Individual and social environment influences on smoking in children and adolescents

OBJECTIVES: A precise knowledge of the risk factors for childhood and adolescent smoking is crucial for the development of appropriate preventive measures. This study investigated current smoking prevalence and the social and regional correlates for smoking among minors (children and adolescents aged 12-17 years) in Germany. METHODS: Bivariate data analysis was performed on the basis of a representative national cross-sectional study performed in 2004, and multivariable logistic regression models were calculated separately for boys and girls. All correlates identified as significant in the bivariate model were used in the multivariable analysis. STUDY DESIGN: The database used in this research was from the study 'Drug Affinity of Young People in the Federal Republic of Germany 2004', with approximately 1298 children and adolescents aged 12-17 years. RESULTS: Twelve percent of male and 9% of female adolescents in Germany reported that they are habitual smokers, and 12% of male and 13% of female adolescents reported that they are occasional smokers. Multivariable data analysis shows that living in a large city is protective for adolescents in terms of local disparities. The educational level of the respondents also correlates significantly with smoking behaviour. The percentage of adolescent smokers is lowest among those with a high level of education. The presence of smokers in the household is associated with a significantly higher prevalence of smoking among adolescents compared with those growing up in a non-smoking household. CONCLUSION: Smoking is a major public health problem among German children and adolescents. Control measures must tackle the structural and social pressures that shape smoking behaviour during childhood.