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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2009

Open Access 01-12-2009 | Research

School-related mediators in social inequalities in smoking: a comparative cross-sectional study of 20,399 adolescents

Authors: Christina W Schnohr, Svend Kreiner, Mette Rasmussen, Pernille Due, Finn Diderichsen

Published in: International Journal for Equity in Health | Issue 1/2009

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Abstract

Background

The aim of this study was to examine the associations between social inequalities and daily smoking among 13 and 15 year olds, and to determine the role of students' academic achievement and school satisfaction in these associations.

Methods

HBSC is an international study including adolescents from 32 countries in Europe, Israel, and North America. The present study was based on information from 20,399 adolescents from Denmark, Sweden, Norway, Finland and the United Kingdom. Data were analysed by regression models.

Results

The initial analyses showed significant inequality in daily smoking in all countries except for Sweden. When adjusted for the mediating role of academic achievement, estimates were attenuated, but remained significant in three countries.

Conclusion

The study found social inequality in daily smoking in Denmark, Sweden, Norway, Finland and United Kingdom, as well as inequalities in students' academic achievement and school satisfaction. The analyses also showed that above average academic achievement was associated with lower OR of smoking. Teachers and politicians may find this information useful, and allocate resources to give higher priority to a supportive environment in schools especially for children and adolescents in lower social groups. Subsequently this prioritisation might contribute to reducing smoking in this group.
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Literature
1.
Lynch JW, Smith GD, Kaplan GD, House JS: Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions. BMJ. 2000, 320: 1200-4. 10.1136/bmj.320.7243.1200.PubMedCentralCrossRefPubMed
2.
Mackenbach JP, Stirbu I, Roskam AJ, Schaap MM, Menvielle G, Leinsalu M, Kunst AE, European Union Working Group on Socioeconomic Inequalities in Health: Socioeconomic Inequalities in Health in 22 European Countries. N Engl J Med. 2008, 358 (23): 2468-81. 10.1056/NEJMsa0707519.CrossRefPubMed
3.
Crone MR, Reijneveld SA, Willemsen MC, van Leerdam FJ, Spruijt RD, Sing RA: Prevention of smoking in adolescents with lower education: a school based intervention study. J Epidemiol Community Health. 2003, 57 (9): 675-80. 10.1136/jech.57.9.675.PubMedCentralCrossRefPubMed
4.
Geckova AM, van Dijk JP, Zezula I, Tuinstra J, Groothoff JW, Post D: Socio-economic differences in health among Slovak adolescents. Soz Praventivmed. 2004, 49 (1): 26-35.CrossRefPubMed
5.
Koivusilta LK, Rimpela AH, Kautiainen SM: Health inequality in adolescence. Does stratification occur by familial social background, family affluence, or personal social position?. BMC Public Health. 2006, 6: 110-10.1186/1471-2458-6-110.CrossRefPubMed
6.
Piko BF, Fitzpatrick KM: Socioeconomic Status, Psychosocial Health and Health Behaviours among Hungarian Adolescents. Eur J Public Health. 2007, 17 (4): 353-60. 10.1093/eurpub/ckl257.CrossRefPubMed
7.
Richter M: The role of social inequality for adolescent health. Gesundheitswesen. 2005, 67 (10): 709-18. 10.1055/s-2005-858652.CrossRefPubMed
8.
Salonna F, van Dijk JP, Geckova AM, Sleskova M, Groothoff JW, Reijneveld SA: Social inequalities in changes in health-related behaviour among Slovak adolescents aged between 15 and 19: a longitudinal study. BMC Public Health. 2008, 8: 57-10.1186/1471-2458-8-57.PubMedCentralCrossRefPubMed
9.
Kristjansson AL, Sigfusdottir ID, Allegrante JP, Helgason AR: Social correlates of cigarette smoking among Icelandic adolescents: a population-based cross-sectional study. BMC Public Health. 2008, 8: 86-10.1186/1471-2458-8-86.PubMedCentralCrossRefPubMed
10.
Kristjansson AL, Sigfusdottir ID, Allegrante JP: Health Behavior and Academic Achievement Among Adolescents: The Relative Contribution of Dietary Habits, Physical Activity, Body Mass Index, and Self-Esteem. Health Educ Behav. 2008,
11.
Martins SS, Alexandre PK: The association of ecstasy use and academic achievement among adolescents in two U.S. national surveys. Addictive Behaviors. 2009, 34: 9-16. 10.1016/j.addbeh.2008.07.022.PubMedCentralCrossRefPubMed
12.
Koivusilta L, Rimpela A, Vikat A: Health behaviours and health in adolescence as predictors of educational level in adulthood: a follow-up study from Finland. Soc Sci Med. 2003, 57 (4): 577-93. 10.1016/S0277-9536(02)00405-7.CrossRefPubMed
13.
Kristjansson AL, Sigfusdottir ID, Allegrante JP, Helgason AR: Adolescent health behavior, contentment in school, and academic achievement. Am J Health Behav. 2009, 33 (1): 69-79.PubMed
