Is there a relation between school smoking policies and youth cigarette smoking knowledge and behaviors?

To comply with workplace legislation, New Zealand schools are required to have policies regarding tobacco smoking. Many schools also have policies to prevent tobacco use by students, including education programmes, cessation support and punishment for students found smoking. This paper investigated the associations between school policies and the prevalence of students' cigarette smoking. Furthermore, we investigated the association between school policy and students' tobacco purchasing behavior, knowledge of health effects from tobacco use and likelihood of influencing others not to smoke. Data were obtained from a self-report survey administered to 2,658 New Zealand secondary school students and staff from 63 schools selected using a multi-stage sampling procedure. Components of school policy were not significantly associated with smoking outcomes, health knowledge or health behavior, and weakly related to a punishment emphasis and students advising others to not smoke. Similarly, weak associations were found between not advising others to not smoke and policies with a punishment emphasis as well as smoke-free environments. The results suggest that having a school tobacco policy was unrelated to the prevalence of tobacco use among students, tobacco purchasing behavior and knowledge of the negative health effects of tobacco.     

A multilevel analysis examining the association between school-based smoking policies, prevention programs and youth smoking behavior: evaluating a provincial tobacco control strategy

This paper examined how smoking policies and programs are associated with smoking behavior among Grade 10 students (n = 4709) between 1999 and 2001. Data from the Tobacco Module from the School Health Action Planning and Evaluation System were examined using multilevel logistic regression analyses. We identified that (i) attending a school with smoking prevention programs only was associated with a substantial risk of occasional smoking among students with two or more close smoking friends and (ii) attending a school with both smoking prevention programs and policies was associated with substantial risk of occasional smoking among students who did not believe there were clear smoking rules present. Students attending schools where year of enrollment in high school starts in Grade 9 were more likely to be regular and occasional smokers. Each 1% increase in Grade 12 smoking rates increased the odds that a Grade 10 student was an occasional smoker. It appears that grade of enrollment, senior student smoking behavior, close friend's smoking behavior and clear rules about smoking at school can impact school-based tobacco control programming. These preliminary study findings suggest the need for further research targeting occasional smoking behavior and the transition stage into high school.     

The impact of school smoking policies and student perceptions of enforcement on school smoking prevalence and location of smoking

The purpose of this study was to comprehensively assess the impact of school tobacco policy intention, implementation and students' perceptions of policy enforcement on smoking rates and location of tobacco use during the school day. Data were obtained from all students in Grades 10-11 (n = 22,318) in 81 randomly selected schools from five Canadian provinces. Policy intention was assessed by coding written school tobacco policies. School administrators most familiar with the tobacco policy completed a survey to assess policy implementation. Results revealed policy intention and implementation subscales did not significantly predict school smoking prevalence but resulted in moderate prediction of tobacco use on school property (R(2) = 0.21-0.27). Students' perceptions of policy enforcement significantly predicted school smoking prevalence (R(2) = 0.36) and location of tobacco use (R(2) = 0.23-0.63). The research findings emphasize: (i) the need to consider both written policy intention and actual policy implementation and (ii) the existence of a policy is not effective in controlling tobacco use unless the policy is implemented and is perceived to be strongly enforced.     

Targeting school tobacco policy: lessons from the Acadiana Coalition of Teens Against Tobacco (ACTT)

This case study examines the comparative effect of no-use school tobacco policies and restricted-use tobacco policies on teacher and student smoking behaviors and attitudes. Data from teachers (n = 1,041) and ninth-grade students (n = 4,763) at 20 schools in five districts in southern Louisiana were available. No significant difference was observed between teacher smoking (11% vs. 13%, p = .42) or student smoking (24.6% vs. 25.2%, p = .75) at no-use versus restricted-use policy schools. The proportion of teachers smoking on campus at no-use or restricted-use schools was not significantly different. Teachers at restricted-use schools were however less concerned about students seeing teachers smoke and less supportive of a no-use policy than teachers at no-use schools. Tobacco use policies are often not promoted, and enforcement of policies impacting teachers is complex. Changing social norms for smoking at high schools through policy promotion and enforcement is understudied.     

