Socioeconomic inequalities in adolescent smoking across 35 countries

a multilevel analysis of the role of family, school and peers

Irene Moor, Katharina Rathmann, Michela Lenzi, Timo-Kolja Pförtner, Gera E Nagelhout, Margreet de Looze, Pernille Bendtsen, Marc Willemsen, Lasse Kannas, Anton E Kunst, Matthias Richter

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    Resumé

    BACKGROUND: Tobacco-related heath inequalities are a major public health concern, with smoking being more prevalent among lower socioeconomic groups. The aim of this study is to investigate the mechanisms leading to socioeconomic inequalities in smoking among 15-year-old adolescents by examining the mediating role of psychosocial factors in the peer group, family and school environment.

    METHODS: Data were derived from the international WHO-collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, including 52 907 15-year-old students from 35 European and North American countries. Socioeconomic position was measured by the Family Affluence Scale. Multilevel logistic regression models were conducted to examine the contribution of family, school and peer factors in explaining the association between family affluence and weekly smoking.

    RESULTS: Across countries, adolescents from low affluent families had an increased risk of weekly smoking (ORboys 1.14, confidence interval (CI) 1.05-1.23; ORgirls 1.36, CI 1.26-1.46) compared with adolescents from high affluent families. Family and school factors mediated the association between family affluence and smoking to a high extent up to 100% (boys) and 81% (girls) in joint analyses. The most important single factors were family structure, relationships with parents, academic achievement and school satisfaction. Peer factors did not mediate the association between family affluence and adolescent smoking.

    CONCLUSION: The association between socioeconomic status and adolescent weekly smoking can largely be explained by an unequal distribution of family- and school-related factors. Focusing on the parent-adolescent relationship and adolescent school achievement can help to better understand inequalities in adolescent smoking behaviour.

    OriginalsprogEngelsk
    TidsskriftEuropean Journal of Public Health
    Vol/bind25
    Udgave nummer3
    Sider (fra-til)457–463
    ISSN1101-1262
    DOI
    StatusUdgivet - 20. feb. 2015

    Fingeraftryk

    Multilevel Analysis
    Smoking
    Logistic Models
    Confidence Intervals
    Adolescent Behavior
    Health Behavior
    Public Health
    Joints
    Parents

    Citer dette

    Moor, Irene ; Rathmann, Katharina ; Lenzi, Michela ; Pförtner, Timo-Kolja ; Nagelhout, Gera E ; de Looze, Margreet ; Bendtsen, Pernille ; Willemsen, Marc ; Kannas, Lasse ; Kunst, Anton E ; Richter, Matthias. / Socioeconomic inequalities in adolescent smoking across 35 countries : a multilevel analysis of the role of family, school and peers. I: European Journal of Public Health. 2015 ; Bind 25, Nr. 3. s. 457–463.
    @article{ed620ae3b2a64da1afd013f25c2cc946,
    title = "Socioeconomic inequalities in adolescent smoking across 35 countries: a multilevel analysis of the role of family, school and peers",
    abstract = "BACKGROUND: Tobacco-related heath inequalities are a major public health concern, with smoking being more prevalent among lower socioeconomic groups. The aim of this study is to investigate the mechanisms leading to socioeconomic inequalities in smoking among 15-year-old adolescents by examining the mediating role of psychosocial factors in the peer group, family and school environment.METHODS: Data were derived from the international WHO-collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, including 52 907 15-year-old students from 35 European and North American countries. Socioeconomic position was measured by the Family Affluence Scale. Multilevel logistic regression models were conducted to examine the contribution of family, school and peer factors in explaining the association between family affluence and weekly smoking.RESULTS: Across countries, adolescents from low affluent families had an increased risk of weekly smoking (ORboys 1.14, confidence interval (CI) 1.05-1.23; ORgirls 1.36, CI 1.26-1.46) compared with adolescents from high affluent families. Family and school factors mediated the association between family affluence and smoking to a high extent up to 100{\%} (boys) and 81{\%} (girls) in joint analyses. The most important single factors were family structure, relationships with parents, academic achievement and school satisfaction. Peer factors did not mediate the association between family affluence and adolescent smoking.CONCLUSION: The association between socioeconomic status and adolescent weekly smoking can largely be explained by an unequal distribution of family- and school-related factors. Focusing on the parent-adolescent relationship and adolescent school achievement can help to better understand inequalities in adolescent smoking behaviour.",
    author = "Irene Moor and Katharina Rathmann and Michela Lenzi and Timo-Kolja Pf{\"o}rtner and Nagelhout, {Gera E} and {de Looze}, Margreet and Pernille Bendtsen and Marc Willemsen and Lasse Kannas and Kunst, {Anton E} and Matthias Richter",
    note = "{\circledC} The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.",
    year = "2015",
    month = "2",
    day = "20",
    doi = "10.1093/eurpub/cku244",
    language = "English",
    volume = "25",
    pages = "457–463",
    journal = "European Journal of Public Health",
    issn = "1101-1262",
    publisher = "Heinemann",
    number = "3",

