Journal Title
Title of Journal: J Youth Adolescence
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Abbravation: Journal of Youth and Adolescence
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Authors: Catherine M Sabiston Chris Y Lovato Rashid Ahmed Allison W Pullman Valerie Hadd H Sharon Campbell Candace Nykiforuk K Stephen Brown
Publish Date: 2009/06/07
Volume: 38, Issue: 10, Pages: 1374-1387
Abstract
The purpose of this study was to explore individual and schoollevel policy characteristics on student smoking behavior using an ecological perspective Participants were 24213 51 female Grade 10–11 students from 81 schools in five Canadian provinces Data were collected using student selfreport surveys written policies collected from schools interviews with school administrators and school property observations to assess multiple dimensions of the school tobacco policy The multilevel modeling results revealed that the school a student attended was associated with his/her smoking behavior Individuallevel variables that were associated with student smoking included lower school connectedness a greater number of family and friends who smoked higher perceptions of student smoking prevalence lower perceptions of student smoking frequency and stronger perceptions of the school tobacco context Schoollevel variables associated with student smoking included weaker policy intention indicating prohibition and assistance to overcome tobacco addiction weaker policy implementation involving strategies for enforcement and a higher number of students smoking on school property These findings suggest that the school environment is important to tobacco control strategies and that various policy dimensions have unique relationships to student smoking School tobacco policies should be part of a comprehensive approach to adolescent tobacco useTobacco use is currently the leading cause of preventable death worldwide World Health Organization 2006 and is widely acknowledged as a critical public health concern Typically smoking initiation occurs during adolescence a time when many youth experiment with addictive substances Tobacco use in adolescence is associated with a range of healthcompromising behaviors and increased risk factors for health problems in adulthood American Lung Association 2003 It is estimated that 90 of current smokers take up smoking before the age of 21 American Lung Association 2003 Despite a number of tobacco control strategies aimed at preventing adolescent smoking approximately 48 of Canadian youth experiment with tobacco products Health Canada 2008 In order to reduce the burden of disease caused by tobacco use efforts should be placed on understanding the complex environment in which adolescents’ smoking initiation and maintenance occursComparable to other developed countries Canadian legislation prohibits the sale of tobacco products to minors and these regulations are actively enforced In recent years many Canadian municipalities have restricted tobacco use in public spaces including workplaces restaurants parks and school grounds In addition to government legislation many schools have developed comprehensive tobacco control interventions that include cessation and prevention programs and policies that ban tobacco use on school property These comprehensive approaches have been guided by ecological frameworks in which the school context is a central dimension associated with student smoking Aveyard et al 2004 Flay et al 1999 Petraitis et al 1995 Specifically there is evidence that school tobacco policies Lovato et al 2007 Moore et al 2001 Schnohr et al 2008 Wakefield et al 2000 and social modeling characteristics such as the visibility of smoking and tobacco norms at school Leatherdale et al 2005a b Maes and Lievens 2003 Moore et al 2001 Poulin 2007 Wakefield et al 2000 are associated with adolescents’ tobacco use There is limited evidence of the combined associations among school tobacco policies the smoking social context and adolescent tobacco use Combined school approaches may help advance efforts aimed at reducing youths’ smoking ratesIn addition to individual factors a second level of influence is the school context The importance of the school context is highlighted by the fact that youth spend much of their time at school and may subsequently be exposed to factors that increase tobacco use in that setting Alexander et al 2001 Schools that have smokefree environments have lower smoking rates and less overall consumption of cigarettes than schools with minimal tobacco guidelines Pentz et al 1997 Wakefield et al 2000 Unfortunately findings of the relationship between school policies and adolescent smoking are mixed Some research indicates a weak to moderate relationship between policies and student smoking while other studies indicate no effects Denman et al 2008 Barnett et al 2007 Darling and Reeder 2003 Griesbach et al 2002 Murnaghan et al 2007 Northrup et al 1998 Poulin 2007 Reitsma and Manske 2004 Wakefield et al 2000 Further efforts are needed to better understand the ambiguity in the associations between tobacco policies and student smoking The current study focuses on assessing multiple dimensions of school tobacco policies see Fig 1 to identify unique efforts that may be most effective at lower smoking rates among youthTo date the literature is limited in terms of understanding specific policy approaches that are most effective at curbing tobacco use among youth In a review of school drug policies EvansWhipp et al 2004 found that school policies varied substantially in their approaches and targeted enforcement Specific to tobacco control more comprehensive and strongly enforced policies were associated with less smoking Part of the general ambiguity in understanding the relationship between school policies and youth smoking stems from the predominant focus on students’ perceptions of policy enforcement with little evaluation of actual school policies or policy characteristics Furthermore whereas comprehensive tobacco control