Analysis of influential factors associated with the smoking behavior of aboriginal schoolchildren in remote Taiwanese mountainous areas

BACKGROUND: A disparity in smoking behavior exists between the general and minority populations residing in Taiwan's mountainous areas. This study analyzed individual and environmental factors associated with children's smoking behavior in these areas of Taiwan. METHODS: In this school‐based study, data on smoking behavior and related factors for mountain‐dwelling students were obtained from the 2008 and 2009 Control of School‐aged Children Smoking Study surveys. A representative sample (N = 1239) from 26 primary schools was included. The association among 3 groups (never‐, former‐, and current‐smokers) and the potential variables were simultaneously examined using unordered polytomous logistic regression analysis. RESULTS: Between 13% and 34% of ever‐smokers reported that their first smoking experience was in third grade. More than 70% were found to have bought cigarettes and 87% reported that the tobacco retailers had sold them cigarettes. The significant factors for current‐smokers were predisposing factors, ie, attitude toward smoking (adjusted odds ratio AOR] = 1.21); reinforcing factors, ie, family smoked in front of me (AOR = 2.44), friends smoked in front of me (AOR = 16.24), and school staff smoked in front of me (AOR = 2.98); and enabling factors, ie, cigarette availability and accessibility (AOR = 2.16 and 2.42, respectively). A student's perceived punishment for smoking at school had a positive significant effect on the risk of being former‐smokers (AOR = 1.57). CONCLUSION: The findings provide a basis for school and community to design and implement effective anti‐smoking programs for remote mountain‐based students to further reduce youth smoking.