Finkelstein Daniel M, Kubzansky Laura D, Goodman Elizabeth
Mathematica Policy Research, Inc., Cambridge, Massachusetts, USA.
J Adolesc Health. 2006 Nov;39(5):678-85. doi: 10.1016/j.jadohealth.2006.04.011. Epub 2006 Jul 10.
Adolescent smoking is associated with increased perceived stress and lower social status, but past research has not explored links between lower social status, stress, and smoking risk. This study examined whether the relation between social status and perceived stress could explain the association between lower social status and increased risk of smoking.
Data were collected from 1021 non-Hispanic black and white adolescents participating in a longitudinal school-based study. Students completed a questionnaire and parents provided information on their highest level of education. Hierarchical logistic regression estimated the effects of parental education, subjective social status (SSS), and stress on smoking risk.
At baseline, students from families without a college-educated parent were at greater risk of current smoking (odds ratio [OR] some college = 1.98, 95% confidence interval [CI] = 1.06-3.67, and OR high school degree or less = 3.34, 95% CI = 1.67-6.60). Higher school SSS decreased risk of current smoking (OR = .73, 95% CI = .62-.87), and higher stress increased smoking risk (OR = 1.05, 95% CI = 1.01-1.08). There was no evidence that the effects of parental education were mediated through stress. At one-year follow-up, both lower school SSS and higher baseline stress were significantly associated with smoking initiation in preliminary models, but only baseline stress (OR = 1.06, 95% CI = 1.02-1.11) predicted smoking initiation in multivariable models.
These findings indicate that higher stress and lower social status increase risk of smoking, but that stress does not explain the association between lower social status and smoking. Therefore, stress reduction interventions may not alleviate social inequalities in teen smoking, but they do hold promise for youth smoking prevention.
青少年吸烟与感知压力增加和社会地位较低有关，但过去的研究尚未探讨社会地位较低、压力与吸烟风险之间的联系。本研究检验了社会地位与感知压力之间的关系是否可以解释社会地位较低与吸烟风险增加之间的关联。
数据收集自1021名参与一项基于学校的纵向研究的非西班牙裔黑人和白人青少年。学生完成一份问卷，家长提供其最高教育水平的信息。分层逻辑回归估计了父母教育程度、主观社会地位（SSS）和压力对吸烟风险的影响。
在基线时，父母没有受过大学教育的家庭中的学生当前吸烟风险更高（比值比[OR]：上过一些大学=1.98，95%置信区间[CI]=1.06-3.67，OR：高中学历或更低=3.34，95%CI=1.67-6.60）。较高的学校SSS降低了当前吸烟风险（OR=0.73，95%CI=0.62-0.87），较高的压力增加了吸烟风险（OR=1.05，95%CI=1.01-1.08）。没有证据表明父母教育程度的影响是通过压力介导的。在一年随访时，在初步模型中，较低的学校SSS和较高的基线压力都与开始吸烟显著相关，但在多变量模型中只有基线压力（OR=1.06，95%CI=1.02-1.11）预测了开始吸烟。
这些发现表明，较高的压力和较低的社会地位会增加吸烟风险，但压力并不能解释社会地位较低与吸烟之间的关联。因此，减轻压力的干预措施可能无法缓解青少年吸烟方面的社会不平等，但它们在预防青少年吸烟方面确实有前景。
