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Addict Behav. 2016 Feb;53:58-66. doi: 10.1016/j.addbeh.2015.09.016. Epub 2015 Oct 9.

Socioeconomic inequalities in the impact of tobacco control policies on adolescent smoking. A multilevel study in 29 European countries.

Author information

Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany; Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany. Electronic address:
Department of Public Health, Ghent University, Ghent, Belgium.
Institute of Public Health, University of Copenhagen, Denmark.
Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Interdisciplinary Social Sciences, Utrecht University, The Netherlands.
Department of Public Health, Jessenius Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia.
Health Promotion Research Centre, School of Health Sciences, National University of Ireland Galway, Galway, Ireland.
Department of Health Sciences, University of Jyväskylä, Finland.
Department of Public Health, AMC, University of Amsterdam, Amsterdam, The Netherlands.



There are concerns that tobacco control policies may be less effective in reducing smoking among disadvantaged socioeconomic groups and thus may contribute to inequalities in adolescent smoking. This study examines how the association between tobacco control policies and smoking of 15-year-old boys and girls among 29 European countries varies according to socioeconomic group.


Data were used from the Health Behaviour in School-aged Children (HBSC) study conducted in 2005/2006 comprising 50,338 adolescents aged 15 years from 29 European countries. Multilevel logistic regression analyses were conducted to assess the association of weekly smoking with components of the Tobacco Control Scale (TCS), and to assess whether this association varied according to family affluence (FAS). Analyses were carried out per gender and adjusted for national wealth and general smoking rate.


For boys, tobacco price was negatively associated with weekly smoking rates. This association did not significantly differ between low and high FAS. Levels of tobacco-dependence treatment were significantly associated with weekly smoking. This association varied between low and high FAS, with higher treatment levels associated with higher probability of smoking only for low FAS boys. For girls, no tobacco policy was significantly associated with weekly smoking, irrespective of the FAS.


Results indicated that most tobacco control policies are not clearly related to adolescent weekly smoking across European countries. Only tobacco price seemed to be adequate decreasing smoking prevalence among boys, irrespective of their socioeconomic status.

[Indexed for MEDLINE]

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