. Negative opinion was associated with lack of motivation to quit smoking.

Trends and Associations of Menthol Cigarette Smoking Among US Middle and High School Students-National Youth Tobacco Survey, 2011-2018.

Youth cigarette smoking decreased significantly over the last two decades in the United States. This study provides estimates and trends from 2011 to 2018 and factors associated with youth menthol and non-menthol smoking from 2016 to 2018. Using data from the 2011-2018 National Youth Tobacco Surveys, past 30-day (current) menthol and non-menthol cigarette smoking were estimated for all youth (prevalence) and youth smokers (proportions). Trends were examined using Joinpoint regression, calculating the annual percent change (APC). Multivariate logistic regression analyses identified factors associated with menthol smoking. From 2011 to 2018, menthol cigarette smoking among current youth cigarette smokers significantly decreased from 57.3% to 45.7% (APC: -3.0%), while non-menthol (38.2% to 47.3% [APC: 2.9%]) and unknown menthol status (not sure\missing) (4.5% to 7.0% [APC: 7.1%]) significantly increased. Menthol cigarette smoking among high school, male, female, and non-Hispanic white current cigarette smokers decreased, but remained unchanged among middle school, non-Hispanic black, and Hispanic smokers. Significantly higher proportions of menthol cigarette smokers smoked on ≥20 days, ≥2 cigarettes per day, and ≥100 cigarettes in their lifetime compared to non-menthol smokers. Among current cigarette smokers, non-Hispanic blacks, Hispanics, flavored non-cigarette tobacco users, frequent smokers (≥20 days), those smoking 2-5 cigarettes per day, and those living with someone who uses tobacco had higher odds of menthol cigarette smoking. In 2018, nearly half of current youth cigarette smokers smoked menthol cigarettes. While menthol cigarette smoking declined from 2011 to 2018 among all youth and among youth smokers, there was no change in menthol cigarette smoking among non-Hispanic black, Hispanic, and middle school cigarette smokers. This study finds that overall cigarette and menthol cigarette smoking declined in youth from 2011 to 2018. However, menthol cigarette smoking among non-Hispanic black, Hispanic, and middle school youth cigarette smokers did not change. Information from this study can help inform efforts to reduce menthol cigarette smoking among US youth, particularly racial/ethnic minority populations.

IMPROVEMENT OF KNOWLEDGE ABOUT CIGARETTE THROUGH HEALTH CARE ABOUT HEALTHY BEHAVIOR BY AVOIDING CIGARETTE

Health promotion activities on Healthy Living Behavior by Avoiding Smoking in Al Islam Middle School, Sidoarjo is one form of community service in the form of counseling aimed at increasing children's knowledge about how to avoid smoking for both active smokers and passive smokers. The activity was carried out on November 29, 2019 at the Al Islam Middle School, Sidoarjo. The target is grade IX students of Al Islam Middle School, Sidoarjo. Before the activity is carried out, there is a process of compiling the activity for approximately 3 weeks before the activity is carried out, starting from determining the theme of counseling to submitting permits to the parties concerned. As a form of evaluation, the activity was attended by 30 students of class IX, participants took part in the activity happily and looked very enthusiastic, health promotion activities could run on time and smoothly. Keywords: Knowledge, health care, health behavior, avoiding cigarette.

School Achievement and Oral Health Behaviour Among Adolescents in Finland: A National Survey.

We examined oral health behaviour and its association with school achievement among Finnish adolescents. This study is part of the Finnish national School Health Promotion study (SHP). The study population comprised a representative sample of Finnish 15-year-olds (N = 45,877). A questionnaire inquired about the respondents' school achievements and health habits (toothbrushing, smoking), background factors (age, gender, school type, family structure), and their parents' background factors (education, smoking). Chi-square tests and logistic regression models were used in the statistical analyses. Better school achievements were associated with better oral health behaviour: 73.1% of students with the highest mean grades (9-10) brushed their teeth twice daily, compared to 33.8% of those with the lowest mean grade (6.9 or less). The lowest mean grade was associated with brushing less than twice daily, especially among boys (odds ratios (OR) = 4.1; 95% CI 3.6-4.7) when compared to those with the highest mean grade, but also among girls (OR = 2.3; 95% CI 2.1-2.7). Smoking among boys was associated with poor oral hygiene (OR = 1.3; 95% CI 1.2-1.4). School success is strongly associated with oral health behaviour among adolescents. Preventive treatment should be targeted especially at boys with poor school achievement and smoking behaviour.

