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The association between family affluence and smoking among 15‐year‐old adolescents in 33 E uropean countries, I srael and C anada: the role of national wealth
Author(s) -
Pförtner TimoKolja,
Moor Irene,
Rathmann Katharina,
Hublet Anne,
Molcho Michal,
Kunst Anton E.,
Richter Matthias
Publication year - 2015
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12741
Subject(s) - demography , odds ratio , logistic regression , per capita , confidence interval , odds , medicine , smoking prevalence , residence , psychology , population , sociology
Aims To examine the role of national wealth in the association between family affluence and adolescent weekly smoking, early smoking behaviour and weekly smoking among former experimenters. Design and Participants Data were used from the H ealth B ehaviour in S chool‐aged C hildren ( HBSC ) study conducted in 2005/2006 in 35 countries from E urope and N orth A merica that comprises 60 490 students aged 15 years. Multi‐level logistic regression was conducted using M arkov chain M onte C arlo methods ( MCMC ) to explore whether associations between family affluence and smoking outcomes were dependent upon national wealth. Measurement F amily A ffluence S cale ( FAS ) as an indicator for the socio‐economic position of students. Current weekly smoking behaviour is defined as at least weekly smoking (dichotomous). Early smoking behaviour is measured by smoking more than a first puff before age 13 years (dichotomous). Weekly smoking among former experimenters is restricted to those who had tried a first puff in the past. Findings The logistic multi‐level models indicated an association of family affluence with current weekly smoking [odds ratio ( OR ) = 1.088; 95% credible interval ( CrI ) = 1.055–1.121, P < 0.001], early smoking behaviour ( OR = 1.066; CrI = 1.028–1.104, P < 0.001) and smoking among former experimenters ( OR = 1.100; CrI = 1.071–1.130; P < 0.001). Gross domestic product ( GDP) per capita was associated positively and significantly with the relationship between family affluence and current weekly smoking ( OR = 1.005; CrI = 1.003–1.007; P < 0.001), early smoking behaviour ( OR = 1.003; CrI = 1.000–1.005; P = 0.012) and smoking among former experimenters ( OR = 1.004; CrI = 1.002–1.006; P < 0.001). The association of family affluence and smoking outcomes was significantly stronger for girls. Conclusions The difference in smoking prevalence between rich and poor is greater in more affluent countries.