Smoking and pupil attitudes towards school: the implications for health education with young people. Results from the WHO Study of Health Behaviour among Schoolchildren.

It has been previously established that young people who have negative attitudes towards school and education are more likely to experiment with cigarette smoking and to become regular smokers. This paper explores this relationship across 10 countries (Austria, Belgium, Finland, Hungary, Israel, Norway, Scotland, Sweden, Switzerland and Wales) using data available from a unique cross-national study of children's health behaviour. The findings show that there is a strong association between regular smoking and alienation from school, which is consistent for both boys and girls in the different cultures and social organizations represented by participating countries. The implications of these findings for designing and managing health education programmes are considered. The importance of providing a supportive school environment and of identifying ways to improve the relevance of school to pupils is emphasized.