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The role of national policies intended to regulate adolescent smoking in explaining the prevalence of daily smoking: a study of adolescents from 27 European countries
Author(s) -
Schnohr Christina W.,
Kreiner Svend,
Rasmussen Mette,
Due Pernille,
Currie Candace,
Diderichsen Finn
Publication year - 2008
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/j.1360-0443.2008.02161.x
Subject(s) - tobacco control , youth smoking , smoking prevalence , environmental health , medicine , odds ratio , demography , odds , monitoring the future , smoking cessation , multilevel model , adolescent health , association (psychology) , logistic regression , public health , psychology , population , psychiatry , substance abuse , nursing , pathology , machine learning , sociology , computer science , psychotherapist
Aims This study seeks to examine whether contextual factors influence adolescents' daily smoking. A focus was placed on three modifiable policies operating at a national level, non‐smoking policy at educational facilities , price and minimum age for buying tobacco . Design This study is based on a merged data set consisting of the 2001/02 Health Behavior in School‐aged Children (HBSC) study and national‐level data collected from the 2003 WHO European Tobacco Control Database and the World Development Indicators Database. HBSC is an international study including adolescents from 32 countries in Europe, Israel and North America. Data were analysed with multi‐level hierarchical regression models. Findings The study found large differences in the prevalence of daily smoking among adolescents, and also large differences between boys and girls within some countries. The study found that smoking bans in schools were associated with lower odds ratios of daily smoking, which was the one positive association in the study. The study found no association between cigarette prices and adolescent daily smoking prevalence, and also the somewhat unexpected finding that having an age limit for allowing adolescents to purchase tobacco was associated with an increased risk of daily smoking. Conclusions There was an association between mandatory national bans on smoking and lower smoking prevalence. This should be confirmed by studies that examine whether mandatory bans are more rigorously implemented than voluntary bans. If this association is causal, introducing mandatory bans may reduce adolescent smoking prevalence. The findings that price was unrelated to smoking prevalence undermine findings elsewhere that adolescent smokers are more price‐sensitive than adult smokers, but longitudinal studies are needed.