de Looze Margaretha, ter Bogt Tom, Hublet Anne, Kuntsche Emmanuel, Richter Matthias, Zsiros Emese, Godeau Emmanuelle, Vollebergh Wilma
1 Faculty of Social and Behavioural Sciences, Utrecht University, The Netherlands.
Eur J Public Health. 2013 Oct;23(5):846-52. doi: 10.1093/eurpub/ckt022. Epub 2013 Mar 13.
Across Europe, tobacco use is more prevalent among secondary school students attending vocational tracks compared with students attending academic tracks. The purpose of the present study is to describe trends in social inequality in daily smoking among adolescents between 2002 and 2010 by addressing both absolute social inequality (prevalence difference between vocational and academic tracks) and relative social inequality (prevalence ratio) in seven European countries.
Analyses were based on data from 15-year-olds who participated in the Health Behaviour in School-aged Children study in 2002, 2006 and 2010 in Belgium, Croatia, France, Germany, Hungary, Italy and The Netherlands (total N = 32 867).
Overall, daily smoking decreased between 2002 and 2010 in Belgium, France, Germany and The Netherlands, increased in Croatia and remained stable in Hungary and Italy. Considerable differences in daily smoking according to educational track existed in all countries. Absolute educational inequalities increased dramatically in Croatia and Italy, while relative inequalities showed a tendency to increase in all countries (significant in Belgium and The Netherlands).
Conclusions on social inequality in adolescent smoking may appear differently when described by absolute and relative measures. Especially the large increase in absolute educational inequalities in daily smoking in Croatia and Italy are worrisome and warrant attention from the public health domain. The findings underline the need for appropriate smoking policies and interventions in vocational schools across Europe.
在欧洲，与接受学术教育的中学生相比，接受职业教育的中学生吸烟更为普遍。本研究的目的是通过分析七个欧洲国家青少年日常吸烟的绝对社会不平等（职业教育和学术教育之间的患病率差异）和相对社会不平等（患病率比），来描述2002年至2010年间青少年日常吸烟社会不平等的趋势。
分析基于2002年、2006年和2010年在比利时、克罗地亚、法国、德国、匈牙利、意大利和荷兰参加学龄儿童健康行为研究的15岁青少年的数据（总样本量N = 32867）。
总体而言，2002年至2010年间，比利时、法国、德国和荷兰的日常吸烟率下降，克罗地亚上升，匈牙利和意大利保持稳定。所有国家按教育路径划分的日常吸烟情况存在显著差异。克罗地亚和意大利的绝对教育不平等大幅增加，而所有国家的相对不平等都有增加的趋势（比利时和荷兰显著）。
用绝对和相对指标描述青少年吸烟的社会不平等时，结论可能不同。特别是克罗地亚和意大利日常吸烟的绝对教育不平等大幅增加令人担忧，值得公共卫生领域关注。研究结果强调了欧洲职业学校制定适当吸烟政策和干预措施的必要性。