STRUKTUR BIROKRASI DAN DISPOSISI DALAM PELAKSANAAN KAWASAN SEHAT BEBAS ASAP ROKOK DI SEKOLAH

Based on the Health Research and Development Agency in 2013, the Special Province of Yogyakarta tended to be high at 21.2% for the proportion of the population aged over or equal to 10 years who smoked every day. One of the districts in the Yogyakarta Special Region that has a policy on non-smoking areas is Bantul Regency. The regulation regarding the non-smoking areas is regulated in the Bantul Regent's Regulation No. 18 of 2016 concerning Healthy Areas Non-Smoking (HANS). This study aims to determine the structure of the bureaucracy and disposition in the implementation of a Healthy Smoke Free Area in Schools. This research uses descriptive qualitative method. Data analysis using data reduction, data presentation, and drawing conclusions. The results of interviews about the bureaucratic structure in the implementation of the HANS found that there were no smoking procedures for smokers in schools. General rules are included in the school code of conduct in the form of a slogan / smoking ban. The disposition aspect possessed by the school could not be said to be good in the implementation of the HANS, it was evident that there were still school residents who still smoked in the school area and found cigarette putp in the school area. The conclusion of the research is that the bureaucratic structure does not yet exist and the disposition factor cannot be carried out properly so that it is expected that there will be a follow-up from the Government of Bantul Regency to be able to socialize Bantul Regent Regulation No. 18 of 2016 concerning Smoke-Free Healthy Areas in the school environment involving the role of the Health Office, BNNP and / or the Police and develop a culture of reporting and providing guarantees for reporters from the Principal, as well as making special regulations / SOPs for school residents who have a smoking habit.

Predictors of current tobacco smoking by adolescents in Nigeria: Interaction between school location and socioeconomic status.

INTRODUCTIONTobacco smoking is the largest preventable cause of global mortality, with its prevalence increasing in Sub-Saharan Africa, particularly among adolescents. We sought to determine the factors associated with tobacco smoking among Nigerian school adolescents and investigate the interaction between school location and socioeconomic status (SES).METHODSUsing a cross-sectional study design, 4332 eighth to tenth grade students in rural and urban secondary schools in Enugu State, Nigeria, were selected by stratified two-stage cluster sampling. We collected data using a modified Global Youth Tobacco Survey (GYTS) Core Questionnaire. Outcome measures were current smoking of cigarettes and other smoked tobacco. Multilevel mixed effects logistic regression models were used to determine factors associated with current tobacco smoking and were considered statistically significant at p<0.05.RESULTSPrevalences of current smoking of cigarettes and other smoked tobacco were 13.3% (95% CI: 11.3–15.7) and 5.8% (95% CI: 4.6–7.2), respectively. Possession of higher weekly allowance, exposure to secondhand smoke or tobacco advertisements, having smoking parents, friends or classmates who smoke, and sale of cigarettes near school, were positively associated with current smoking of tobacco. Female sex, having both parents employed and being exposed to tobacco teaching in school were negatively associated with current cigarette smoking while increasing age and high father’s SES were negatively associated with current smoking of other tobacco products. There was an interaction between school location and father’s SES in the association with cigarette smoking. The higher odds of smoking in rural versus urban schools were much higher for students with fathers of high SES compared to low SES. In rural schools, high SES was associated with higher odds of smoking, but in urban schools low SES was associated with higher odds of smoking. CONCLUSIONS Environmental factors are associated with adolescent tobacco smoking. Tobacco control programs should use targeted strategies that vary depending on the local context.

Do the socioeconomic context and the European geographical area modify parental influences on smoking experimentation among adolescents?

Adolescent smoking is a major public health problem. While the socioeconomic status (SES) of the neighbourhood and that of the family are known to play a role in smoking onset and progression, it is not clear whether it modifies the association between parental influences and adolescent behaviour. The purpose of this study is to investigate family correlates of adolescent smoking experimentation and to explore the modifying role of socioeconomic context and European geographical area in a sample of European adolescents. This is a secondary analysis of the baseline survey of the European Drug Addiction Prevention (EU-Dap) trial which took place in seven European countries and involved 7079 students. School SES was used as indicator of socioeconomic context. European countries were aggregated in two geographical areas: North-Central and South. The associations between parental, family factors, and adolescents smoking experimentation were analysed through multilevel mixed-effect logistic regression models, stratified by school SES and European geographical area. Parental smoking, permissiveness towards tobacco, family conflicts, problematic relationships, low connectedness, and low parental control were significantly associated with adolescent smoking experimentation. Paternal smoking was a stronger correlate of adolescent smoking in low SES schools, while maternal smoking in high SES schools. Parental permissiveness was a stronger correlate in low SES schools. Family conflicts and low parental control were correlates only in low SES schools. The associations did not substantially differ between European geographical areas, with the exception of parental smoking that was a stronger correlate in the North, and parental control that was a correlate only in the South of Europe. To reduce inequalities in tobacco-related outcomes, prevention efforts in low socioeconomic contexts appear to be a public health priority. Parental smoking, permissiveness, family relationships, and connectedness should be addressed in preventive programs.

