School policies and smoking intention in a Swiss sample of adolescents.

The majority of today's adult smokers took up the habit during adolescence. The school community and the rules it imposes are important factors that can influence adolescents' smoking intention and behaviour. Research on the effect of school tobacco policies on adolescents' smoking concludes with mixed results. Our study aims to look at the influence of these policies on the intention to smoke and to know if this relation is mediated by individual and environmental factors. The study includes information on social norms, attitude towards smoking and smoking intention from 4515 students of 32 Ticino middle schools and on the tobacco policy implemented in this school. Linear regression indicates a marginal impact of school policy on intention to smoke. Schools that strongly enforce tobacco policy obtain an increase in their students' intention to smoke, while schools that implement assistance programmes to overcome tobacco use decrease intention to smoke. Mediation models show that the influence of some of tobacco policy dimensions on the intention to smoke is mediated by personal attitudes towards smoking, beliefs about health consequences of smoking and perceived peers smoking. Increasing visibility of tobacco policies and having tobacco prevention programmes have stronger positive effects on smoking intention than other policy dimensions, but only through the mediation of individual and environmental factors.