Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Institute, Amsterdam, the Netherlands.
Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Institute, Amsterdam, the Netherlands.
Drug Alcohol Depend. 2019 Nov 1;204:107521. doi: 10.1016/j.drugalcdep.2019.06.023. Epub 2019 Aug 24.
Smoke-free school policies (SFSPs) may influence adolescents' smoking through the development of anti-smoking beliefs. We assessed which types of anti-smoking beliefs (health, social and societal) are associated with SFSPs and whether these associations were different for adolescents in smoking permissive versus prohibitive families.
Survey data was collected in 2016-2017 from 10,980 adolescents between 14-16 years old and 315 staff in 55 schools from seven European cities. We separately measured adolescent-perceived SFSP and staff-reported SFSP at the school-level. Associations between SFSP and anti-smoking health, social and societal beliefs were studied using multi-level logistic regression, adjusting for demographics and school-level smoking prevalence. We tested for interactions between family norms and SFSP, and estimated associations for adolescents in permissive and prohibitive families, respectively.
Adolescent-perceived SFSP was not significantly associated with anti-smoking health (OR:1.08, 95%CI:0.94-1.25), social (OR:0.89, 95%CI:0.75-1.04) and societal beliefs (OR:1.15, 95%CI:0.99-1.33). Staff-reported SFSP were associated with anti-smoking health beliefs (OR:1.12, 95%CI:1.01-1.24), but not with social (OR:0.94, 95%CI:0.83-1.07) or societal beliefs (OR:1.02, 95%CI:0.90-1.14). Most results were comparable between adolescents in smoking prohibitive and permissive families. However, in smoking prohibitive families, adolescent-perceived SFSP were associated with societal beliefs (OR:1.24, 95%CI:1.06-1.46), but not in permissive families (OR:1.06, 95%CI:0.90-1.25). Also, in smoking permissive families, staff-reported SFSP were associated with more pro-smoking social beliefs (OR:0.83, 95%CI:0.72-0.96), but not in prohibitive families (OR:1.05, 95%CI:0.92-1.16).
We found evidence that SFSP are associated with some anti-smoking beliefs, but more so among adolescents from smoking prohibitive families than from permissive families.
无烟学校政策（SFSP）可能通过培养反吸烟信念来影响青少年吸烟。我们评估了哪些类型的反吸烟信念（健康，社会和社会）与 SFSP 相关，以及这些关联在吸烟放任家庭和禁烟家庭的青少年中是否存在差异。
2016-2017 年，我们从七个欧洲城市的 55 所学校中，从 10980 名 14-16 岁的青少年和 315 名工作人员那里收集了调查数据。我们分别在学校层面测量了青少年感知到的 SFSP 和工作人员报告的 SFSP。使用多水平逻辑回归，调整人口统计学和学校吸烟率后，研究了 SFSP 与反吸烟健康，社会和社会信念之间的关联。我们测试了家庭规范与 SFSP 之间的相互作用，并分别估计了放任家庭和禁烟家庭中青少年的关联。
青少年感知到的 SFSP 与反吸烟健康信念（OR：1.08，95％CI：0.94-1.25），社会信念（OR：0.89，95％CI：0.75-1.04）和社会信念（OR：1.15，95％CI：0.99-1.33）没有显著关联。工作人员报告的 SFSP 与反吸烟健康信念有关（OR：1.12，95％CI：1.01-1.24），但与社会信念无关（OR：0.94，95％CI：0.83-1.07）或社会信念（OR：1.02，95％CI：0.90-1.14）。在吸烟禁止家庭和放任家庭中，大多数结果都是可比的。但是，在禁止吸烟的家庭中，青少年感知到的 SFSP 与社会信念有关（OR：1.24，95％CI：1.06-1.46），但在放任家庭中却没有（OR：1.06，95％CI：0.90-1.25）。另外，在吸烟放任家庭中，工作人员报告的 SFSP 与更赞成吸烟的社会信念有关（OR：0.83，95％CI：0.72-0.96），但在禁止吸烟的家庭中则没有（OR：1.05，95％CI：0.92-1.16）。
我们有证据表明 SFSP 与某些反吸烟信念有关，但在来自禁烟家庭的青少年中比来自放任家庭的青少年更为明显。