14.
Lynskey M, Hall W: The effects of adolescent cannabis use on educational attainment: a review. Addiction. 2000, 95 (11): 1621-30. 10.1046/j.1360-0443.2000.951116213.x.CrossRefPubMed
15.
Patterson F, Lerman C, Kaufmann VG, Neuner GA, Audrain-McGovern J: Cigarette Smoking Practices Among American College Students: Review and Future Directions. Journal of American College Health. 2004, 52 (5): 203-10. 10.3200/JACH.52.5.203-212.CrossRefPubMed
16.
Schoon I, Sacker A, Bartley M: Socio-economic adversity and psychosocial adjustment: a developmental-contextual perspective. Social Science & Medicine. 2003, 57 (6): 1001-15. 10.1016/S0277-9536(02)00475-6.CrossRef
17.
Elgar FJ, Roberts C, Parry-Langdon N, Boyce W: Income inequality and alcohol use: a multilevel analysis of drinking and drunkenness in adolescents in 34 countries. Eur J Public Health. 2005, 15 (3): 245-50. 10.1093/eurpub/cki093.CrossRefPubMed
18.
Kim H, Clark PI: Cigarette smoking transition in females of low socioeconomic status: impact of state, school, and individual factors. J Epidemiol Community Health. 2006, 60 suppl 2: 13-19. 10.1136/jech.2005.045658.PubMed
19.
Diderichsen F, Evans T, Whitehead M: The social basis of disparities in health. Challenging inequities in health. From ethics to action. Edited by: Evans T, Whitehead M, Diderichsen F, Bhuiya A, Wirth M. 2001, New York: Oxford University Press, 12-23.CrossRef
20.
Whitehead M, Burstrom B, Diderichsen F: Social policies and the pathways to inequalities in health: a comparative analysis of lone mothers in Britain and Sweden. Social Science & Medicine. 2000, 50 (2): 255-70. 10.1016/S0277-9536(99)00280-4.CrossRef
21.
West P: Health inequalities in the early years: Is there equalisation in youth?. Social Science & Medicine. 1997, 44 (6): 833-58. 10.1016/S0277-9536(96)00188-8.CrossRef
22.
West P, Sweeting H: Evidence on equalisation in health in youth from the West of Scotland. Social Science & Medicine. 2004, 59 (1): 13-27. 10.1016/j.socscimed.2003.12.004.CrossRef
23.
Roberts C, Currie C, Samdal O, Currie D, Smith R, Maes L: Measuring the health and health behaviours of adolescents through cross-national survey research: recent developments in the Health Behaviour in School-aged Children (HBSC) study. Journal of Public Health. 2007, 15 (3): 179-86. 10.1007/s10389-007-0100-x.CrossRef
24.
Currie C, Elton RA, Todd J, Platt S: Indicators of socioeconomic status for adolescents: the WHO Health Behaviour in School-aged Children Survey. Health Educ Res. 1997, 12 (3): 385-97. 10.1093/her/12.3.385.CrossRefPubMed
25.
Schnohr CW, Kreiner S, Due E, Currie C, Boyce W, Diderichsen F: Differential Item Functioning of a Family Affluence Scale: Validation Study on Data from HBSC 2001/02. Social Indicators Research. 2008, 89 (1): 79-95. 10.1007/s11205-007-9221-4.CrossRef
26.
Kreiner S, Christensen KB: Validity and objectivity in health related summated scales: Analysis by graphical log-linear Rasch models. Multivariate and mixture distribution Rasch models. Extensions and applications. Edited by: von Davier M, Carstensen CH. 2006, New York: Springer Verlag, 329-46.
27.
Kreiner S: Validity and objectivity. Reflections of the role and nature of Rasch models. Nordic Psychology. 2007, 59: 268-98.CrossRef
28.
Currie C, Molcho M, Boyce W, Holstein B, Torsheim T, Richter M: Researching health inequalities in adolescents: the development of the Health Behaviour in School-Aged Children (HBSC) family affluence scale. Soc Sci Med. 2008, 66 (6): 1429-1436.CrossRefPubMed
29.
Currie C, Samdal O, Boyce W, Smith R: Health Behaviour in School-aged Children: a WHO Cross-National Study (HBSC), Research Protocol for the 2001/2002 Survey. 2001, Child and Adolescent Health Research Unit (CAHRU), University of Edinburgh
30.
OECD – Organisation for Economic Growth and Development: Learning for Tomorrow's World. First Results from PISA 2003. 2004, Paris, OECD
31.
Koivusilta LK, Rimpela AH, Rimpela M, Vikat A: Health behavior-based selection into educational tracks starts in early adolescence. Health Education Research. 2001, 16 (2): 201-14. 10.1093/her/16.2.201.CrossRefPubMed
32.
Veselska Z, Geckova AM, Orosova O, Gajdosova B, van Dijk JP, Reijneveld SA: Self-esteem and resilience: The connection with risky behavior among adolescents. Addictive Behaviors. 2009, 34 (3): 287-91. 10.1016/j.addbeh.2008.11.005.CrossRefPubMed
Metadata
Title
School-related mediators in social inequalities in smoking: a comparative cross-sectional study of 20,399 adolescents
Authors
Christina W Schnohr
Svend Kreiner
Mette Rasmussen
Pernille Due
Finn Diderichsen
Publication date
01-12-2009
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2009
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/1475-9276-8-17

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