Access point analysis in smoking and nonsmoking adolescents: findings from the European Smoking Prevention Framework Approach study.

This study analyzed possibilities to access European adolescents for tobacco control activities in out-of-school settings as part of comprehensive tobacco control programs. Data on leisure time behaviors of secondary school students were gathered during three waves from six European Union countries as part of the European Smoking Prevention Framework Approach study. The results revealed that streets, shops, sport clubs, swimming pools and snack bars were the most popular leisure time settings for adolescents across the six countries. In addition, leisure time activities were similar across the six countries. European-wide prevention programmes can reach adolescents in similar out-of-school settings. Furthermore, smokers and nonsmokers differed in the places that they visited. Whereas smokers preferred social places such as bars, house/rave parties, discos, snack bars, streets and shops, nonsmokers preferred sport clubs and libraries. Smokers tended to visit more unsupervised and less structured places where smoking tends to be permitted, whereas nonsmokers tended to visit places with more structured activities and places under adult supervision. Over time, both smoking and nonsmoking adolescents tended to spend more of their leisure time in settings with low adult supervision. As structured activities under the supervision of adults can have a protective effect against the involvement in risky behaviours, participation in these types of activities must be promoted. Additional strategies for settings with less supervision need to be developed as they attract more smoking adolescents and older nonsmoking adolescents.