Cigarette Smoking Behavior Among Menthol and Nonmenthol Adolescent Smokers

PurposeAs cigarette rates have decreased, the proportion of menthol cigarette use among youth smokers has increased. Thus, it is important to monitor the menthol-associated behaviors among youth. The present study examined the associations between menthol cigarette use and smoking frequency, intention to continue smoking, and quit intention among youth. MethodsWe used data from the 2017 and 2018 National Youth Tobacco Surveys. Separate multivariable logistic regression models were used to examine the associations between menthol cigarette use and smoking frequency, intention to continue smoking, and intention to quit. ResultsAcross both years, 1,707 youth reported past 30-day cigarette use, 50.7% of whom used menthol cigarettes. Menthol cigarette users had significantly higher odds of smoking at least 10 out of the 30 days before the survey than nonmenthol smokers (adjusted odds ratio [aOR] 1.48, 95% confidence interval [CI] 1.14–1.94). We found similar results in the stratified analysis by grade level. Menthol cigarette smokers in middle (aOR 2.36, 95% CI 1.01–5.49) and high school (aOR 1.41, 95% CI 1.09–1.82) were more likely to have smoked at least 10 out of the 30 days before the survey than nonmenthol smokers. Menthol cigarette users had higher odds of intention to continue smoking (aOR 1.54, 95% CI 1.08–2.19) than nonmenthol cigarette users. Menthol use was not significantly associated with intention to quit. ConclusionsCompared with nonmenthol cigarette use, menthol cigarette use was associated with smoking more frequently as well as the intention to continue smoking among middle school and high school students.

'[…] the situation in the schools still remains the Achilles heel.' Barriers to the implementation of school tobacco policies-a qualitative study from local stakeholder's perspective in seven European cities.

School tobacco policies (STPs) are a crucial strategy to reduce adolescents smoking. Existing studies have investigated STPs predominantly from a school-related 'insider' view. Yet, little is known about barriers that are not identified from the 'schools' perspective', such as perceptions of local stakeholders. Forty-six expert interviews from seven European cities with stakeholders at the local level (e.g. representatives of regional health departments, youth protection and the field of addiction prevention) were included. The analysis of the expert interviews revealed different barriers that should be considered during the implementation of STPs. These barriers can be subsumed under the following: (i) Barriers regarding STP legislature (e.g. inconsistencies, partial bans), (ii) collaboration and cooperation problems between institutions and schools, (iii) low priority of smoking prevention and school smoking bans, (iv) insufficient human resources and (v) resistance among smoking students and students from disadvantaged backgrounds. Our findings on the expert's perspective indicate a need to enhance and implement comprehensive school smoking bans. Furthermore, collaboration and cooperation between schools and external institutions should be fostered and strengthened, and adequate human resources should be provided.

Tobacco Use and Exposure Among Secondary School Students — China, 2019

What is already known about this topic? Using the framework of the global youth tobacco survey (GYTS), China CDC conducted the first round of a national tobacco survey among junior high school (JHS) students in 2014, indicating that 17.9% and 5.9% of respondents were experimental and current cigarette smokers, respectively. What is added by this report? China CDC implemented a second round of the survey in 2019 and included senior high school (SHS) and vocational senior high school (VSHS) students. Experimental and current cigarette use was much higher among VSHS (30.3%, 14.7%) and SHS (21.6%, 5.6%) students than in JHS students (12.9%, 3.9%). Minors being able to buy cigarettes without refusal, tobacco advertisements and promotions on movies, TV, and at retail outlets, parents smoking, and teacher smoking in school were also widely prevalent. What are the implications for public health practice? Despite positive changes from 2014 to 2019, the external factors compelling teenagers to smoke were extensive. The priority for tobacco control among secondary school students should be strengthening the implementation of existing laws and regulations and developing targeted policies and measures for VSHS.

