The association between smoke-free school policies and adolescents' anti-smoking beliefs: Moderation by family smoking norms.

Schreuders, Michael;Kuipers, Mirte Ag;Mlinarić, Martin;Grard, Adeline;Kunst, Anton E;et.al.
(2019) Drug and Alcohol Dependence — Vol. 204, n° n.a, p. 107521 (2019)

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Authors
  • Schreuders, Michael
    Author
  • Kuipers, Mirte Ag
    Author
  • Mlinarić, Martin
    Author
  • Grard, Adelineorcid-logoUCLouvain
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  • Author
  • Kunst, Anton E
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Abstract
Smoke-free school policies (SFSPs) may influence adolescents' smoking through the development of anti-smoking beliefs. We assessed which types of anti-smoking beliefs (health, social and societal) are associated with SFSPs and whether these associations were different for adolescents in smoking permissive versus prohibitive families. Survey data was collected in 2016-2017 from 10,980 adolescents between 14-16 years old and 315 staff in 55 schools from seven European cities. We separately measured adolescent-perceived SFSP and staff-reported SFSP at the school-level. Associations between SFSP and anti-smoking health, social and societal beliefs were studied using multi-level logistic regression, adjusting for demographics and school-level smoking prevalence. We tested for interactions between family norms and SFSP, and estimated associations for adolescents in permissive and prohibitive families, respectively. Adolescent-perceived SFSP was not significantly associated with anti-smoking health (OR:1.08, 95%CI:0.94-1.25), social (OR:0.89, 95%CI:0.75-1.04) and societal beliefs (OR:1.15, 95%CI:0.99-1.33). Staff-reported SFSP were associated with anti-smoking health beliefs (OR:1.12, 95%CI:1.01-1.24), but not with social (OR:0.94, 95%CI:0.83-1.07) or societal beliefs (OR:1.02, 95%CI:0.90-1.14). Most results were comparable between adolescents in smoking prohibitive and permissive families. However, in smoking prohibitive families, adolescent-perceived SFSP were associated with societal beliefs (OR:1.24, 95%CI:1.06-1.46), but not in permissive families (OR:1.06, 95%CI:0.90-1.25). Also, in smoking permissive families, staff-reported SFSP were associated with more pro-smoking social beliefs (OR:0.83, 95%CI:0.72-0.96), but not in prohibitive families (OR:1.05, 95%CI:0.92-1.16). We found evidence that SFSP are associated with some anti-smoking beliefs, but more so among adolescents from smoking prohibitive families than from permissive families.
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Schreuders, M., Kuipers, M. A., Mlinarić, M., Grard, A., Linnansaari, A., Rimpela, A., Richter, M., Perelman, J., Lorant, V., van den Putte, B., & Kunst, A. E. (2019). The association between smoke-free school policies and adolescents’ anti-smoking beliefs: Moderation by family smoking norms. Drug and Alcohol Dependence, 204(n.a), 107521. https://doi.org/10.1016/j.drugalcdep.2019.06.023 (Original work published 2019)