School of Health sciences, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
Faculty of Education, University of the Ryukyus, 1 Senbaru, Nishihara, Okinawa, 903-0213, Japan.
Environ Health Prev Med. 2021 Feb 17;26(1):24. doi: 10.1186/s12199-021-00948-y.
Smoking among Japanese adolescents has decreased noticeably. However, little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016.
We conducted a repeated cross-sectional study using data from three surveys of high school students in Okinawa, Japan, in 2008, 2012, and 2016. The study participants consisted of 7902 students in grades 10 through 12 (15-18 years). Smoking was assessed as current cigarette use. SES indicators included familial SES (parental education and family structure) and student's own SES (school type). To evaluate absolute and relative inequalities, prevalence differences (PDs) and ratios (PRs) between low and high SES groups were estimated. The slope index of inequality (SII) and relative index of inequality (RII) were also calculated.
Smoking prevalence among boys and girls significantly declined from 11.5% and 6.2% in 2008 to 4.7% and 1.9% in 2016, respectively. Similar decreasing trends in smoking were found among most of the SES groups. The PDs and SII for parental education in boys and family structure in girls decreased over time while those for school type persisted among boys and girls. The PRs and RII for school type in boys increased while those for other SES indicators among both sexes remained stable over time.
Smoking among Japanese adolescents has been declining and time trends of socioeconomic inequalities in smoking varied by absolute and relative measures. Further policies and/or interventions to reduce smoking inequalities should focus on the context of schools, especially in vocational high schools.
日本青少年的吸烟率明显下降。然而，目前尚不清楚青少年吸烟率的下降趋势是否可以在所有社会经济地位（SES）群体中看到。本研究旨在检验日本青少年 SES 不平等与吸烟之间的趋势，时间范围为 2008 年至 2016 年。
我们使用日本冲绳地区三次高中生调查的数据（2008 年、2012 年和 2016 年）进行了一项重复的横断面研究。研究参与者包括 7902 名 10 至 12 年级（15-18 岁）的学生。吸烟状况评估为当前吸烟。SES 指标包括家庭 SES（父母教育程度和家庭结构）和学生自身 SES（学校类型）。为了评估绝对和相对不平等，估计了低 SES 群体和高 SES 群体之间的流行率差异（PD）和比率（PR）。同时还计算了不平等斜率指数（SII）和相对不平等指数（RII）。
男孩和女孩的吸烟率分别从 2008 年的 11.5%和 6.2%显著下降到 2016 年的 4.7%和 1.9%。大多数 SES 群体也呈现出类似的下降趋势。男孩中父母教育程度的 PD 和 SII 以及女孩中家庭结构的 PD 和 SII 随时间下降，而男孩和女孩的学校类型的 PD 和 SII 则持续存在。男孩的 PR 和 RII 随着时间的推移而增加，而男孩和女孩的其他 SES 指标的 PR 和 RII 则保持稳定。
日本青少年的吸烟率一直在下降，SES 与吸烟之间的不平等随时间的变化趋势因绝对和相对衡量标准而异。为了减少吸烟不平等，需要进一步制定政策和/或干预措施，重点关注学校环境，特别是职业高中。