    }

    Moor, I, Rathmann, K, Lenzi, M, Pförtner, T-K, Nagelhout, GE, de Looze, M, Bendtsen, P, Willemsen, M, Kannas, L, Kunst, AE & Richter, M 2015, 'Socioeconomic inequalities in adolescent smoking across 35 countries: a multilevel analysis of the role of family, school and peers', European Journal of Public Health, bind 25, nr. 3, s. 457–463. https://doi.org/10.1093/eurpub/cku244

    Socioeconomic inequalities in adolescent smoking across 35 countries : a multilevel analysis of the role of family, school and peers. / Moor, Irene; Rathmann, Katharina; Lenzi, Michela; Pförtner, Timo-Kolja; Nagelhout, Gera E; de Looze, Margreet; Bendtsen, Pernille; Willemsen, Marc; Kannas, Lasse; Kunst, Anton E; Richter, Matthias.

    I: European Journal of Public Health, Bind 25, Nr. 3, 20.02.2015, s. 457–463.

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    TY - JOUR

    T1 - Socioeconomic inequalities in adolescent smoking across 35 countries

    T2 - a multilevel analysis of the role of family, school and peers

    AU - Moor, Irene

    AU - Rathmann, Katharina

    AU - Lenzi, Michela

    AU - Pförtner, Timo-Kolja

    AU - Nagelhout, Gera E

    AU - de Looze, Margreet

    AU - Bendtsen, Pernille

    AU - Willemsen, Marc

    AU - Kannas, Lasse

    AU - Kunst, Anton E

    AU - Richter, Matthias

    N1 - © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

    PY - 2015/2/20

    Y1 - 2015/2/20

    N2 - BACKGROUND: Tobacco-related heath inequalities are a major public health concern, with smoking being more prevalent among lower socioeconomic groups. The aim of this study is to investigate the mechanisms leading to socioeconomic inequalities in smoking among 15-year-old adolescents by examining the mediating role of psychosocial factors in the peer group, family and school environment.METHODS: Data were derived from the international WHO-collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, including 52 907 15-year-old students from 35 European and North American countries. Socioeconomic position was measured by the Family Affluence Scale. Multilevel logistic regression models were conducted to examine the contribution of family, school and peer factors in explaining the association between family affluence and weekly smoking.RESULTS: Across countries, adolescents from low affluent families had an increased risk of weekly smoking (ORboys 1.14, confidence interval (CI) 1.05-1.23; ORgirls 1.36, CI 1.26-1.46) compared with adolescents from high affluent families. Family and school factors mediated the association between family affluence and smoking to a high extent up to 100% (boys) and 81% (girls) in joint analyses. The most important single factors were family structure, relationships with parents, academic achievement and school satisfaction. Peer factors did not mediate the association between family affluence and adolescent smoking.CONCLUSION: The association between socioeconomic status and adolescent weekly smoking can largely be explained by an unequal distribution of family- and school-related factors. Focusing on the parent-adolescent relationship and adolescent school achievement can help to better understand inequalities in adolescent smoking behaviour.

    AB - BACKGROUND: Tobacco-related heath inequalities are a major public health concern, with smoking being more prevalent among lower socioeconomic groups. The aim of this study is to investigate the mechanisms leading to socioeconomic inequalities in smoking among 15-year-old adolescents by examining the mediating role of psychosocial factors in the peer group, family and school environment.METHODS: Data were derived from the international WHO-collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, including 52 907 15-year-old students from 35 European and North American countries. Socioeconomic position was measured by the Family Affluence Scale. Multilevel logistic regression models were conducted to examine the contribution of family, school and peer factors in explaining the association between family affluence and weekly smoking.RESULTS: Across countries, adolescents from low affluent families had an increased risk of weekly smoking (ORboys 1.14, confidence interval (CI) 1.05-1.23; ORgirls 1.36, CI 1.26-1.46) compared with adolescents from high affluent families. Family and school factors mediated the association between family affluence and smoking to a high extent up to 100% (boys) and 81% (girls) in joint analyses. The most important single factors were family structure, relationships with parents, academic achievement and school satisfaction. Peer factors did not mediate the association between family affluence and adolescent smoking.CONCLUSION: The association between socioeconomic status and adolescent weekly smoking can largely be explained by an unequal distribution of family- and school-related factors. Focusing on the parent-adolescent relationship and adolescent school achievement can help to better understand inequalities in adolescent smoking behaviour.

    U2 - 10.1093/eurpub/cku244

    DO - 10.1093/eurpub/cku244

    M3 - Journal article

    VL - 25

    SP - 457

    EP - 463

    JO - European Journal of Public Health

    JF - European Journal of Public Health

    SN - 1101-1262

    IS - 3

    ER -