Université Paris-Saclay, Faculté de médecine UVSQ, Université Paris-Sud, Villejuif, France.
Institut national de la statistique et des études économiques, Montrouge, France.
Addiction. 2023 Jan;118(1):149-159. doi: 10.1111/add.16026. Epub 2022 Aug 26.
Among European countries, France is particularly concerned by adolescent tobacco smoking, especially in disadvantaged socio-economic backgrounds (SES). We measured the respective contributions of parental smoking and family living arrangement to social disparities in smoking during adolescence.
Secondary analysis of survey data.
A cross-sectional nation-wide exhaustive 12-day survey in March 2017 of French youth aged 17-18.5 years participating in the national mandatory civic information day.
A total of 13 314 adolescents answering a pen-and-paper questionnaire about their own tobacco consumption and the smoking of their parents.
Risk ratios (RRs) were computed using modified Poisson regressions, and population-attributable fraction (PAF) was used as a measure of the explanatory roles of the different factors as mediators of SES.
Adolescents living within very privileged and privileged SES were significantly less likely to report daily tobacco smoking (20.4 and 22.7%, respectively) than those within modest and disadvantaged ones (26.0 and 28.6%, respectively). Parental smoking and family living arrangement independently explained the smoking inequalities among adolescents. After adjusting for schooling factors, the risks associated with parental smoking ranged between RR = 1.64 [95% confidence interval (CI) = 1.50-1.79] when the father only smoked and RR = 2.17 (95% CI = 1.99-2.36) when both parents smoked, compared with non-smoking parents; the risk associated with living in a non-intact family was 1.35 (95% CI = 1.26-1.43) and that of living outside the parental home was 1.20 (95% CI = 1.10-1.30). Apprentices and adolescents out of school had higher risks than those at school (RR = 1.82, 95% CI = 1.68-1.98) and RR = 2.10, 95% CI = 1.92-2.29). The contribution of parental smoking to adolescent smoking (PAF = 32%) was greater than that of SES (PAF = 9%), family living arrangement (PAF = 17%) or schooling factors (14%). The share of SES decreased from 18 to 9% when considering these mediating factors.
In France, parental smoking appears to be the factor that most influences adolescent smoking, followed by family living arrangement; the role of family socio-economic status is small in comparison.
在欧洲国家中，法国特别关注青少年吸烟问题，尤其是社会经济地位（SES）较低的青少年。我们测量了父母吸烟和家庭生活安排对青少年吸烟的社会差异的相对贡献。
对调查数据的二次分析。
2017 年 3 月，在法国全国强制性公民信息日期间，对 17-18.5 岁的法国青少年进行了一项全国性的、全面的、为期 12 天的横断面调查。
共有 13314 名青少年回答了一份关于自己吸烟和父母吸烟情况的纸笔问卷。
使用修正泊松回归计算风险比（RR），并使用人群归因分数（PAF）作为不同因素作为 SES 中介的解释作用的衡量标准。
处于非常优越和优越 SES 的青少年报告每天吸烟的可能性明显低于处于适度和不利 SES 的青少年（分别为 20.4%和 22.7%）。父母吸烟和家庭生活安排独立解释了青少年吸烟的不平等现象。在校因素调整后，与不吸烟的父母相比，仅父亲吸烟的 RR=1.64（95%可信区间（CI）=1.50-1.79），父母双方都吸烟的 RR=2.17（95%CI=1.99-2.36）；与生活在完整家庭的青少年相比，生活在不完整家庭的青少年的风险为 1.35（95%CI=1.26-1.43），生活在父母家以外的青少年的风险为 1.20（95%CI=1.10-1.30）。学徒和辍学者的风险高于在校学生（RR=1.82，95%CI=1.68-1.98）和 RR=2.10，95%CI=1.92-2.29）。父母吸烟对青少年吸烟的影响（PAF=32%）大于 SES（PAF=9%）、家庭生活安排（PAF=17%）或学校教育因素（14%）。当考虑到这些中介因素时，SES 的份额从 18%下降到 9%。
在法国，父母吸烟似乎是影响青少年吸烟的最重要因素，其次是家庭生活安排；相比之下，家庭社会经济地位的作用较小。