Smoking Behavior among Undergraduate Female Students in Universitas Padjadjaran Bandung

Background: Smoking is an addictive habit of affecting human behavior. Global data has shown that 47.5% of men and 10.3% of women are active smokers. Based on Survei Sosial Ekonomi Nasional in 2007, the prevalence of women smokers in Indonesia is increased from 1.3% to 5.2%. This study was conducted to describe the smoking behavior among undergraduate female students in Universitas Padjadjaran, Bandung. Methods: This was a descriptive cross-sectional study, including female students from 9 faculties in Universitas Padjadjaran, using a snowball sampling technique. A self-administered questionnaire was distributed, consisting of questions about when students smoked for the first time, level of addiction, smoking intensity, smoking location, and the affecting mood. Result: Of 99 female students, 40.40% have started smoking in high school, 31.32% in the university, and 25.25% in junior high school. The smoking intensity was moderate (45.45%), but some were high (29.30%). The location preference for smoking was both in private and public places (88.89%), driven by both positive and negative moods (88.89%). Interestingly, the most addiction level was situational (34.34%) or intensive (34.34%). Conclusions: Since most of the female students have started smoking before enrolling in the university, smoking education and cessation in junior high school need to be strengthened.

Pengaruh Therapy Supportif Konsep Diri terhadap Konsep Diri Anak Sekolah Dasar

Permasalahan kenakalan anak usia sekolah yang sering terjadi adalah bolos, melangar peraturan sekolah, merokok, tauran hingga bully. Hal ini disebabkan karena saat perkembangan konsep diri anak mengalami kerancuan identitas, hingga depersonalisasi. Untuk mencegah hal itu maka diperlukan suatu tindakan preventif, salah satunya dengan melakukan therapy supportif. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh Therapy Supportif terhadap Konsep Diri dan perkembangan anak, dengan metode quasi eksperimental pre-post test with control group dan menggunakan kuesioner konsep diri. Sampel berjumlah 80, 40 Kelompok Intervensi dan 40 kontrol, mengunakan tehnik random sampling. Hasil penilitian didapatkan ada pengaruh yang bermakna pada Therapy supporti terhadap perkembangan dan konsep diri, denga nilai rerata variabel perkembangan sebelum diberikan Therapy supportif pada kelompok intervensi 72,78 atau 77,45% dan nilai rerata setelah dilakukan therapy supportif 83 atau 88,32% dari nilai tersebut terjadi peningkatan perkembangan sebesar 10,22 (10,87%) yang artinya Therappy Supportif memiliki pengaruh bermakna terhadap perkembangan anak, Sedangkan untuk nilai variabel konsep diri sebelum dilakukan terapi suportif pada kelompok intervensi 68,28 atau 72,63%, Setelah dilakukan Therapy Supportif didapatkan nilai rerata 83,87 atau 89,22%, dari nilai tersebut dapat dianalisis bahwa terjadi peningkatan, sebesar 15,59 atau 22,84% yang artinya Therappy Supportif memiliki pengaruh bermakna terhadap konsep diri anak Kata kunci: terapi supportif, konsep diri, anak sekolah dasar THE EFFECT OF THERAPY SUPPORTIVE SELF-CONCEPT AGAINSTCHILDREN'S CONCEPT OF BASIC SCHOOL ABSTRACTThe problem of delinquency in school-age children that often occurs is truancy, violating school rules, smoking, mixing, and bullying. This is because when the child's self-concept development experiences confusion in identity, to depersonalization. To prevent that, we need a preventive action, one of them is by doing supportive therapy. The purpose of this study was to determine the effect of Supportive Therapy on Self-Concept and child development, with a quasi-experimental method of pre-post test with control group and using a self-concept questionnaire. Samples amounted to 80, 40 intervention groups and 40 controls, using random sampling techniques. The results of the study, found that there is a significant relationship in supportive therapy to development and supportive therapy in self-concept, with the average value of the development variables before being given supportive therapy in the intervention group 72.78 or 77.45% and the mean value after supportive therapy 83 or 88.32% of the value there was an increase in development of 10.22 (10.87%) which means that Therappy Supportive has a significant influence on children's development, while for the value of self-concept variables before supportive therapy in the intervention group 68.28 or 72, 63%, after supportive therapy, the mean value is 83.87 or 89.22%. From this value, it can be analyzed that there is an increase of 15.59 or 22.84%, which means that therapeutic support has a significant influence on the child's self-concept Keywords: supportive therapy, self-concept, elementary school children

School Smoking Policies and Health Science Students' Use of Cigarettes, Shisha, and Dipping Tombak in Sudan.