policies may be most effective EvansWhipp et al 2004 there have been limited efforts directed at detailing and assessing the multiple characteristics of school tobacco policies Specifically interrelated processes in school tobacco policy development and execution must be considered to ensure effectiveness Trinidad et al 2005 Willemsen and De Zwart 1999 Previous studies have focused on global measures such as the absence or presence of a policy Policy intent ie what is intended based on developed written documents implementation ie what actions are taken according to administrators and enforcement ie what is the outcome following action should be viewed as separate yet highly dependent factors associated with adolescent smoking behavior Previous research has often failed to make any distinction between these policy elements This has led to inconsistencies in the way tobacco control policies are defined measured and evaluated thus making it difficult to synthesize results and provide best practice advice to decisionmakersGiven the multilevel nature of these data a preliminary aim of this study was to describe the smoking context in schools across Canada It was hypothesized that smoking rates and policy characteristics would vary across schools The main purpose of this study was to explore the relationships among individual factors ie family and friend smoking school connectedness perceptions of school tobacco context school policy characteristics intention implementation and enforcement and adolescent smoking behavior Based on empirical and theoretical evidence it was hypothesized that greater exposure to family and friends who smoke and lower school connectedness would be related to higher youth smoking levels Furthermore students reporting being at a school with more smokers seeing smoking occurring on school grounds and being unaware of tobacco rules and consequences would be more likely to smoke Finally it was hypothesized that lower levels of school policy intent implementation and enforcement would be associated with higher school smoking ratesAn original cohort of 130 secondary schools with students in grades 10 and 11 was established in five Canadian provinces—British Columbia BC Manitoba MB Ontario ON Quebec QC and Newfoundland NL—using a systematic probability sampling procedure These provinces were selected for pragmatic reasons since they had established infrastructure in place to conduct data collection had central survey research centers represented a reasonable geographical balance and spanned the range of 15–19 year old smoking rates 15–24 as reported at the time of the data collection Health Canada 2004 Eligible schools had students in both Grades 10 and 11 were located in municipalities with a population of at least 100001 and were not of private religious or chartered nature Eligible school districts within municipalities in BC MB and ON were grouped together based on their respective health region’s smoking rate School districts were grouped to ensure that all municipalities in the same group had the same health district and hence the same smoking rate In QC each eligible school district with a minimum of three eligible schools was considered a group In NL 13 schools were eligible to participate and thus all schools were approached to participate in the study without being grouped
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Other Papers In This Journal:
- Extracurricular Participation Among Adolescents from Immigrant Families
- Supportive Romantic Relationships as Predictors of Resilience Against Early Adolescent Maternal Negativity
- Pregnant and Parenting Adolescents: A Study of Ethnic Identity, Emotional and Behavioral Functioning, Child Characteristics, and Social Support
- Patterns of Problem Behavior in Relation to Thriving and Precocious Behavior in Late Adolescence
- Pubertal Timing and Substance Use in Middle Adolescence: A 2-Year Follow-up Study
- Bidirectional Associations Between Valued Activities and Adolescent Positive Adjustment in a Longitudinal Study: Positive Mood as a Mediator
- Moderating Effects of Aggression on the Associations Between Social Withdrawal Subtypes and Peer Difficulties During Early Adolescence
- Evaluation of Yoga for Preventing Adolescent Substance Use Risk Factors in a Middle School Setting: A Preliminary Group-Randomized Controlled Trial
- Youth Empowerment and High School Gay-Straight Alliances
- Self-Injurious Thoughts and Behaviors Among Youth in an Underserved Area of the Southern United States: Exploring the Moderating Roles of Gender, Racial/Ethnic Background, and School-Level
- Mother–Child Discrepancy in Perceived Family Functioning and Adolescent Developmental Outcomes in Families Experiencing Economic Disadvantage in Hong Kong
- The Effect of Corporal Punishment and Verbal Abuse on Delinquency: Mediating Mechanisms
- Emotion Regulation Difficulties, Youth–Adult Relationships, and Suicide Attempts Among High School Students in Underserved Communities
- Race and Perceived Pubertal Transition Effects on Girls’ Depressive Symptoms and Delinquent Behaviors
- Interrelations of Behavioral, Emotional, and Cognitive School Engagement in High School Students
- Jamel K. Donnor and Adrienne D. Dixson (Eds.): The Resegregation of Schools: Education and Race in the Twenty - First Century
- Associations of Parental and Peer Characteristics with Adolescents’ Social Dominance Orientation
- Predictors of Level of Voice in Adolescent Girls: Ethnicity, Attachment, and Gender Role Socialization
- Linking Community, Parenting, and Depressive Symptom Trajectories: Testing Resilience Models of Adolescent Agency Based on Race/Ethnicity and Gender
- Rural and Non-Rural African American Youth: Does Context Matter in the Etiology of Problem Behaviors?
- Perceived Social Support and Early Adolescents’ Achievement: The Mediational Roles of Motivational Beliefs and Emotions
- Psychosocial Correlates of Shape and Weight Concerns in Overweight Pre-Adolescents
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