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School-Based Tobacco Control and Smoking in Adolescents: Evidence from Multilevel Analyses

Author

Listed:
  • Seong Yeon Kim

    (Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea)

  • Myungwha Jang

    (Institute of Health and Environment, Seoul National University, Seoul 08826, Korea)

  • Seunghyun Yoo

    (Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
    Institute of Health and Environment, Seoul National University, Seoul 08826, Korea)

  • Jung JeKarl

    (Department of Health Convergence, College of Science and Industry Convergence, Ewha Womans University, Seoul 03760, Korea)

  • Joo Youn Chung

    (Korea Health Promotion Institute, Seoul 04554, Korea)

  • Sung-il Cho

    (Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
    Institute of Health and Environment, Seoul National University, Seoul 08826, Korea)

Abstract

Since 2015, universal comprehensive school-based tobacco control programs have been provided in all primary and secondary schools in Korea. This study explored the association of school-level tobacco control with adolescent smoking, and the interactions to investigate whether gender moderates the impact of school tobacco control programs and school-level norms. Both school- and individual-level data were drawn from the 2015 School-Based Tobacco Prevention Program Survey. Multilevel logistic regression analyses were performed using data from 4631 students (ages 10–18 years) who were nested in 62 secondary schools in Seoul, Korea. Students who participated in more prevention programs were less likely to smoke (OR = 0.47, 95% CI 0.30–0.74). The effect of the programs was significantly moderated by gender. For boys, exposure to a greater number of programs decreased the risk of smoking (OR = 0.32, 95% CI 0.18–0.57) but not for girls. At the school level, the school norm regarding tobacco control regulations was negatively associated with smoking (OR = 0.28, 95% CI 0.11–0.76), and its effect was significant for girls only (OR = 0.35, 95% CI 0.17–0.76). This study highlights how the school environment is associated with adolescent smoking behavior, and the effects of programs and norms are different by gender. The findings suggest the need to develop strategies to enhance school-based tobacco control programs and the school norm considering gender differences.

Suggested Citation

  • Seong Yeon Kim & Myungwha Jang & Seunghyun Yoo & Jung JeKarl & Joo Youn Chung & Sung-il Cho, 2020. "School-Based Tobacco Control and Smoking in Adolescents: Evidence from Multilevel Analyses," IJERPH, MDPI, vol. 17(10), pages 1-13, May.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:10:p:3422-:d:358092
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    References listed on IDEAS

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    1. Dedobbeleer, Nicole & Béland, Francois & Contandriopoulos, André-Pierre & Adrian, Manuella, 2004. "Gender and the social context of smoking behaviour," Social Science & Medicine, Elsevier, vol. 58(1), pages 1-12, January.
    2. Schreuders, Michael & Nuyts, Paulien A.W. & van den Putte, Bas & Kunst, Anton E., 2017. "Understanding the impact of school tobacco policies on adolescent smoking behaviour: A realist review," Social Science & Medicine, Elsevier, vol. 183(C), pages 19-27.
    3. Maes, Lea & Lievens, John, 2003. "Can the school make a difference? A multilevel analysis of adolescent risk and health behaviour," Social Science & Medicine, Elsevier, vol. 56(3), pages 517-529, February.
    4. Michael Schreuders & Loekie Klompmaker & Bas van den Putte & Anton E Kunst, 2019. "Adolescent Smoking in Secondary Schools that Have Implemented Smoke-Free Policies: In-Depth Exploration of Shared Smoking Patterns," IJERPH, MDPI, vol. 16(12), pages 1-13, June.
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    1. Sookyung Kim & Seunghyun Yoo & Sung-il Cho & Hanna Jung & Yeaseul Yang, 2021. "Experiences of the First Year Implementation of a Nationwide School-Based Smoking Prevention Program in Korea," IJERPH, MDPI, vol. 18(6), pages 1-13, March.

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