School-Based Tobacco Control and Smoking in Adolescents: Evidence from Multilevel Analyses

Seong Yeon Kim, Myungwha Jang, Seunghyun Yoo, Jung JeKarl, Joo Youn Chung and Sung-il Cho
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Seong Yeon Kim: Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
Myungwha Jang: Institute of Health and Environment, Seoul National University, Seoul 08826, Korea
Seunghyun Yoo: Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
Jung JeKarl: Department of Health Convergence, College of Science and Industry Convergence, Ewha Womans University, Seoul 03760, Korea
Joo Youn Chung: Korea Health Promotion Institute, Seoul 04554, Korea
Sung-il Cho: Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea

IJERPH, 2020, vol. 17, issue 10, 1-13

Abstract: Since 2015, universal comprehensive school-based tobacco control programs have been provided in all primary and secondary schools in Korea. This study explored the association of school-level tobacco control with adolescent smoking, and the interactions to investigate whether gender moderates the impact of school tobacco control programs and school-level norms. Both school- and individual-level data were drawn from the 2015 School-Based Tobacco Prevention Program Survey. Multilevel logistic regression analyses were performed using data from 4631 students (ages 10–18 years) who were nested in 62 secondary schools in Seoul, Korea. Students who participated in more prevention programs were less likely to smoke (OR = 0.47, 95% CI 0.30–0.74). The effect of the programs was significantly moderated by gender. For boys, exposure to a greater number of programs decreased the risk of smoking (OR = 0.32, 95% CI 0.18–0.57) but not for girls. At the school level, the school norm regarding tobacco control regulations was negatively associated with smoking (OR = 0.28, 95% CI 0.11–0.76), and its effect was significant for girls only (OR = 0.35, 95% CI 0.17–0.76). This study highlights how the school environment is associated with adolescent smoking behavior, and the effects of programs and norms are different by gender. The findings suggest the need to develop strategies to enhance school-based tobacco control programs and the school norm considering gender differences.

Keywords: adolescent; smoking; school-based tobacco control; social norm (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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