Contextual factors associated with smoking among Brazilian adolescents

Abstract

BackgroundVery few studies have examined the role of school, household and family contexts in youth smoking in middle-income countries.MethodsThis work describes smoking exposure among 59 992 high school students who took part in the Brazilian Survey of School Health and investigates contextual factors associated with regular smoking, defined as smoking cigarettes at least once in the past 30 days. The explaining variables were grouped into: socio-demographic characteristics, school context, household context and family rapport. Variables independently associated with smoking in each context were identified by multiple logistic regression analysis.Results53% of the total sample were girls, 89% were aged 13–15 years. 24% had already experimented with cigarettes, 50% before the age of 12 years. The prevalence of regular smoking was 6.3% (95% CI 5.87 to 6.74), with no sex variation. Smoking was not associated with either the mother's education or the index of household assets. In the multivariable analysis, studying at a private school, the possibility of purchasing cigarettes at school and skipping of classes without parents' consent increased the chances of smoking. In the household context, living with both parents was negatively associated with smoking, while having smoking parents and exposure to other people's smoking was positively related to smoking. In the family context, parental unawareness of what the adolescent was doing increased smoking, but having meals with the mother one or more days per week and parents' negative reactions to adolescent smoking reduced the chances of smoking.ConclusionThe results reinforce the role of school, household and family contexts in youth smoking behaviours and will help improve public health policies aimed at preventing smoking and health promotion in adolescents.

Adverse childhood experiences and consumption of alcohol, tobacco and illicit drugs among adolescents of a Brazilian birth cohort

“…Regarding illicit drugs experimentation, a prevalence below the one observed in PeNSE 3 was seen, even though similar drugs were investigated in both studies. It is worth pointing out that in the nationwide survey, despite the fact that most students were between 13 and 15 years old, older adolescents were also interviewed, which may account for the higher prevalence of drug use compared to the present study, since drug use tends to increase with age 1,30,31 .…”

Fatores associados à procura de serviços de saúde entre escolares brasileiros: uma análise da Pesquisa Nacional de Saúde do Escolar (PeNSE), 2012

“…O modelo ecológico de desenvolvimento humano, durante os primeiros anos de vida, aborda a existência de uma complexa interação entre os fatores contextuais, incluindo a influência da comunidade, colegas, escola, famí-lia, entre outros 35 . Assim como neste trabalho, outros estudos observaram a relação das características familiares nos desfechos estudados entre adolescentes, como na investigação relacionada aos fatores de risco e proteção para doenças crô-nicas não transmissíveis 36 ; tabagismo entre ado-lescentes e a realização de atividades sem consentimento dos pais 37 ; comportamento sexual desprotegido entre adolescentes e viver em família monoparental e baixa supervisão dos pais 38 . É importante o papel das famílias no cuidado junto ao adolescente como fator de proteção que influencia também no maior acesso aos serviços de saúde.…”

Socioeconomic Status and Tobacco Consumption Among Adolescents: A Multilevel Analysis of Argentina's Global Youth Tobacco Survey

“…Adolescents from families with low SES may be exposed more frequently to parental smoking, with a corresponding increase in the chance of smoking initiation ( Barreto et al, 2011 ;Wilkinson, Shete, & Prokhorov, 2008 ). In addition , adolescents from families with low SES may use tobacco for coping with economic problems ( Stead, MacAskill, MacKintosh, Reece, & Eadie, 2001 ;Wiltshire, Bancroft, Parry, & Amos, 2003 ).…”

“…The socioeconomic environment where the school is located may infl uence the smoking behaviors of students through several mechanisms, including exposure to tobacco advertising ( Barreto et al, 2011 ;Seidenberg et al, 2010 ), availability of tobacco products, and the development of social norms that facilitate or detract from youth smoking ( Lovato et al, 2010 ). However, we could not fi nd studies in developing countries that address the impact of socioeconomic context of the school among youth.…”