School, parent, and student perspectives of school drug policies

BACKGROUND: Schools use a number of measures to reduce harmful tobacco, alcohol, and drug use by students. One important component is the school's drug policy, which serves to set normative values and expectations for student behavior as well as to document procedures for dealing with drug-related incidents. There is little empirical evidence of how policy directly or indirectly influence students' drug taking. This study compares how effectively schools communicate school drug policies to parents and students, how they are implemented, and what policy variables impact students' drug use at school and their perceptions of other students' drug use at school. METHODS: Data were obtained from 3876 students attending 205 schools from 2 states in the United States and Australia, countries with contrasting national drug policy frameworks. School policy data were collected from school personnel, parents, and students. RESULTS: Schools' policies and enforcement procedures reflected national policy approaches. Parents and students were knowledgeable of their school's policy orientation. CONCLUSIONS: When delivered effectively, policy messages are associated with reduced student drug use at school. Abstinence messages and harsh penalties convey a coherent message to students. Strong harm-minimization messages are also associated with reduced drug use at school, but effects are weaker than those for abstinence messages. This smaller effect may be acceptable if, in the longer term, it leads to a reduction in harmful use and school dropout within the student population.     

中学生吸烟行为危险因素研究

目的：为了预防与控制中学生的吸烟行为，降低中学生吸烟及尝试吸烟率，在河南省新乡市4所中学进行了中学生吸烟行为危险因素的调查分析和中学生控烟模式的研究。方法：采用整群随机抽样方法，对2763名学生通过自填问卷的方式进行了调查。结果：学生的吸烟率为6．6％，有8．7％的学生以前尝试过吸烟。年龄阶段10～12岁为中学生开始吸烟的主要阶段。吸烟容易与他人接近是引起学生吸烟的主要原因。多因素分析表明，母亲吸烟，同学或朋友吸烟是中学生吸烟行为的主要相关危险因素，学校对吸烟持否定态度是防止学生吸烟的重要保护因素。结论：中学生吸烟是一个复杂的行为，行之有效的控烟干预措施应从多方面入手。     

北京市2019年中小学校教职工烟草监测结果

目的 了解和掌握2019年北京市中小学校教职工人群烟草使用现状以及烟草使用的认知和态度,监测影响青少年烟草使用和暴露的中小学校教职工有关因素现状,为促进学校无烟环境建设提供参考依据.方法 2019年4-6月采用PPS抽样方法在全市范围内分别抽取小学、初中、高中和职高校的监测点校.每所监测学校随机调查20名教职员工,共纳...     

Smoking Policies of Secondary Schools in Arizona

ABSTRACT: The cigarette smoking policies of all accredited secondary schools in Arizona (N = 169) were analyzed in this study. One hundred sixty principals (94.7%) responded to a 16–item questionnaire. Data collected included the existence of a written smoking policy, how students, faculty/staff, and visitors were informed of the policy, the extent to which smoking was permitted on school grounds, the availability of smoking cessation programs and who facilitated those programs, and the inclusion of health education in the school curriculum. Findings indicated a trend toward prohibiting student smoking both during and outside of school hours and restricting faculty/staff smoking to designated areas. However, penalties were imposed only for student violation of the policy. Few schools offered smoking cessation programs and no major differences existed in policy components by school size or the existence of a written policy or health education program. Recommendations to develop or revise smoking policies for secondary schools are offered.     

