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A Study of Smoking Disparity and Factors Associated With Children Smoking Behavior in the Mountain and City Schools in Taiwan |
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| Authors: | Hsiao-Ling Huang DrPH Ted Chen PhD Fu-Li Chen PhD Jeanette Magnus MD PhD Janet Rice PhD Yea-Yin Yen PhD Chih-Cheng Hsu MD DrPH |
| Affiliation: | Assistant Professor, (), Department of Oral Hygiene, Kaohsiung Medical University, 100, Shi-Chuan 1st Rd, Kaohsiung City, Taiwan 807, Taiwan.; Professor, (), Department of Community Health Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, Suite 2300, New Orleans, LA 70112.; Associate Professor, (), Department of Public Health, Fu-Jen Catholic University, 510 Chung Cheng Rd, Hsinchuang, Taipei County, Taiwan 24205, Taiwan.; Cecile Usdin Professor in Women's Health, Professor of Public Health &Medicine, and Head MCH Section, (), Department of Community Health Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, TW-19, New Orleans, LA 70112.; Associate Professor, (), Department of Biostatistics, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, Rm 20223, New Orleans, LA 70112.; Associate Professor, (), Department of Oral Hygiene, Kaohsiung Medical University, 100, Shi-Chuan 1st Rd, Kaohsiung City, Taiwan 807, Taiwan.; Associate Investigator, (), Center for Health Policy Research and Development, National Health Research Institutes, 35 Kenyan Rd, Zhunan Town, Miaoli County, Taiwan 350, Taiwan. |
| Abstract: | BACKGROUND: While higher smoking prevalences have been better described for adults and adolescents in the mountainous areas than in the plain area in Taiwan, no studies have previously examined whether this disparity begins with children in elementary schools. The purpose of this study was thus designed to explore clustering in smoking behavior among elementary school children attending mountain schools compared to those attending city schools. METHODS: This study analyzed data obtained by a survey on smoking behavior collected during the School Smoking Survey Project performed in 13 elementary schools of Taoyuan County, Taiwan. Overall, 1585 third and fourth graders (mean age 8.9 years) participated in the study. A multilevel logistic regression analysis was performed to explore the effects of school location on individual smoking behavior among elementary school children while controlling for individual-level characteristics. RESULTS: Overall, 34.9% of the elementary school students in the mountain schools reported having tried cigarette smoking compared to only 9.6% of students from city schools. Students attending mountain schools had a greater likelihood of reporting smoking than students attending city schools after controlling for individual-level characteristics (OR = 2.57, 95% CI = 1.10-5.99). CONCLUSIONS: A significant individual clustering in smoking behavior was found among third- and fourth-grade children attending mountain schools. The new findings suggest that the adult geographic smoking disparity begins in elementary school. Interventions aimed at reducing smoking disparity in adults need to target elementary schools in high-risk locations. |
| Keywords: | smoking children behavior clustering disparity Taiwan |