The relationship between school smoking policies and students' tobacco use is ambiguous, and little is known about the effect of these policies in low- and middle-income countries. This study was designed to assess the effects of schools' smoking policies and the exposure to residential smoking on cigarette smoking and the use of different kinds of tobacco products by Health Science students. Self-reports of cigarette smoking, use of shisha (smoking of fruits-mixed tobacco using a bowl and a connected hose); dipping tombak (local smokeless tobacco that users usually place inside oral cavity in the groove behind the lower lip), and tobacco use on school premises are analyzed. A cross-sectional survey was carried out using a modified self-report questionnaire, originally developed by WHO, among a representative sample of 1,590 third-year HSS from 25 schools drawn from 13 universities, using a multi-stages sampling technique. The response rate was 100% for schools and 68% for students. A multilevel analysis was performed by nesting student-level in school-level variables. Results from the adjusted models revealed that, when students reported awareness of smoking restriction, they were more likely to be current smokers (OR = 2.91; 95% CI: 1.68–5.02; p = 0.021) and shisha users (OR = 2.17; 95% CI: 1.54–3.06; p = 0.021). Results from additional analysis performed among tobacco users only, showed increased risk of smokers and tombak dippers who smoked or dipped on school premises (OR = 2.38; 95% CI: 1.34–4.25; p = 0.003, OR = 2.60; 95% CI: 1.22–5.56; p = 0.013, respectively). Current smokers (OR = 3.12; 95% CI: 1.98–4.92; p = ≤ 0.001), ever smokers (OR = 1.66; 95% CI: 1.31–2.10; p = ≤ 0.001) and shisha users (OR = 1.73; 95% CI: 1.36–2.21; p = ≤ 0.001) were exposed to residential smoking on one or more days during the previous 7 days. High percentages of those who used any kind of tobacco products reported being aware of school smoking policies, indicating no clear evidence that school smoking policies had an effect on use of any of the mentioned tobacco products. The lack of compliance with school policies shows the need for further policy enforcement and sustainability, taking into account the effect of residential smoking and social influences.

School policies and smoking intention in a Swiss sample of adolescents.

The majority of today's adult smokers took up the habit during adolescence. The school community and the rules it imposes are important factors that can influence adolescents' smoking intention and behaviour. Research on the effect of school tobacco policies on adolescents' smoking concludes with mixed results. Our study aims to look at the influence of these policies on the intention to smoke and to know if this relation is mediated by individual and environmental factors. The study includes information on social norms, attitude towards smoking and smoking intention from 4515 students of 32 Ticino middle schools and on the tobacco policy implemented in this school. Linear regression indicates a marginal impact of school policy on intention to smoke. Schools that strongly enforce tobacco policy obtain an increase in their students' intention to smoke, while schools that implement assistance programmes to overcome tobacco use decrease intention to smoke. Mediation models show that the influence of some of tobacco policy dimensions on the intention to smoke is mediated by personal attitudes towards smoking, beliefs about health consequences of smoking and perceived peers smoking. Increasing visibility of tobacco policies and having tobacco prevention programmes have stronger positive effects on smoking intention than other policy dimensions, but only through the mediation of individual and environmental factors.

Cost of youth tobacco-control policies in seven European countries.

BackgroundTobacco-control policies have been suggested to reduce smoking among adolescents. However, there is limited evidence on the real-world costs of implementation in different settings. In this study, we aimed at estimating the costs of school smoking bans, school prevention programmes and non-school bans (smoking bans in non-educational public settings, bans on sales to minors and bans on point-of-sale advertising), implemented in Finland, Ireland, the Netherlands, Belgium, Germany, Italy and Portugal, for 2016.MethodsWe retrospectively collected costs related to the inspection, monitoring and sanctioning activities related to bans and educational activities related to smoking prevention programmes. We used an ‘ingredients-based’ approach, identifying each resource used, quantity and unit value for one full year, under the state perspective. Costs were measured at national, regional, local and school-level and were informed by data on how these activities were performed in reality.ResultsPurchasing power parities adjusted-costs varied between €0.02 and €0.74 (average €0.24) per person (pp) for bans implemented outside schools. Mean costs of school smoking bans ranged from €3.31 to €34.76 (average €20.60), and mean costs of school educational programmes from €0.75 to €4.65 (average €2.92).ConclusionsIt is feasible to estimate costs of health policies as implemented in different settings. Costs of the tobacco control policies evaluated here depend mainly on the number of person-hours allocated to their implementation, and on the scale of intervention. Non-school bans presented the lowest costs, and the implementation of all policies cost up to €36 pp for 1 year.