Effects of School-Level Norms on Student Substance Use

This study examines the relationship between school norms of substance use disapproval (disapproval by the student body) and students' use of cigarettes, alcohol, and marijuana. Data came from nationally representative samples of 8th (N = 16,051), 10th (N = 13,251), and 12th (N = 8,797) grade students, attending 150, 140, and 142 schools, respectively. These students participated in the Monitoring the Future Project in 1999. Measures of school norms of disapproval of substance use were obtained by aggregating students' personal disapproval of daily cigarette use, heavy drinking, and marijuana use within each school. Analysis using logistic nonlinear hierarchical models indicated that in general, school-level disapproval lowered the probability of students' use of these substances, controlling for their own disapproval and for student and school demographic characteristics. The beneficial effect of school-level disapproval of cigarette and marijuana use on 8th-grade students' probability of daily cigarette use and marijuana use was significantly higher than it was for the 12th-grade students. The effect of school-level disapproval of heavy drinking on the probability of students' drinking was not significantly different across the three grades. Further, a school environment of disapproval was also found to create a protective environment for those students in the 8th and 10th grades who were themselves not disapproving of daily cigarette use. These results argue for prevention programs that include creation of an overarching environment of disapproval of substance use in schools.     

National and school policies on restrictions of teacher smoking: a multilevel analysis of student exposure to teacher smoking in seven European countries

The paper examines the association between restrictions on teacher tobacco smoking at school and student exposure to teachers who smoke during school hours. The data are taken from a European Commission-funded study 'Control of Adolescent Smoking' (the CAS study) in seven European countries. Multilevel modelling analyses were applied to investigate associations between national legislation concerning tobacco smoking in school, local school smoking restrictions and students' exposure to teachers who smoke at school. The analyses integrate data from three levels: national (types of policy and how restrictive they are), school (survey among teachers, n = 455) and student (survey among 15-year-old students, n = 10890). The results suggest that both national- and school-level policies on restriction of smoking among teachers are associated with a decreased probability of students reporting that they are exposed to teachers who smoke indoors, but an increased probability of being exposed to teachers smoking outdoors.     

Perceived smoking prevalence at school-level and children's smoking initiation: a multi-level analysis of a cross-sectional data in Taiwan

OBJECTIVES: Literature on the influence of smoking prevalence at school-level on the smoking initiation among elementary school children is scarce. The aim of the current study was to explore this in school clusters stratified according to student's perceived smoking prevalence in the school while adjusting for social impact of individual students. METHOD: The data was obtained from a survey administered to 13 elementary schools in Taoyuan County, a final sample of 1585 3rd and 4th grade students. Multi-level logistic regression analysis (MLRA) was used to examine the influence variable at school-level as well as individual socio-environment level had on smoking status of elementary schools students. RESULTS: Attending a school where the students reported a perception of high smoking prevalence had a greater effect on smoking behavior in boys than girls when compared with students attending a lower smoking prevalence school, after adjustment for student-level characteristics. CONCLUSIONS: Our study confirmed that a broader school environment with a high student perception of smoking prevalence is associated with children's smoking behavior in boys. The findings further indicate the need for enforcement of anti-smoking policies within schools with higher smoking rates to reduce visibility of smoking among school children.     

Symptoms of nicotine dependence and other predictors of student smoking at school: implications for school smoking policy

Students who violate school smoking policies present a difficult health and disciplinary issue for school officials. Professionals know little about the characteristics of students who smoke at school. In a prospective study of 679 students in two cities in central Massachusetts, researchers examined how nicotine dependence contributes to the problem of smoking at school. After three years of follow up, smoking at school was reported by 10.3% of students. Among subjects who admitted to smoking at school, 63% reported that symptoms of nicotine dependence preceded their smoking at school. After adjusting for other variables, student smokers with symptoms of nicotine dependence were nine times more likely to report smoking in school (OR 9.1, 95% CI 2.9-28.5) than were student smokers without symptoms. Smoking at school was more common among daily smokers and those who paid for their own cigarettes. Age, gender, race, and parental smoking status were not significantly associated with students' reports of smoking at school. These data suggest nicotine dependence as an important contributor to the problem of smoking at school, but not the only reason why students violate school smoking policies. Disciplinary action against students caught violating school smoking policies should be supplemented with an offer of treatment for nicotine dependence.     

