Vesa Saaristo NHPRC2013

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School systematic tobacco use documenting, pupils’ smoking and perceptions of school smoking policy

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Vesa Saaristo NHPRC2013

  1. 1. School systematic tobacco use documenting, pupils’ smoking and perceptions of school smoking policy Vesa Saaristo, Jenni Kulmala, Susanna Raisamo, Arja Rimpelä, Timo Ståhl The 7th Nordic Health Promotion Research Conference Vestfold University College, Horten, Norway 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 1
  2. 2. Objective • Studies report contradictory results of the effectiveness of school smoking policies in adolescent smoking prevention. • We studied whether the enforcement of a tobacco use documenting policy at school is associated with – pupils’ perceptions of school smoking policy and – their smoking behaviour 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 2
  3. 3. Datasets • Two nationally representative cross-sectional datasets – TEAviisari (http://www.thl.fi/teaviisari) • a national database on health promotion capacity building • data collected from Finnish comprehensive school administrations in autumn 2009 – School Health Promotion Study • school based pupil survey for 14-15 year olds • collected in spring 2009 and spring 2010 covering the whole country • pupils reported their perceptions of school’s smoking policy and their smoking behaviour during the school day – For this study we restricted the data to schools where smoking had been detected (n=496; 74,143 pupils) 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 3
  4. 4. Method • Mixed effects logistic regression – R function glmer (package lme4, Bates et al. 2012) – Binary outcome variables – Logit link function – Ordinal school-level predictor • Documenting policy for smoking – Dichotomous pupil-level predictors • Smoking status (Daily/No) • Gender (Boy/Girl) • Grade (8th/9th) • Parents’ education – Random intercept for each school 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 4
  5. 5. Results • The prevalence of daily smoking was 15 %. 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 5 Never smoked/ Only one cigarette % Quit % Less than weekly % Weekly % Daily % Total % N Boys 8th 61 15 7 4 14 100 18,660 9th 52 15 8 5 20 100 18,703 Girls 8th 64 13 8 4 10 100 18,912 9th 53 14 12 6 16 100 18,784 TOTAL 57 14 9 5 15 100 75,059
  6. 6. Results 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 6 Never smoked/ Only one cigarette % Quit % Less than weekly % Weekly % Daily % Total % N Don’t know (3) 70 11 9 5 6 100 112 Smoking did not exist (32) 60 15 11 5 10 100 804 Existed, detected cases were not documented (54) 58 14 8 4 15 100 7,219 Existed and detected cases were documented (417) 57 14 9 5 15 100 62,553 Existed, detected cases were documented and school-specific summaries were conducted (25) 58 14 9 5 14 100 4,371 TOTAL 57 14 9 5 15 100 75,059
  7. 7. Results 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 7 Never smoked/ Only one cigarette % Quit % Less than weekly % Weekly % Daily % Total % N Don’t know 70 11 9 5 6 100 112 Smoking did not exist 60 15 11 5 10 100 804 Existed, detected cases were not documented (54) 58 14 8 4 15 100 7,219 Existed and detected cases were documented (417) 57 14 9 5 15 100 62,553 Existed, detected cases were documented and school-specific summaries were conducted (25) 58 14 9 5 14 100 4,371 TOTAL 57 14 9 5 15 100 75,059 p=0.17
  8. 8. ”Smoking restrictions are monitored at school” 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 8 0.10 1.00 10.00 Neither At least one parent (ref.) PARENT HAS A HIGHER EDUCATION DEGREE 9th 8th (ref.) GRADE Girl Boy (ref.) GENDER Yes No (ref.) PUPIL SMOKES DAILY Documented and summarised Documented No (ref.) SMOKING DOCUMENTED BY SCHOOL ODDS RATIO OR 1,88 OR 1,67 72 % 81 % 84 %
  9. 9. “Smoking is totally prohibited at school” 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 9 0.10 1.00 10.00 Neither At least one parent (ref.) PARENT HAS A HIGHER EDUCATION DEGREE 9th 8th (ref.) GRADE Girl Boy (ref.) GENDER Yes No (ref.) PUPIL SMOKES DAILY Documented and summarised Documented No (ref.) SMOKING DOCUMENTED BY SCHOOL OR 2,43 OR 2,35 ODDS RATIO 83 % 92 % 92 %
  10. 10. 0.1 1 10 Neither At least one parent (ref.) PARENT HAS A HIGHER EDUCATION DEGREE 9th 8th (ref.) GRADE Girl Boy (ref.) GENDER Yes No (ref.) PUPIL SMOKES DAILY Documented and summarised Documented No (ref.) SMOKING DOCUMENTED BY SCHOOL OR 1,82 A pupil who smokes at least weekly (n=14,523) never smokes at the vicinity of the school 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 10 ODDS RATIO 19 % 28 % 26 %
  11. 11. 0.1 1 10 Neither At least one parent (ref.) PARENT HAS A HIGHER EDUCATION DEGREE 9th 8th (ref.) GRADE Girl Boy (ref.) GENDER Yes No (ref.) PUPIL SMOKES DAILY Documented and summarised Documented No (ref.) SMOKING DOCUMENTED BY SCHOOL A pupil who smokes at least weekly (n=14,523) never smokes at school, in school area 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 11 ODDS RATIO 39 % 40 % 44 %
  12. 12. 0.1 1 10 Neither At least one parent (ref.) PARENT HAS A HIGHER EDUCATION DEGREE 9th 8th (ref.) GRADE Girl Boy (ref.) GENDER Yes No (ref.) PUPIL SMOKES DAILY Documented and summarised Documented No (ref.) SMOKING DOCUMENTED BY SCHOOL A pupil who smokes at least weekly (n=14,523) never smokes on the way to/from school 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 12 ODDS RATIO 17 % 16 % 17 %
  13. 13. Conclusions • Documenting detected tobacco use during the school day was associated with – pupils’ perceptions of school’s smoking policy – their smoking at the vicinity of the school • but not their – smoking on school premises – smoking on the way to or from school – overall smoking status • A simple and fairly inexpensive documenting policy could be an effective tool for reducing pupils’ smoking during the school day. 17.6.2013 Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 13

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