Associations of school tobacco policies and legislation with youth smoking: a cross-sectional study of Danish vocational high schools

BackgroundIn vocational high schools, the prevalence of smoking is high (nearly 40% daily smoking in Danish vocational high schools). Schools are increasingly adopting school tobacco policies (STPs) and a national...

Adolescent Smoking in Secondary Schools that Have Implemented Smoke-Free Policies: In-Depth Exploration of Shared Smoking Patterns.

Large numbers of adolescents smoke during school hours, despite the implementation of smoke-free school policies (SFSPs). Studies about SFSPs predominantly analyse smoking as individual behaviour, yet there is increasing recognition that smoking should be understood as social behaviour. We explored shared smoking patterns specifying where, when, and with whom, and social meanings about why groups of adolescents smoke in two Dutch schools that have implemented SFSPs. Surveys among adolescents were held to obtain contextual information about the schools. Four focus group discussions and fourteen individual interviews were held with adolescents to identify shared smoking patterns in each school. Two shared patterns were identified at a school where 17% of students smoked daily: Dependent smoking and Rebellious smoking. Both built on pro-smoking norms and underscored the benefits of smoking. Three shared patterns were identified at a school where 3% of students smoked daily: Social bonding smoking, Low-profile smoking and Smoking-friendly event smoking. These built on anti-smoking norms and helped smokers cope with negative social judgements related to smoking. We conclude that adolescent smoking during school hours is embedded in diverse shared smoking patterns. Future studies should develop more understanding about how to deal with adolescents’ shared smoking patterns that decrease the effectiveness of tobacco policies.

Results of outdoor smoking bans at secondary schools on adolescents smoking behaviour: a quasi-experimental study.

Research on the effectiveness of school smoking policies on adolescents' smoking behaviour remain inconclusive. This study evaluates the results of an outdoor school ground smoking ban at secondary schools on adolescents smoking behaviour, taking individual characteristics into account. Data on 2684 adolescents from 18 Dutch secondary schools (nine with and nine without an outdoor smoking ban) were obtained at two moments. Associations between outdoor school ground smoking bans, individual characteristics, and smoking prevalence and frequency were measured. Multilevel logistic regression analyses were used. At schools with a ban implementation fidelity was checked. Although smoking prevalence and frequency appeared to make a slower increase at schools with an outdoor smoking ban compared with schools without an outdoor smoking ban, the differences were not significant. Differences between schools in the prevalence of smoking behaviour of students could mainly be explained by individual characteristics. Smoking prevalence and frequency were higher among adolescents with a positive attitude towards smoking and when significant others were more positive about smoking. Smoking prevalence and frequency were significantly lower when adolescents perceived it as easy not to smoke. Implementation fidelity was good at schools with a ban. No short-term effects were found of an outdoor smoking ban. A longer follow-up time than 6 months is needed. In addition, future research should investigate effectiveness in relation to the enforcement of the ban, comprehensiveness of the ban and when it is prohibited to leave school grounds, as smoking behavior might be transferred off school grounds.

Cigarette smoking and reasons for leaving school among school dropouts in South Africa

BackgroundSchool dropouts are at heightened risk of tobacco use compared to in-school learners. School dropouts are described as those not currently enrolled in school for the academic year, have not completed their schooling, and are between 13 and 20 years old. This paper examines the relationship between reasons for leaving school and past month cigarette smoking, taking into account gender differences.MethodsMultiple logistic regression was used to analyse survey data (n = 4185). Geographical location was also incorporated into the analysis as effect moderators.ResultsAlthough no significant main effects between reasons for leaving school and tobacco use were found, results showed that those who leave school early smoke more. When examining interaction effects with gender, leaving school due to ‘not being able to pay for school fees’ was significantly associated with smoking, but only among girls residing in urban areas (OR = 0.327, p = .023).ConclusionsMore research is needed to understand why learners leave school and their subsequent tobacco use. This knowledge will help researchers identify and target those students that are at risk for dropping out of school and using tobacco.