A survey on smoking habits and attitudes among adolescents in Greece

The objective of the present study was to investigate smoking habits among 699 secondary school students, along with their attitudes toward smoking and their perceptions on the consequences of tobacco use in their health. Our results indicate that Greek adolescents begin to smoke mainly due to curiosity and for stress reasons. Furthermore, having friends who smoke is highly associated with smoking and intention for smoking. Likewise, paternal smoking seems to reinforce students' intention for smoking. On the contrary, parental disapproval of smoking leads to anti-smoking behavior. Adolescents' attitudes toward smoking are also related to a series of similar factors such as parental educational status, parental smoking, and parental disapproval of smoking, friends who smoke, and, finally, adolescents' age, smoking behavior, and intention for smoking. The impact of tobacco use in human health seems to be understood better by older students. All these factors must be taken into account for a successful implementation of an anti-smoking intervention program.     

The importance of peer effects, cigarette prices and tobacco control policies for youth smoking behavior

This paper expands the youth cigarette demand literature by undertaking an examination of the determinants of smoking among high school students incorporating the importance of peer effects and allowing cigarette prices (taxes) and tobacco control policies to have a direct effect and an indirect effect (via the peer effect) on smoking behavior. To control for the potential endogeneity of our school-based peer measure we implement a two-stage generalized least squares estimator for a dichotomous dependent variable and implement a series of diagnostic tests. The key finding is that peer effects play a significant role in youth smoking decisions: moving a high-school student from a school where no children smoke to a school where one quarter of the youths smoke is found to increase the probability that the youth smokes by about 14.5 percentage points. The results suggest that there is a potential for social multiplier effects with respect to any exogenous change in cigarette taxes or tobacco control policies.     

Attitudes toward anti-tobacco policy among California youth: associations with smoking status, psychosocial variables and advocacy actions

To prevent smoking and exposure to environmental tobacco smoke, California has implemented anti-tobacco policies, including laws restricting youth access to tobacco, and smoking bans in workplaces, schools, restaurants and bars. Although studies have examined adults' attitudes toward anti-tobacco policies, little is known about adolescents' awareness of and support for these policies. This study examined attitudes toward anti-tobacco policies in a sample of 6887 10th grade California adolescents. Awareness of anti-tobacco policies was highest among current smokers and lowest among susceptible never-smokers. Support for anti-tobacco policies was highest among non-susceptible never-smokers and lowest among current smokers. Policy awareness and support were significantly associated with psychosocial tobacco-related variables (e.g. perceived consequences of smoking, friends' smoking, perceived access to cigarettes, prevalence estimates of smoking among peers, cigarette offers and cigarette refusal self-efficacy). Policy awareness and support were associated with the probability of performing advocacy actions against tobacco use. Although these results cannot prove a causal association, they suggest that adolescents' attitudes toward anti-tobacco policies may play a role in their decisions about smoking. Tobacco control and education programs should include information about existing anti-tobacco policies, and should educate youth about the importance and benefits of anti-tobacco policies.     

The relationship between school-based smoking policies and prevention programs on smoking behavior among grade 12 students in Prince Edward Island: a multilevel analysis

PURPOSE: To examine how school-based smoking policies and prevention programs are associated with occasional and regular smoking among a cohort of grade 12 students in Prince Edward Island, Canada, between 1999 and 2001. METHODS: Data from the Tobacco Module of the School Health Action, Planning and Evaluation System (SHAPES) collected from 3,965 grade 12 students in 10 high schools were examined using multi-level regression analysis. RESULTS: Attending a school with smoking prevention programming was associated with a decreased risk of being an occasional smoker (OR 0.42, 95% CI: 0.18, 0.97). School-based policies banning smoking on school property were associated with a small increased risk of occasional smoking (OR 1.06, 95% CI: 0.67, 1.68) among some students. The combination of both policies and programs was not associated with either occasional or regular smoking. CONCLUSION: This preliminary evidence suggests that tailored school-based prevention programming may be effective at reducing smoking uptake; however, school smoking policies and the combination of programs and policies were relatively ineffective. These findings suggest that a new approach to school-based tobacco use prevention may be required.     

