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Addict Behav. 2014 Sep;39(9):1329-36. doi: 10.1016/j.addbeh.2014.04.015. Epub 2014 Apr 21.

We do not smoke but some of us are more susceptible than others: a multilevel analysis of a sample of Canadian youth in grades 9 to 12.

Author information

1
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada. Electronic address: skaai@uwaterloo.ca.
2
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada; Propel Centre for Population Health Impact, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada; Department of Statistics and Actuarial Science, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada. Electronic address: ksbrown@uwaterloo.ca.
3
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada. Electronic address: sleatherdale@uwaterloo.ca.
4
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada; Propel Centre for Population Health Impact, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada. Electronic address: steve.manske@uwaterloo.ca.
5
School of Nursing, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, C1A 4P3 Canada. Electronic address: dmurnaghan@upei.ca.

Abstract

BACKGROUND:

Smoking susceptibility has been found to be a strong predictor of experimental smoking. This paper examined which student- and school-level factors differentiated susceptible never smokers from non-susceptible never smokers among a nationally representative sample of Canadian students in grades 9 to 12.

METHODS:

Student-level data from the 2008-2009 Canadian Youth Smoking Survey were linked with school-level data from the 2006 Census, and one built environment characteristic (the density of tobacco retailers surrounding schools). These data were examined using multilevel logistic regression analyses.

RESULTS:

The likelihood of a never smoker being susceptible to smoking significantly varied across schools (p=0.0002). Students in this study were more likely to be susceptible never smokers if they reported low self-esteem, held positive attitudes towards smoking, used alcohol or marijuana, had close friends who smoked, and came from homes without a total ban on smoking. The school location (rural versus urban), the socioeconomic status of the neighbourhood surrounding a school, and the density of tobacco retailers that were located within 1-km radius of each school were not associated with students' smoking susceptibility.

CONCLUSION:

These findings underscore the continued need to develop school-based tobacco use prevention policies and/or programs that enhance students' self-esteem, address tobacco use misinformation and substance use, and include strategies targeting friends who smoke, and students who come from homes without a total ban on smoking.

KEYWORDS:

Adolescents; Canada; Multilevel analysis; Susceptibility; Tobacco smoking

PMID:
24837756
DOI:
10.1016/j.addbeh.2014.04.015
[Indexed for MEDLINE]

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