北京市2010年中学生烟草使用流行现状分析

目的 了解2010年北京市中学生烟草使用相关行为和二手烟暴露现状以及对烟草的认知和态度,为积极开展学校控烟工作提供参考.方法 采用分层整群抽样的方法,于2010年4-5月对北京市共计33所学校中11242名学生进行匿名自填式问卷调查,共回收有效问卷11208份.结果 中学生尝试吸烟率为24.70％,现在吸烟率为9.11％,吸烟率为5.06％;不吸烟中学生的二手烟暴露率为38.47％.男生、住宿生的烟草使用率均显著高于女生和非住宿生;郊区、非重点校、职业中学的烟草使用率分别高于城区、重点校和普通中学,差异均有统计学意义(P值均＜0.01).现在吸烟率和吸烟率较2008年均略有下降,二手烟暴露率有了明显下降.结论 中学生尝试吸烟率居高不下,对于烟草危害及有关态度的认识有待于进一步提高.建议继续加强对中学生开展健康教育,引导和教育中学生坚决“拒吸第一支烟”.     

The power of policy: the relationship of smoking policy to adolescent smoking.

This study examined the effects of smoking policy on 4,807 adolescents in 23 schools over a two-county area in California. Amounts and prevalence rates of adolescent smoking were measured with a self-report survey and a biochemical measure; school smoking policy was measured with two independent surveys of school staff. Policy effects were evaluated with multiple and logistic regression analyses controlling for school-level socioeconomic status and environmental support for teaching and administration. Of the 23 schools, 100 percent had a formal written and regularly enforced policy component restricting student smoking on school grounds, 94 percent restricted students leaving school grounds, 65 percent restricted smoking near school grounds, and 57 percent had a smoking prevention education plan. Schools with policies having all four versus less than four components, high versus low emphasis on prevention, and a low versus high emphasis on cessation reported lower amounts of smoking in the last week and in the last 24 hours. Punitive consequences of policy violation had no effect. Results were compared to school staff observations of adolescent smoking, and school archival records of student smoking violations in the last year. Results suggest that school smoking policy is associated with decreased amounts of smoking in adolescents.     

College campus smoking policies and programs and students' smoking behaviors

Background  

Although tobacco use in the United States has declined over the past 20 years, cigarette use among college students remains high. Additional research is thus needed to determine how university tobacco control policies and preventive education programs affect college students' smoking behaviors.     

Factors associated with Taiwanese junior high school personnel advising students to quit smoking

BACKGROUND: Most smokers in developing countries begin smoking before age 18, and smoking prevalence is rising among adolescents. School personnel represent a target group for tobacco‐control efforts because they interact daily with students, are role models for students, teach about tobacco‐use prevention in school curricula, and implement school tobacco‐control policies. The prevalence of teenage smoking has been examined in numerous studies, but few have focused on the influence of school personnel and the characteristics of school personnel who enforce school nonsmoking policy. The purpose of this study was to determine the factors associated with junior high school personnel advising students to quit smoking. METHODS: School personnel (N = 7129) were recruited by cluster sampling from 60 junior high schools in Taiwan; of these, 5280 voluntarily returned self‐administered, anonymous questionnaires (response rate = 74.06%) in 2004. RESULTS: Most personnel (70%) had advised students to quit smoking. School personnel who were older, male, responsible for teaching health, smokers, with positive attitude against tobacco, or with more knowledge of tobacco hazards were more likely to advise students to quit smoking. Personnel with more interest in and access to tobacco‐related materials were more likely to advise students to quit smoking. Personnel who had received tobacco‐prevention training were 2.41 times more likely to persuade students to quit smoking after adjusting for other factors. However, only half of the participants had ever had access to educational materials about tobacco use, and 8% had ever received training to prevent tobacco use. CONCLUSIONS: To reduce youth smoking prevalence, school tobacco‐control programs should support tobacco‐prevention training for school personnel.